INDONESIA - AVIAN INFLUENZA (AI) AND THE PRESIDENT"S

UNCLAS JAKARTA 013194 SIPDIS SENSITIVE SIPDIS DEPT FOR EAP/MLS, EAP/IET, MED/DASHO/EMR AND MED DEPT FOR G/AIAG AND OES DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ICD/LAIDIG DEPT ALSO PASS TO USDA/FAS/FAA/DYOUNG AND USDA/APHIS/ANNELLI DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL DEPT ALSO PASS TO HHS/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH NSC FOR JMELINE E.O. 12958: N/A TAGS: TBIO AMED CASC EAGR AMGT PGOV ID KFLU SUBJECT: INDONESIA - AVIAN INFLUENZA (AI) AND THE PRESIDENT"S VISIT REF: A) Jakarta 13143 (NAMRU Negotiations) B) Jakarta 12828 (AI Update) C) Jakarta 12775 (GOI 2007 budget) D) Jakarta 11379 (GOI Social Spending) ¶1. (SBU) Summary. Although the Government of Indonesia has not yet finalized its FY 2007 allocations for AI control programs, senior GOI officials including Coordinating Minister Bakrie and Minister of Finance Sri Mulyani Indrawati have assured the Embassy that total AI spending will match or exceed 2006 levels. The Ambassador and Foreign Ministry Director General Eddi Hariyadhi opened negotiations on a new Memorandum of Understanding for the Naval Medical Research Unit (NAMRU-2) on November 9. At that meeting, Dr. Triono Soendoro, the Director of the Indonesian National Institutes of Health Research and Development advocated strongly on NAMRU-2's behalf. On November 8, an Embassy interagency team conducted a site visit to Bogor to see the Participatory Disease Surveillance (PDS) program in action and better understand the Participatory Disease Surveillance/Response program (PDS/PDR). With our AI agenda moving forward on all fronts, we continue to urge Washington to announce a bold deliverable of increased USG financial assistance on AI during the President's November 20 visit. End Summary. AI Budget Remains Unclear But Assurances Given -------------- - ¶2. (U) Despite our efforts to seek GOI clarification on AI program spending, the GOI has not yet finalized this information. Parliament passed a broad FY 2007 budget on October 17, but this document does not contain program-by-program spending breakdowns. The GOI will likely release more detailed program information o/a November 30. However, Finance Minister Sri Mulyani Indrawati, in a meeting with the Ambassador on October 30, reiterated that the GOI would increase its AI spending in 2007, not decrease it. This statement is similar to Coordinating Minister for People's Welfare Aburizal Bakrie's announcement to the press on September ¶15. ¶3. (SBU) On November 7, Executive Secretary for the National Committee for AI Control and Pandemic Prevention Bayu Krisnamurthi told us that he will not know final AI numbers until November 15 at the earliest. However, Bayu assured us that total AI spending would not be lower than 2006 levels. He further explained that last year, GOI treated AI spending similar to "disaster management" spending. However, this year, senior officials have recognized AI as a long term problem that must be budgeted and organized accordingly. Bayu noted therefore that analysts' efforts to compare AI spending relative to last year may not result in a simple apples-to-apples comparison. Pots of money may be different. NAMRU Negotiations Underway -------------- ¶4. (SBU) Ambassador Pascoe and Deplu Director General [xxxxx] opened negotiations on a new NAMRU-2 MOU on November 9. The negotiations lasted for several hours. During the negotiation session, Dr. Triono Soendoro, the Director of the Indonesian National Institutes of Health Research and Development strongly advocated on NAMRU-2's behalf. Both sides agreed to stress the importance of NAMRU-2 in the visit communiqu and resume discussions after the President's visit. PDS/PDR Program Observations -------------- ¶5. (U) On November 8, representatives from NAMRU-2, APHIS, FAS, USAID and the Economics Section visited Bogor for a field site visit to better understand the Food and Agricultural Organization (FAO) PDS/PDR program. Two veterinarians, including one poultry specialist from APHIS and one veterinarian from NAMRU-2 participated in the site visit. The field trip included a presentation given by FAO representatives, followed by a brief visit to the Local Disease Control Center and observation of PDS team interviews in the field. Throughout the trip, the group discussed the issues of vaccination, culling, compensation, program staffing, and PDS/PDR strengths and limitations. Usefulness and Availability of Vaccine -------------- ¶6. (U) The team discussed with FAO presenters vaccine policy, supply and effectiveness. The GOI blanket vaccination policy suffers from limitations including the potential for vaccinators to spread the disease and insufficient vaccine supply. There is some evidence of chickens dying with AI symptoms soon after vaccination. There may be two reasons for this: vaccinators may be vaccinating already infected chickens or vaccinators may unwittingly carry the virus from farm to farm. The PDR team trains poultry owners to vaccinate poultry at their own farms to avoid spreading the virus. ¶7. (U) FAO raised the issue of limited vaccine supply. Currently the Government of Indonesia (GOI) has only 45 million doses of vaccine against an estimated need of 1.2 billion. However, the Minster of Agriculture announced last week that the GOI would make available 450 million doses in the 2007 budget cycle. The World Bank and USAID will also provide additional vaccine in early 2007 and USAID will pilot social marketing of the vaccine as a more sustainable long-term community financed approach. However, additional resources will be necessary to meet the vaccine need. Culling, Compensation, and PDS/PDR Staffing -------------- ¶8. (U) FAO recommends focal culling when teams identify AI infected chickens. The GOI has a compensation program of Rps 12,500 per culled bird (about US$1.35) that is rarely applied. FAO noted that decentralization and fear of anti-corruption laws play a significant role in hampering timely compensation to affected farmers. Decentralization impedes the speed of funds flowing from national to local levels. Given limited compensation, poultry owners are often reluctant to cull and PDR teams must persuade local communities that culling is in their best long-term interests. FAO reported at present, approximately 50% of focal culling was taking place through PDR. In other areas not covered by PDR, culling is rare. In collaboration with the FAO and USG, the World Bank has earmarked funds for developing a more effective compensation system. ¶9. (U) FAO stated that training was ongoing. By May 2007, FAO will have trained 1240 Ministry of Agriculture staff members (650 teams) and approximately 200 trainers in PDS/PDR. PDS/PDR Successes and Challenges -------------- ¶10. (U) The visiting embassy team noted that the primary strength of the PDS/PDR program is that FAO teams are on the ground, highly focused on the issue, and gain significant insights about the prevalence, nature and spread of AI among poultry populations. Teams interview numerous farmers, local village leaders and owners in the informal poultry sector (sector 3-4). By speaking to this largely informal sector, PDS/PDR officials are able to gain valuable information and educate the population on preventative measures and dealing rapidly with outbreaks. ¶11. (U) FAO representatives acknowledged that the PDS/PDR program alone will not contain AI given compensation and culling challenges, ineffective poultry transportation regulations, insufficient vaccination programs, and the absence of full implementation of the GOI national strategic plan. FAO stressed that the effort to contain the disease will require additional inputs from GOI, FAO, and the international donor community. The U.S. Department of Agriculture representative also cited the lack of a comprehensive policy to control the virus in larger industrial farms (sector 1-2) as a significant weakness in the effort to control the disease in Indonesia, although this lies outside the scope of the PDS/PDR program. Observers noted the need for PDS/PDR teams to provide local communities with handouts, flyers and other ancillary items to ensure better knowledge of safe poultry rearing and handling practices and to provide ongoing references on poultry and human health risks. FAO officials stress that they welcome opportunities to improve the program and will conduct an external evaluation of all Southeast Asia FAO AI programs in January 2007. Comment: POTUS Visit: Important Opportunity on AI -------------- -------------- ¶13. (SBU) We share the view of other donors that the GOI has made significant progress in the past year in managing the AI threat. But even under the best case budget scenario, GOI will not be able to meet the requirements for an effective revised AI control program without increased contributions from donors, including the U.S. Perhaps more importantly, announcing a major increase of USG assistance for AI control programs will give us strong leverage to seek a stronger private and public commitment from President Yudhoyono to increase the GOI's AI control programs. The Indonesian press has already reported that Presidents Bush and Yudhoyono will discuss AI control during President Bush's visit, and announcing an increase in assistance would enable us to show that we are ready to back up our concern with concrete assistance. In this context, we continue to urge Washington to announce a bold deliverable of increased AI financial assistance during the President's November 20 visit. PASCOE