Identifier
Created
Classification
Origin
06JAKARTA3199
2006-03-10 11:28:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Jakarta
Cable title:  

INDONESIA - MARCH 10 AVIAN INFLUENZA UPDATE

Tags:  TBIO AMED CASC EAGR AMGT KFLU ID 
pdf how-to read a cable
VZCZCXRO4759
PP RUEHCHI RUEHDT RUEHHM
DE RUEHJA #3199/01 0691128
ZNR UUUUU ZZH
P 101128Z MAR 06
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 0946
RUEHPH/CDC ATLANTA GA PRIORITY
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RUENMED/BUMED WASHINGTON DC
RHEFDIA/DIA WASHINGTON DC
RUEKJCS/SECDEF WASHDC
RHHMUNA/CDR USPACOM HONOLULU HI
RUEKJCS/CJCS WASHDC
RUEHBY/AMEMBASSY CANBERRA 9182
RUEHFR/AMEMBASSY PARIS 0819
RUEHRO/AMEMBASSY ROME 1848
RUEHIN/AIT TAIPEI 1767
RUEHHK/AMCONSUL HONG KONG 2105
RUEHBJ/AMEMBASSY BEIJING 3315
RUEHHM/AMCONSUL HO CHI MINH CITY 0041
RUEHGZ/AMCONSUL GUANGZHOU 0201
UNCLAS SECTION 01 OF 04 JAKARTA 003199 

SIPDIS

SIPDIS
SENSITIVE

DEPT FOR EAP/IET, A/MED AND S/ES-O
DEPT FOR OES/FO, OES/EID, OES/PCI, OES/STC AND OES/IHA
DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ICD/LAIDIG
DEPT ALSO PASS TO USDA/FAS/FAA/DYOUNG AND USDA/APHIS
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL
DEPT ALSO PASS TO HHS/BILL STEIGER AND AMAR BHAT
PARIS FOR FAS/AG MINISTER COUNSELOR
CANBERRA FOR APHIS/DHANNAPEL
ROME FOR FAO
NSC FOR JMELINE
BANGKOK FOR RMO, CDC, USAID/RDM/A
USPACOM PASS to JO7


E.O. 12958: N/A
TAGS: TBIO AMED CASC EAGR AMGT KFLU ID
SUBJECT: INDONESIA - MARCH 10 AVIAN INFLUENZA UPDATE

REF: A) Jakarta 02915 and previous

JAKARTA 00003199 001.2 OF 004


UNCLAS SECTION 01 OF 04 JAKARTA 003199

SIPDIS

SIPDIS
SENSITIVE

DEPT FOR EAP/IET, A/MED AND S/ES-O
DEPT FOR OES/FO, OES/EID, OES/PCI, OES/STC AND OES/IHA
DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ICD/LAIDIG
DEPT ALSO PASS TO USDA/FAS/FAA/DYOUNG AND USDA/APHIS
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL
DEPT ALSO PASS TO HHS/BILL STEIGER AND AMAR BHAT
PARIS FOR FAS/AG MINISTER COUNSELOR
CANBERRA FOR APHIS/DHANNAPEL
ROME FOR FAO
NSC FOR JMELINE
BANGKOK FOR RMO, CDC, USAID/RDM/A
USPACOM PASS to JO7


E.O. 12958: N/A
TAGS: TBIO AMED CASC EAGR AMGT KFLU ID
SUBJECT: INDONESIA - MARCH 10 AVIAN INFLUENZA UPDATE

REF: A) Jakarta 02915 and previous

JAKARTA 00003199 001.2 OF 004



1. (SBU) Summary. A USAID Washington avian influenza (AI)
team met with a range of stakeholders during a March 1-5
visit to Indonesia, including the Ambassador and the
Embassy's Avian Influenza Working Group (AIWG),to discuss
USAID's USD 11 million FY 2006 AI allocation for Indonesia.
Officials from Singapore, Indonesia, the United States, and
other multilateral donors met March 3 in Singapore to
discuss the proposed Avian Influenza Trilateral Project in
Tangerang. Media reports indicate continuing GOI interest
in locally developing an AI vaccine for humans, although the
U.S. firm Baxter International has reportedly denied it is
cooperating with the GOI. Indonesia has also reportedly
expressed interest in producing the generic version of
Tamiflu as part of a push to secure 22 million doses of the
drug by 2007. The Ministry of Agriculture (MOA) reportedly
plans to start a 2-month mass vaccination program later in
March under which it would distribute 55 million doses of
poultry vaccine to 27 AI-affected provinces. The total
number of confirmed human AI cases in Indonesia rose to 29
(with 21 deaths) on March 10 when the U.S. Centers for
Disease Control and Prevention (CDC) confirmed the H5N1
virus in a recently deceased 3-year-old boy from Semarang,
Central Java. End Summary.

USAID AI Team Visit
--------------


2. (U) USAID Washington Avian Influenza Director Dennis
Carroll led a team to Indonesia March 1-3 to review and
finalize USAID's draft spending plan for USD 11 million in

FY 2006 supplemental resources. The 2006 funds will help
expand on-going animal and human health sector activities,
including (a) support for the government's "National AI
Commission" responsible for overseeing Indonesia's
integrated national AI prevention and preparedness strategy;
(b) the expansion of key agricultural sector prevention and
control activities; (c) the scale-up of mass media outreach
on AI; and (d) supporting operational costs for the
critically needed investigation of human cases. USAID
Indonesia programmed USD 3.15 million in AI funds in 2005.


3. (U) The AI team met with a range of key AI stakeholders,
including the Mission's Avian Influenza Working Group
(AIWG),the Food and Agricultural Organization (FAO),the
Academy for Educational Development (AED) and the Naval
Medical Research Unit (NAMRU-2). They team also joined the
FAO on a trip to investigate the latest report of poultry
infections in Banten Province, and participated in a 3-hour
meeting with the GOI and donors to discussed the status of
AI strategy implementation in Indonesia. Finally, the team
provided out briefs to the Ambassador and USAID senior
management.

AI Trilateral Meeting in Singapore
--------------


4. (U) Officials from Singapore, Indonesia, the United

JAKARTA 00003199 002.2 OF 004


States, the World Bank, the WHO, the FAO and the World
Organization for Animal Health (OIE) met March 3 in
Singapore to flesh out details of the proposed Avian
Influenza Trilateral Project in Tangerang Municipality,
Banten Province, Indonesia. Dr. Nyoman Kandun, Director
General for Disease Control and Environmental Health at the
Indonesian Ministry of Health (MOH),and Ms Yong Ying-I,
Permanent Secretary of the Singaporean MOH co-chaired the
meeting. The U.S. delegation was lead by Dr. Chuck Lambert,
Acting Under Secretary of Marketing and Regulatory Programs
at the U.S. Department of Agriculture and Dr. Amar Bhat,
Director of the Office of Asia and the Pacific in the
Department of Health and Human Service (HHS).
Representatives from Embassies Jakarta and Singapore and
NAMRU-2 also participated.


5. (U) As noted in the joint press release issued
immediately after the meeting, Kandun said the goals of the
pilot project are "to translate the GOI's national plan to
control AI "in a defined, localized geographic area; reduce
the prevalence of H5NI AI; replicate project from lessons
learned; and strengthen local capability and capacity."
Kandun stressed that the project was timely and should be
dynamic (i.e., subject to revision). He continued that it
was not separate from the national AI plan and in fact
should serve as a model for its implementation. Kandun also
provided an update on the AI situation in Indonesia,
highlighting key challenges such as coordination, early
warning systems, public awareness, funding, animal and human
surveillance, poultry traffic and vaccination, and
compensation for culling. Kandun also noted that the
National Committee on AI Control would soon be operational,
which an Embassy contact later confirmed. He added that the
GOI plans to purchase four million doses of Tamiflu in the
next two months and increase the number of national referral
hospitals from 44 to 100.


6. (SBU) Ying Li said Singapore is enthusiastic about the
project and called for input from donors to refine its
operational details. She added that Singapore would donate
USD 1.5 million to the project, as well as technical
assistance, and asked what technical and financial
assistance other participants planned to contribute. USG
representatives said they could not commit financial aid,
but offered technical assistance as part of the overall USG
assistance to the national effort to control avian
influenza. For instance, Dr. Lambert noted USDA/APHIS's
plan to place as soon as possible a U.S. direct hire
veterinarian and four locally recruited employees in
Indonesia within the next year. In addition, Dr. Bhat
raised the possibility of HHS/CDC assigning someone to
Indonesia in the near future. The FAO and the World Bank
also promised to consider technical aid but did not commit
funds. Participants agreed to implement the project in
three phases beginning in April 2006.


7. (SBU) Comment: A number of participants, including a
representative from Indonesia's MOH, noted the strong bias
toward human health in the project plan, a bias reflected in

JAKARTA 00003199 003.2 OF 004


MOH's heavy representation at the meeting (10 MOH officials
attend compared to only once official from the Ministry of
Agriculture). Kandun acknowledged this imbalance and agreed
to review the project. Several participants told us on the
sidelines of the meeting that they feared the project risks
failure if the MOA participation is not significantly
strengthened. End Comment.

Confusion About Vaccine Development
--------------


8. (U) The Surabaya daily newspaper Surya reported March 3
the signing of a March 2 MOU between state-owned
pharmaceutical firm PT Biofarma and Surabaya's Airlangga
University (UNAIR) to develop an AI vaccine for humans. A
source told us UNAIR will provide technical experts and PT.
Biofarma a production site, including laboratory facilities.
The Tropical Disease Center (TDC) in Surabaya may also be
involved in this effort. In addition, MOH officials have
reiterated the Ministry's intention to work with the U.S.
vaccine producer Baxter International to produce a vaccine
in Indonesia. In a December 19, 2005 press release,
Minister of Health Siti Fadilah reported the MOH would work
on vaccine production with Baxter and PT. Bio Farma. The
Minister repeated this statement on February 28, when she
told the press her ministry had "already signed a
cooperation deal with Baxter." However, Baxter Healthcare
Corp., a Baxter subsidiary, denied this claim.

Tamiflu Acquisition
--------------


9. (SBU) With its tamiflu stockpile dwindling to 35,000
doses, the MOH announced on March 2 an ambitious plan under
which it would seek to buy 22 million doses of the drug by
2007 to cover about 10 percent of Indonesia's 220 million
population. MOH officials have told the press they
anticipate purchasing 4 million doses by April 2006, largely
through Kimia Farma, state-owned pharmaceutical firm PT Indo
Farma, and Roche. Our contacts tell us that the latter is
also in negotiations with the government to allow local
production of Oseltamivir.

Poultry Vaccination
--------------


10. (U) According to a March 6 article in the local
Indonesian language daily Koran Tempo, the MOA plans to
provide 55 million doses AI vaccine for poultry as part of a
national vaccination program. The MOA will reportedly
distribute the vaccine to Indonesia's 27 AI-affected
provinces, with priority given to the six most affected
provinces (Central Java, West Java, East Java, Banten,
Jakarta, and Lampung). The MOA hopes to start a mass
vaccination program later this month and complete it in
April.

Human AI Case Profile
--------------

JAKARTA 00003199 004.2 OF 004




11. (U) The U.S. Centers for Disease Control and Prevention
(CDC) confirmed another human AI case on March 10, a
recently deceased 3-year-old boy from the Central Java city
of Semarang. The MOH has also listed a 12-year old girl
from Solo as a probable case based upon serology (the girl
is still alive).


12. (SBU) NAMRU-2 data indicates the following AI-related
case profile as of March 10.

-- Number of laboratory confirmed (positive PCR and/or
serology) human AI cases: 29, of which 21 have been fatal
(fatality rate of 72 percent).

-- Number of probable AI cases: 5, with 4 deaths (fatality
rate of 80 percent).

-- Number of cases awaiting verification by the US CDC: 0.

-- Number of possible AI cases under investigation (last 30
days): approximately 54.

-- Number of excluded AI cases: 218.

PASCOE