INDONESIA - MARCH 22 AVIAN INFLUENZA (AI) UPDATE

UNCLAS SECTION 01 OF 03 JAKARTA 003896 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 22 AVIAN INFLUENZA (AI) UPDATE REF: A) Jakarta 3430 and previous JAKARTA 00003896 001.2 OF 003 ¶1. (SBU) Summary. President Yudhoyono signed a Presidential Regulation on March 13 establishing a "National Committee on Avian Influenza Control and Pandemic Preparedness." The decree designates the Coordinating Minster for Peoples' Welfare as the "National Coordinator" for AI policy and activities. Assisted by three deputies, the Coordinator will report to the President. Media reports indicated that there are now 6 suspected human AI cases in Takalar Regency, South Sulawesi province. As of March 23, the total number of confirmed human AI cases in Indonesia remained at 30 (with 22 deaths). We removed a previous probable AI case (a 42 year-old male from North Jakarta) based on negative results from the Hong Kong University laboratory. However, we have added a new probable AI case (a 6 year-old boy (deceased) from East Jakarta) based on NAMRU-2 testing. International confirmation for this case is pending. End Summary AI Presidential Regulation -------------- ¶2. (U) President Susilo Bambang Yudhoyono (SBY) signed on March 13 Presidential Regulation 7/2006 creating a National Committee on Avian Influenza Control and Pandemic Preparedness (Komnas FBPI). A Presidential Regulation (Peraturan Presiden) is a step higher in the hierarchy of Government of Indonesia (GOI) regulations than the more common Presidential decree (Keputusan Presiden). The Regulation's 13 articles detail the roles and responsibilities of the National AI Committee (NAC),GOI ministries and provincial, district and municipal administrations. It formally designates the Coordinating Minister for Peoples' Welfare as NAC Chairman and national coordinator for AI policy. The Regulation notes the need to improve the management of AI and increase the awareness of a possible influenza pandemic "requires comprehensive steps and joint efforts from all national government institutions, local governments, the business community, professional organizations, non-government organization (NGOs), universities and international organizations." Key provisions in the Regulation include: --Article 2 states that the NAC "is under and reports directly to the President," while Article 9 requires the NAC to report on its work program and activities every three months to and upon request by the President. -- Article 3 outlines the NAC's main duties, which include determining national policy and planning of AI and influenza pandemic preparedness; determining the strategic steps necessary to prevent, control and manage avian influenza and influenza pandemic preparedness; coordinating the implementation of preventive measures for animals and humans; supervising and evaluating the implementation of Indonesia's AI strategy and preparedness; coordinating data management and information related to AI, and: providing guidance to Provincial Committee and Regent/City Committee JAKARTA 00003896 002.2 OF 003 on all aspects of AI and influenza pandemic alert. --Article 5 instructs governors, regents and mayors to form and chair NACs at their respective levels, develop AI policies that reflect the NAC's "policy, strategy and guidance," and periodically report their activities to the NAC Chairman. --Articles 6-8 describe the NAC's structure, including the creation of a Secretariat headed by the Chairman and an option to establish work groups and expert panels when necessary. --Article 10 establishes a four-year mandate for the NAC, subject to extension. --Article 11 stipulates that the NAC will derive its operational costs from the national and regional budgets, and "other non-binding funding sources." --Article 12 instructs the NAC Chairman to issue implementing regulations for the Presidential Decree, which is effective as of March 13, 2006. ¶3. (U) Article 4 of the Regulation sets out the NAC's management and members as follows: A) Board of Management: --Chairman: Coordinating Minister for People's Welfare --Vice Chairman I: Coordinating Minister for the Economy --Vice Chairman II: Minister of Agriculture --Vice Chairman III: Minister of Health B) Members --The Ministers of Internal Affairs; Foreign Affairs; Finance; Forestry; Industry; Trade; Transportation, Education; Culture and Tourism; Communication and Information; Research and Technology; Environment; and National Planning; the Head of the Indonesian Armed Forces; the Chief of the Indonesian National Police, and; the Chairman of the Indonesian Red Cross. C) Secretary and Member --Deputy Minister for Agriculture and Marine Affairs, the Coordinating Ministry of Economic Affairs. FAS Observations from West and Central Java -------------- ¶4. (SBU) During the Agricultural Counselor's March 6-10 swing through West and Central Java, it was clear that regency and municipal officials responsible for local AI surveillance and monitoring had received little in the way of direction, systematic guidance or procedural advice from provincial Agriculture departments or the Ministry of Agriculture in Jakarta. All reported poultry die-offs as of JAKARTA 00003896 003.2 OF 003 early March 2006, but had not tested for the H5N1 virus among dead birds. There was little liaison with local health authorities. Many local officials expressed a need for rapid testing kits, and also hoped the GOI would be able to better cover infected areas with a workable poultry vaccination program. None were aware of places where culls within 1 kilometer of known AI outbreaks had occurred, the stated Agriculture Ministry objective. Human AI in South Sulawesi? -------------- ¶5. (U) According to a March 20 news item in Metrotvnews.com, there are now six suspected human AI cases in Takalar Regency in South Sulawesi Province. The provincial Health Department reportedly took blood samples from the six patients and sent them to Jakarta for testing. To date, there have been no confirmed human AI cases is South Sulawesi province. Human AI Case Profile -------------- ¶6. (SBU) During the week of March 20, NAMRU-2 removed a previous AI probable case (a 42 year-old male) based on Hong Kong University laboratory results. However, NAMRU-2 has determined another probable case of H5N1 infection in a 6 year-old male from East Jakarta who died on March 19. NAMRU- 2 data indicates the following AI-related case profile as of March 16: -- Number of laboratory confirmed (positive PCR and/or serology) human AI cases: 30, of which 22 have been fatal (fatality rate of 73 percent). -- Number of probable AI cases: 6, with 5 deaths (fatality rate of 83 percent). -- Number of cases awaiting verification by the US CDC: 2 -- Number of possible AI cases under investigation (last 30 days): 36. -- Number of excluded AI cases: 241. PASCOE