INDONESIA - APRIL 27 AVIAN INFLUENZA (AI) UPDATE

UNCLAS SECTION 01 OF 03 JAKARTA 005308



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SUBJECT:INDONESIA - APRIL 27 AVIAN INFLUENZA (AI) UPDATE



REF: A) Jakarta 4467 B) Jakarta 3896



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1. (SBU) Summary: The April 19 appointment of a new Director

General (DG) for the National Institute for Health Research

and Development (LITBANGKES) bodes well for improved

relations with the Mission's Naval Medical Research Unit

(NAMRU-2). The Executive Director and Chair of the newly

created National Committee for AI Control (ref),Dr. Bayu

Krisnamukti, told us the Committee plans to hold a workshop

in the coming weeks to clarify the role of donor assistance.

In addition, the Committee will seek help from the World

Bank on the Government of Indonesia's (GOI) AI master plan.

The local Department of Animal Husbandry in East Java

reports that AI outbreaks in poultry continue in the Kediri

District of East Java. The Ministry of Health concluded

that one of the victims of a recent family cluster in

Lampung was infected with an H3 virus, although NAMRU-2

disagrees with this finding. NAMRU-2 reports no new human

H5N1 cases over the past two weeks. End summary.



New Head at Litbangkes

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2. (SBU) On April 19, the GOI appointed Dr. Triono Soedoro

as the new Director General (DG) for the National Institute

for Health Research and Development (LITBANGKES),a position

that had been vacant since January 2006. Soedoro previously

served as Chief of the Bureau of Social Welfare, Health and

Nutrition in the National Development Planning Agency

(BAPPENAS) from 1996-2006. He graduated in 1979 from the

Medical Faculty of the University of Airlangga, Surabaya and

obtained a Doctoral Degree from Yale University. In one of

his first acts as the new DG, Soedoro paid a 2-hour visit to

NAMRU-2 facilities and indicated that he wants to enhance

cooperation between Litbangkes and NAMRU-2. (Comment: Given

tension between some LITBANGKES officials and NAMRU-2, this

is a very favorable development.)



The National AI Committee

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3. (U) In a recent meeting with NAMRU-2 Commander Mark

Wooster and other NAMRU-2 and USAID health officials, the

Executive Director and Chair of the newly-created National

Committee for AI Control Dr. Bayu Krisnamukti provided

details on the Committee's structure. Bayu said the

Committee has two main functions: a) coordination; and b)

establishment of strong linkages between the central and

local level governments in both the animal and human health

sectors. Bayu said that as Chair, he oversees six

interagency subcommittees with distinct "specialty areas" or

areas of focus, each of which will be headed by the most

senior GOI official working in that area. For instance, Dr.

Nyoman Kandun, Director General for Disease Control and

Environmental Health in the Ministry of Health, will chair

the health subcommittee and Dr. Delima Ashari, Special

Advisor to the Minister of Agriculture for Inter-agency and

International Relations will chair the agriculture

subcommittee. The Ministry of Finance, Indonesian Armed

Forces (TNI) and the Indonesian Red Cross (PMI) will also



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chair subcommittees.



4. (U) Bayu confirmed that Dr. Emil Agustiono, Senior

Advisor to Coordinating Minister for People's Welfare will

serve as his deputy. The Committee's Secretary is Dr. Tri

Satya Putri Naipospos (Dr. Tata),the former Director of

Animal Health in the Ministry of Agriculture who was fired

in 2005. In addition to the subcommittee chairs, an Experts

Panel of approximately 16-17 veterinarians and medical

doctors will support the national committee. Bayu insisted

that the National AI Committee will not act without the

blessing of the expert panel. He also invited NAMRU-2 to

share its expertise with the panel.



5. (U) Bayu added that in the interest of coordination, the

Committee has asked for support from the World Bank to

scrutinize the GOI's Master AI Plan to "make it more

operational". The Committee will then organize a 1-2 day

workshop in May to bring together GOI ministries and donors

to help identify who will take the lead and support the

different aspects of the Master Plan.



AI in East Java

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6. (U) Abriyanti Dwiwin of the Office of Animal Health in

the Kediri Department of Animal Husbandry in East Java told

Congen Surabaya officials about two recently reported avian

influenza outbreaks in poultry in her district. Most

recently, the Department of Animal Husbandry confirmed that

four dead chickens found in Kanyoran Village on March 23

were infected with AI. Dwiwin noted that the Animal

Husbandry Department culled birds in the immediate area only

and did not do a mass culling because no other chickens died

following the death of the four birds. She claimed Kediri

authorities followed Ministry procedures by vaccinating and

disinfectant spraying in a larger radius around the

outbreak. She added that the Department managed to borrow

automatic spuits from local commercial poultry farmers to

more quickly administer vaccinations to protect local

flocks. Dwiwin noted that it takes around two months for

the central government to process and distribute

compensation to farmers for culled birds.



Human AI Case Profile

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7. (U) NAMRU-2 reports no new H5N1 cases in humans since we

transmitted Ref A on April 6. The Ministry of Health

concluded that one of the victims of a recent family cluster

in Lampung was infected with an H3 virus. However, NAMRU-2

does not support this finding, having found both the sample

from the MOH and a separate sample to be negative.



8. (SBU) NAMRU-2 data indicates the following AI-related

case profile as of April 24:



-- Number of laboratory confirmed (positive PCR and/or

serology) human AI cases: 35, of which 26 have been fatal

(fatality rate of 74 percent).



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-- Number of probable AI cases: 3, with 2 deaths (fatality

rate of 66 percent).



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



-- Number of possible AI cases under investigation:

approximately 54.



-- Number of excluded AI cases: 257.



PASCOE