INDONESIA - JUNE 16 AVIAN INFLUENZA (AI) UPDATE

UNCLAS SECTION 01 OF 04 JAKARTA 007626 SIPDIS SIPDIS SENSITIVE DEPT FOR EAP/MLS, EAP/IET, A/MED AND S/ES-O DEPT FOR G/AIAG/JLANGE AND RFENDRICK 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/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH PARIS FOR FAS/AG MINISTER COUNSELOR CANBERRA FOR APHIS/DHANNAPEL ROME FOR FAO NSC FOR JMELINE BANGKOK FOR RMO, CDC, USAID/RDM/A USPACOM ALSO PASS TO J07 E.O. 12958: N/A TAGS: TBIO AMED CASC EAGR AMGT PGOV ID KFLU SUBJECT: INDONESIA - JUNE 16 AVIAN INFLUENZA (AI) UPDATE REF: A) Jakarta 7166 and previous JAKARTA 00007626 001.2 OF 004 ¶1. (SBU) Summary: The Executive Director of the National Committee for AI and Pandemic Control (Komnas) Bayu Krisnamurti told participants in a June 12 AI donor meeting that the GOI would host a WHO-led technical assessment of its AI strategy June 21-23, with participation from the World Bank and FAO. The GOI will also hold a workshop to allow donors to present concrete funding plans in support of its National AI Strategy. UNICEF is helping Komnas prepare a matrix of donor assistance and GOI funding to allow the GOI to determine funding gaps for its 2006-08 AI control budget. In the past week, the number of confirmed H5N1 cases in humans in Indonesia has remained unchanged, with confirmed cases holding at 51, with 39 deaths (76 percent). Indonesia currently ranks second in the world in both H5N1 cases (51 confirmed) and deaths (39),and leads the world in case fatality rates (76 percent) for countries with more than ten confirmed cases. End Summary. National AI Committee Meeting -------------- ¶2. (U) The Executive Director and Chair of the National Committee for AI and Pandemic Control (Komanas) Bayu Krisnamukti chaired a combined interagency and donor coordination AI meeting on June 12. Bayu called the meeting in preparation for a scheduled session on AI at the June 14 Consultative Group of Indonesia (CGI) meeting and an AI workshop or seminar for donors in early July. (Note: The GOI subsequently dropped the AI item from the CGI agenda.) Participants attended from the Ministry of Agriculture (MOA),Ministry of Health (MOH),National Development Planning Agency (Bappenas),Ministry of Communications (MOC),and State Ministry of Research and Technology (Menristek),as well as the WHO, World Bank, FAO, USAID, AUSAID, DFID, Singapore, Korea, and Japan. Bayu said the two goals for the meeting were to share information on the GOI's AI strategy, and coordinate and synergize GOI and donor AI activities. ¶3. (U) An official from Bappenas gave a brief synopsis of the GOI's National Strategy on AI Control and Prevention, highlighting its two main strategies and six goals, as well as detailing the budgetary challenges and funding gaps in the various ministries. He noted that the GOI's "AI Control Cost Plan" calls for spending of Rp 1.9, 2.4 and 2.2 trillion rupiah in 2006, 2007 and 2008 respectively (USD 203, 256, and 235 million respectively at current exchange rates). In addition, the budget for Pandemic Influenza Preparedness amounts to Rp 738, 792 and 907 billion in 2006, 2007 and 2008 respectively (USD 79, 85, and 97 million respectively at current exchange rates). He thanked donors for their current and planned financial and technical support, but urged that they quickly complete the assistance matrix the UNDP is preparing for the GOI. (Note: UNDP is helping Komnas prepare a matrix of donor assistance and GOI funding to allow the GOI to determine funding gaps). JAKARTA 00007626 002.2 OF 004 ¶4. (U) Bayu noted the GOI's AI strategy is on track following the formulation of a National AI Plan in December 2005 and the launch of its implementation in January 2006. He admitted, however, that given the notable rise in human AI cases in 2006, the GOI needs to refocus and adjust its strategy and was thus welcomes input from donors. For that reason, the GOI would host June 21-23 a WHO-led technical review/assessment of its AI strategy, with participation from the World Bank and FAO. (Note: CDC influenza specialist Dr. Tim Uyeki will in the review). Bayu added that the GOI will also hold a workshop in early July to enable donors to present concrete funding plans in support of Indonesia's national AI strategy. ¶5. (U) Bayu said the GOI will emphasize the following six priorities over the next 18 months: --Conducting an information and public awareness campaign focusing on children and family; the media; decision makers such as GOI officials, politicians, doctors and veterinarians; high-risk groups such as poultry traders and farmers; and the general public. --Sharpening the GOI's focus on the AI virus in poultry and birds. Bayu said that with 194 districts AI endemic, the GOI needs a massive surveillance program. In that regard, he thanked the FAO for its newly launched surveillance program funded by USAID. --Developing a proper compensation program for culled birds, without which required depopulation of infected areas would be very difficult. --Improving human surveillance and preparedness, including a focus on personal protective equipment (PPE),isolation rooms and anti-virals. --Conducting pandemic preparedness simulations: The GOI plans to conduct simulations in three areas (not specified), although more are clearly needed. --Increasing research and investigation to address many answered questions, especially with respect to human AI clusters. ¶6. (U) In the discussion that followed, the MOA requested more direct operational support to supplement ongoing technical assistance. The World Bank called for a freer flow of information from the GOI, citing as an example the lack of specifics and GOI conclusions about the recent large human AI cluster in North Sumatra (ref). In reply, Bayu said the government has been open with its communications, especially via the WHO and FAO. He then remarked that limited human-to-human transmission had taken place in the Medan cluster case. Asked why this was not yet in the public domain since several ministers discounted that possibility, Bayu agreed that the GOI needed help to initiate a good communication strategy, but that it would need to be "tailored to Indonesia with its extremely free JAKARTA 00007626 003.2 OF 004 media." Muhammadiyah Supports AI Prevention Efforts -------------- ¶7. (U) Indonesia's second largest mass Islamic organization, Muhammadiyah, announced plans to support the GOI's efforts to control and prevent AI at a June 7 ceremony attended by senior officials from the Coordinating Ministry for People's Welfare, the MOH, and MOA, and representatives of universities and professional organizations. The Chairman of Muhammadiyah's Health Council, Dr. Natsir Nugroho, and the Chairman of Muhammadiyah's Central Board Dr. Sudibyo Markus opened the event and Minister of Health Siti Fadilah Supari formally the launched the program. Natsir stressed the need for broad participation from the GOI, NGOs and the wider community to prevent the spread of AI, and adequately prepare for a possible pandemic. Markus claimed that Muhammadiyah's nationwide community-based network would support this effort, using its vast network of universities, schools, hospitals and other independent organizations to "socialize" the public about the dangers posed by AI and the need for preventative measures. Markus later told the press there would be a fund raising component to the project, and a "train the trainers" program with a budget of around Rp 20 billion rupiah (USD 2.1 million). Minister Fadilah thanked Muhammadiyah for its involvement in addressing socioeconomic and health problems and its willingness to join the GOI in its fight against AI. The Minister also thanked USAID and AUSAID for their AI assistance. Human AI Case Profile -------------- ¶8. (U) In the past week, the number of confirmed H5N1 cases in humans in Indonesia remained the same, at 51, with 39 deaths (76 percent). ¶9. (SBU) NAMRU-2 data indicates the following AI-related case profile as of June 15: -- Number of laboratory confirmed (positive PCR and/or serology) human AI cases: 51, of which 39 have been fatal (case fatality rate of 76 percent). -- Number of probable AI cases: 5, with 3 deaths (fatality rate of 60 percent). -- Number of cases awaiting verification by the US CDC: 1. -- Number of possible AI cases under investigation: approximately 17. -- Number of excluded AI cases: 319. ¶10. (SBU) We offer the following additional data on the recent trajectory of AI cases in Indonesia: Number of Confirmed and Probable Cases Reported per Month: JAKARTA 00007626 004.2 OF 004 2005 -------------- June - 1 July - 2 August - 0 September - 5 October - 3 November - 5 December - 4 2006 -------------- January - 7 February - 5 March - 5 April - 2 May - 14 June - 3 Areas Affected in the last 30 days: District/City Province No. Confirmed Cases -------------- -------------- Karo North Sumatra 7 Bekasi West Java 1 Surabaya East Java 2 Jakarta 1 Bandung West Java 2 Padang West Sumatra 1 Tasikmalaya West Java 1 Tangerang West Java 2 AMSELEM