WHO INTERGOVERNMENTAL MEETING: USDEL BILATERAL

C O N F I D E N T I A L GENEVA 002507 SIPDIS SIPDIS DEPT FOR G/AIAG, IO/T, OES PASS TO HSC E.O. 12958: DECL: 11/21/2012 TAGS: KFLU TBIO EAID WHO SUBJECT: WHO INTERGOVERNMENTAL MEETING: USDEL BILATERAL WITH INDONESIAN HEALTH MINISTER Classified By: Ambassador John Lange for reasons 1.4 b/d ¶1. (SBU) Summary. Special Representative on Avian and Pandemic Influenza John Lange met November 21 with Indonesian Health Minister Siti Fadilah Supari on the margins of the WHO Intergovernmental Meeting on Pandemic Influenza Preparedness: Sharing of Influenza Viruses and Access to Vaccines and Other Benefits. Noting Indonesia has raised a legitimate issue about access by developing countries to vaccines and other benefits flowing from the WHO Global Influenza Surveillance Network (GISN),Ambassador Lange, reaffirming the U.S. commitment to the provision of such benefits, stressed they must be available to all countries in need, based on those countries' responsible participation in the GISN. Lange noted the fundamental difference in the U.S. approach - that provision of benefits must be voluntary - and Indonesia's insistence on the mandatory receipt of benefits through control of the virus. Supari, repeatedly insisting that the WHO system is unfair, inequitable, and non-transparent, said Indonesia has no idea what happens to the viruses it submits to GISN and receives no benefits from its contributions to the system. The two parties fundamentally disagreed on the concept of free and unencumbered sample sharing. Lange asked Supari to resume sample sharing while negotiations continued, and Supari said that would require a Materials Transfer Agreement (MTA) or other mechanism. Despite the divergence of views, both Lange and Supari agreed that continued bilateral discussion of these issues could be fruitful. End summary. ¶2. (SBU) As originally proposed by Indonesia, Ambassador John Lange, Special Representative on Avian and Pandemic Influenza (G/AIAG),met November 21 with Indonesian Health Minister Siti Fadilah Supari during the second day of the WHO Intergovernmental Meeting on Pandemic Influenza Preparedness: Sharing of Influenza Viruses and Access to Vaccines and Other Benefits (PIP-IGM). Supari was joined by Indonesia's Ambassador in Geneva, Makarim Wibisono, and three notetakers. Lange was accompanied by Mission Health Attache and Deputy Head of USDel David Hohman. ¶3. (SBU) Expressing appreciation for the meeting, Lange underscored President Bush's personal concern about a possible influenza pandemic and stressed the importance to global public health of providing viruses to the GISN. Lange enumerated the extensive assistance provided to Indonesia for both avian influenza and pandemic influenza from the Departments of Health and Human Services and Agriculture and USAID, amounting to more than $50 million. Lange also noted the fundamental difference in the Indonesian and U.S. approaches to benefits (such as pandemic vaccines),which the U.S. believes should continue to be provided on a voluntary basis. ¶4. (C) Supari responded by raising a series of familiar GOI issues, repeatedly insisting that the GISN is unfair, inequitable, and non-transparent. Supari said Indonesia had submitted over fifty H5N1 virus samples to WHO and had no further information on how they had been used. She said some of the viruses were now at the Los Alamos National Laboratories, although she did not provide the source of this information. (Note: this is presumably the basis for her assertion in her Nov. 20 speech to the PIP-IGM that shared viruses "may be utilized for the development of biological weapons.") ¶5. (SBU) Responding to the Minister's concerns about non-transparency, Lange outlined the U.S. proposal for an electronic tracking system, managed by WHO, that would provide constantly updated information to users as virus samples flow through the WHO system. Supari, apologizing if her words made the U.S. uncomfortable, said the U.S. may have technical expertise, but if "you don't have viruses from us, you have nothing." Lange also noted the efforts by the WHO Collaborating Center at HHS/CDC Atlanta to return materials as requested by Indonesia. ¶6. (SBU) Lange, recognizing the contributions of Indonesia and other developing countries, reiterated the U.S. commitment to providing benefits to affected countries, noting the U.S. contribution to the WHO Global Action Plan to Increase Vaccine Supply, which provided funds to Indonesia and other developing countries for vaccine production capacity building. Lange also noted the U.S.-supported antivirals stockpile located in Asia as a contribution intended for containment of an incipient pandemic. ¶7. (SBU) Thanking Lange for the charity and good-will of donor countries, Supari described Indonesia's "bad experience" with the smallpox virus, noting that when smallpox was eradicated WHO had destroyed Indonesia's supply of the virus. Now, Supari said, Indonesia was unable to produce its own smallpox vaccine and had to buy such vaccine. She said she didn't want to repeat that experience. Elaborating on this point, Supari said Indonesia should have its own WHO Collaborating Center that could produce its own seed viruses, which it would then provide to manufacturers through MTAs. The resulting vaccines would be placed in WHO-managed stockpiles and distributed based on public health needs. ¶8. (SBU) Lange responded that part of the U.S. assistance to Indonesia was to strengthen Indonesia's laboratory capacity and train Indonesian scientists. But this took time and it was necessary to support the current WHO system in the meantime. Lange asked Supari to resume sample sharing while negotiations continued. Supari reiterated that would require MTAs or other mechanisms. ¶9. (SBU) In closing the meeting, Ambassador Wibisono said there clearly was a divergence of views, but the dialogue between Indonesia and the United States should continue. He expressed appreciation for the frank and open discussion, noting these issues could not be resolved in one meeting. Ambassador Lange welcomed Indonesia's willingness to continue the bilateral discussions and cited Ambassador Hume's engagement on these issues in Jakarta. ¶10. (C) COMMENT. Minister Supari's statements during the one-hour meeting reflected now-familiar themes. Her insistence on MTAs or other mechanisms to maintain control over the virus as it passes through GISN has been manifested in GOI interventions during PIP-IGM plenary discussions and does not bode well for resolution of this impasse in the near future. END COMMENT. TICHENOR