INDONESIA - NOVEMBER 5 AVIAN INFLUENZA UPDATE

UNCLAS SECTION 01 OF 02 JAKARTA 003075

SIPDIS

SENSITIVE
SIPDIS

DEPT FOR EAP/MTS, G/AIAG AND OES
USAID FOR ANE/CLEMENTS AND GH/CARROLL
DEPT ALSO PASS TO HHS/WSTEIGER/MABDOOM/STLOUIS AND HHS/NIH
GENEVA FOR WHO/HOHMAN
USDA/FAS/OSTA BRANT, ROSENBLUM
USDA/APHIS ANNELLI

E.O. 12958: N/A
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID
SUBJECT: INDONESIA - NOVEMBER 5 AVIAN INFLUENZA UPDATE

REF: A) Jakarta 3025 B) Jakarta 2795

1.(SBU) Summary. APHIS and Indonesian health authorities
co-sponsored a Geographic Information System/Global Positioning
System training workshop in Tangerang from October 22-31.
Government of Indonesia (GOI) officials attributed delays in
Tangerang Trilateral Project implementation to GOI funding
shortfalls during an October 24 meeting on the project. The
Ministry of Health (MOH) is planning a simulation exercise for rapid
containment of an epicenter outbreak of avian influenza in March

2008. USAID delivered 100,000 new sets of personal prevention
equipment (PPE) to GOI during the month of October. According to a
public opinion poll commissioned by Tempo Magazine (Indonesia's
leading weekly news magazine),the MOH headed by Siti Fadilah Supari
received the third highest performance rating among Indonesia's
ministries. The MOH confirmed two new cases of avian influenza
during the week of October 31, raising total confirmed cases to 112,
with 90 deaths. End summary.

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APHIS Hosts GIS/GPS Workshop
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2. (U) Over 60 Tangerang municipal government health and agriculture
workers participated in a Geographic Information System (GIS) and
Global Positioning System (GPS) training workshop during October
22-31 sponsored by APHIS/USDA, National Committee for Avian
Influenza Control and Pandemic Preparedness (KOMNAS),and the
Tangerang Secretariat. Two scientists from USDA's Center for
Epidemiology and Animal Health conducted the training. USDA is
providing 50 hand-held GPS devices, five desktop computers, and GIS
software to support the Tangerang Trilateral Project.

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Tangerang Project Stalls Due to Lack of GOI Funds
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3. (SBU) In an October 24 meeting with Regional Emerging Diseases
Intervention (REDI) Centre and Embassy officials, Center for
Diseases Control and Environmental Health Director General Dr.
Nyoman Kandun and members of the Tangerang Secretariat attributed
projected delays to GOI funding shortfalls. Although the U.S. and
Singaporean support for the project is now in place, GOI reportedly
used 2007 money planned for Tangerang towards an important poverty
program.


4. (SBU) Kandun was not optimistic that additional GOI funds would
be available for 2007. He believes that most of the requested $2.3
million for 2008 for Tangerang will materialize, but access to funds
may be delayed until April or May. Kandun promised to do everything
possible to secure the funds for next year. The Ministry of
Agriculture did not request specific 2008 funds to support AI
control in poultry. Without some assurance of GOI funding, the
project will remain stymied.


5. (SBU) AI surveillance in poultry by the local Animal Health
Service and the Participatory Disease Surveillance team in Tangerang
indicates that AI is endemic in the district and that more human
cases can be expected if appropriate control measures are not
instituted. Since most of the Tangerang cases (13 of 14 cases)
occurred in the district and not in the municipality, the
Secretariat recommended expanding the trilateral project coverage to

SIPDIS
the district.

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CDC COLLABORATES ON PLANS FOR SIMULATION TRAINING
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6. (U) U.S. Centers for Disease Control (CDC) is working closely
with the MOH, KOMNAS, the Indonesian military, Indonesian police,
and other key Ministries to plan a field simulation exercise for
rapid containment of an AI outbreak with sustained human to human
transmission. The simulation exercise will test operational plans
(developed by inter-sectoral working groups),for rapid containment

JAKARTA 00003075 002 OF 002


of an avian flu outbreak in Jembrana District, Bali in March 2008
(date TBD).


7. (SBU) CDC is also working with the MOH zoonosis sub-directorate
on a communication strategy for AI at the provincial and district
levels. Recruitment is underway for an Egyptian consultant to
assist MOH establish a work plan for the BSL3 laboratory. The MOH
together with CDC plan to revitalize the CDC Field Epidemiology
Training Program (FETP) in Indonesia. A team of external
consultants will arrive November 4-14 to review activities and
assist in the development of a long-term plan.

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USAID EXPANDS PPE DISTRIBUTION AND TRAINING
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8. (U) In October, USAID provided 100,000 new sets of Personal
Protective Equipment (PPE) to the GOI for use in human and poultry
surveillance and response activities. USAID is sending a portion to
KOMNAS for an emergency stockpile and distributing other PPE to
about 100 referral hospitals in Indonesia. USAID will provide
additional PPE as the current stock is depleted.


9. (U) USAID Community Based Avian Influenza Control program (CBAIC)
trained 13,138 volunteers to support AI prevention and surveillance
services to communities throughout Java, Bali, and parts of Sumatra.
With support from USAID, the UN Food and Agriculture Organization
(FAO) commenced refresher as well as expansion training of animal
health surveillance and response officers and expect fully trained
officers covering all districts on Java, Bali, and Sumatra by the
end of May 2008.


10. (U) The World Health Organization (WHO),with support from
USAID, continues to train human surveillance officers. To date,
authorities have trained 104 officers to cover most districts in
Java, Bali, and parts of Sumatra. Training in North Sumatra will
commence on November 5.

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INDONESIANS SATISFIED WITH MINISTRY OF HEALTH
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11. (U) In a recent public opinion poll of President Susilo Bambang
Yudhoyono and his government published in Tempo weekly magazine,
Indonesians ranked the MOH, headed by Minister Supari, as third
highest in performance(75.9%)of all the Ministries after the
Indonesian Military (84%) and the Ministry of Religious Affairs
(77.6%).

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AVIAN INFLUENZA CASE REPORT
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12. (U) On October 31, the MOH and Eijkman Institute confirmed H5N1
in a 3-year old boy from Tangerang District. The hospital
discharged the boy at the insistence of the boy's family, against
doctor's advice. The patient is a Tangerang neighbor of a recent
5-year old female H5N1 victim.


13. On November 2, MOH confirmed H5N1 in a 30-year old female from
Tangerang who died over the weekend. Currently Indonesia reports
112 H5N1 cases with 90 fatalities.

HUME