INDONESIA - FEB 23 AVIAN INFLUENZA (AI) UPDATE

UNCLAS JAKARTA 000504 SIPDIS SENSITIVE SIPDIS DEPT FOR EAP/MLS, EAP/IET, MED/DASHO/EMR AND MED DEPT FOR G/AIAG AND OES DEPT PASS TO USDA/FAS/HWETZEL DEPT ALSO PASS TO USDA/FAS/FAA/DEVER AND USDA/APHIS/ANNELLI DEPT ALSO PASS TO USDA/FAS/OTCB/ROSENBLUM AND USDA/APHIS AUSTGEN 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 BANGKOK FOR APHIS/CARDENAS, RMO, CDC, USAID/RDM/A CANBERRA FOR APHIS/EDWARDS ROME FOR FAO NSC FOR JMELINE E.O. 12958: N/A TAGS: TBIO AMED CASC EAGR AMGT PGOV ID SUBJECT: INDONESIA - FEB 23 AVIAN INFLUENZA (AI) UPDATE REF: A) Jakarta 00431 B) Jakarta 00310 and previous ¶1. (SBU) Summary: Despite the February 16 joint media statement by the Ministry of Health (MOH) and World Health Organization (WHO), Indonesia has not yet resumed the sharing of AI samples. Various Indonesian media outlets have quoted Minister of Health Fadillah Supari as saying Indonesia will not resume shipment of virus specimens to the WHO until a "new mechanism" for sample sharing is in place. The inability of international laboratories to confirm MOH-diagnosed AI cases has led to a gap between the GOI's case count (85 AI cases with 65 deaths) and the counts of NAMRU-2 and the WHO (81 cases with 63 deaths). According to an officer from the Singaporean Embassy in Jakarta, the Government of Indonesia (GOI) continues to make progress on the Tangerang trilateral project. End Summary. Optimistic Joint Statement But Impasse Continues -------------- --- ¶2. (U) Following five hours of negotiations on February 16, WHO and MOH officials released a Joint Media Statement agreeing that "responsible, free and rapid sharing of influenza viruses with WHO, including H5N1, is necessary for global public health security" and that the MOH will "resume sharing viruses for this purpose." The WHO team included David Heymann, Assistant Director-General of the WHO for Communicable Diseases; Dr. Keji Fukuda, flu epidemiology expert; and Georg Peterson, Director of WHO's Jakarta office. According to journalists present at the media event, Heymann commented that he trusted that the shipment of specimens would resume soon. But according to the English-language version of the weekly magazine Tempo, Supari replied "Without the new regulations, until our last drop of blood, the answer is still no, no, no!" Director General for Infectious Diseases Nyoman Kandun echoed this sentiment in a February 22 meeting that was unrelated to sample sharing. The MOH and WHO have agreed to convene a meeting of Asian Health Ministers in March to discuss mechanisms for jointly using AI virus samples. ¶3. (U) Indonesian press continues to run stories on the sample sharing issue, including an interview in the Jakarta Post with Dr. Triono Soendoro, Director of Litbangkes and a two-page article in Tempo. Most press stories have focused primarily on the need for developing countries to benefit from sharing virus samples, including access to quality pandemic vaccines at affordable prices. A variety of sources have indicated that the MOH has appointed a prominent local defense attorney and anti-corruption advocate, Todung Mulya Lubis, to handle the legal aspects of the issue. Conflicting AI Counts -------------- ¶4. (SBU) As a result of the sample impasse, NAMRU-2 and WHO now classify AI cases differently than the Ministry of Health. NAMRU-2 and WHO show the same numbers for Indonesia with 81 Human H5N1 cases and 63 deaths for a CFR of 78%. The MOH counts four additional cases: (1) a 15 year-old surviving female from Jakarta. NAMRU-2 data from separate samples suggest she had an H3 (normal flu) virus. (2) a 30 year-old surviving male from Bandung; NAMRU-2 data on separate samples suggest he was not infected. (3) a 20 year-old deceased female from Garut; NAMRU-2 does not have samples (4) a 9 year-old deceased male from Garut; NAMRU-2 does not have samples. ¶5. (SBU) NAMRU-2 has encouraged NIHRD researchers to both share samples with NAMRU-2 and seek additional laboratory results from a WHO-reference laboratory. In the cases of the surviving patients, virus isolation, full genome sequencing and microneutralization could resolve the case discrepancy. Tangerang Trilateral Project Update -------------- ¶6. (SBU) According to a Singaporean Embassy contact, Singapore has agreed to provide $600,000 worth of in-kind contributions (including vehicles, computers, other equipment) for use in the Tangerang trilateral project. The Singaporean Government has also engaged Sembawang Logistics Company, a third party contractor to begin implementing the in-kind contributions. Additionally, Singapore is prepared to transfer $900,000 before the end of March to the GOI to fulfill the remaining portion of their Tangerang funding commitment. Although specific activities have not yet been identified nor the MOU finalized between Singapore and Indonesia, the MOH has agreed to begin using the funds and providing quarterly activity reports. HEFFERN