INDONESIA - SEPTEMBER 11 AVIAN INFLUENZA UPDATE

UNCLAS SECTION 01 OF 02 JAKARTA 001733

SIPDIS
UNCLASSIFIED

DEPT FOR EAP/MTS, G/AIAG, L/DL, EAP/EX, AND OES/IHA
USAID FOR ANE/CLEMENTS AND GH/CARROLL
DEPT ALSO PASS TO HHS/WSTEIGER/MSTLOUIS AND HHS/NIH
DEPT ALSO PASS TO DOJ for OFL
GENEVA FOR WHO/HOHMAN
USDA/FAS/OSTA BRANT, ROSENBLUM
USDA/APHIS ANNELLI

E.O. 12958: N/A
TAGS: TBIO EAGR AMGT PGOV ID KLIG
SUBJECT: INDONESIA - SEPTEMBER 11 AVIAN INFLUENZA UPDATE


1. (U) Summary. On 8 September, the Ministry of Health (MOH)
publicly reported two avian influenza (AI) cases, and the World
Health Organization (WHO) followed suit. MOH experienced staffing
changes including a change in Director General of the Directorate of
Disease Control & Environmental Hygiene (DCEH),Head of Biomedical
and Pharmacy Research at the National Institute of Health Research
and Development. Minister of Health Supari reviewed and approved the
cooperative agreement between DCEH and the US Centers for Disease
Control and Prevention. Minister Supari received negative press in
recent weeks for some of her actions and continues to give speeches
about her book and work on behalf of developing nations. The Animal
and Plant Health Inspection Service hosted a workshop to better
coordinate government and commercial farmers to develop an industry
safety assessment mechanism to create disease free farms. End
Summary.

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Two Cases Reported by MOH, Featured on WHO Web Site
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2. (SBU) The Ministry of Health posted two new AI cases on its web
site in Bahasa Indonesia the week of 8 September. On 10 September
the WHO updated its web site to reflect those same cases. The WHO
reports the total case count at 137 with 112 fatalities. Post was
aware of these cases before the Ministry of Health and WHO
officially announced them.


3. (U) The first patient was a 38 year old male from Tangerang
Municipality, Banten Province who developed symptoms on 4 July 2008,
was hospitalized on 9 July, and died on 10 July. There were free
roaming poultry throughout his neighborhood, including a commercial
poultry pen owned by a neighbor. The second patient, a 20 year old
male from Tangerang District, developed symptoms on 20 July, was
hospitalized on 29 July, and died on 31 July. Reports indicate that
chickens from the case's household had died in the week preceding
the onset of his symptoms and that he had slaughtered and consumed
some of his stock during this period.


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Changes in Staffing Within the Ministry of Health
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4. (U) Dr. I. Nyoman Kandun, Director, Directorate of Direct
Transmitted Disease Control, Directorate General of Disease Control
& Environmental Hygiene, (P2M) retired 1 September. His interim
replacement as is Dr. Tjandra Yoga Aditama, who is linked
politically to Minister Supari. Dr. Tjandra previously worked as
Head of the Subdirectorate of Directly Transmitted Diseases, and has
a background in pulmonary medicine. CDC staff worked extensively
with him on the pandemic simulation exercise in Bali in April 2008.


5. (U) Management changes also occurred at the National Institute of
Health Research and Development (NIHRD). Dr. Trihono, former Head of
Program and Cooperation, in the Research and Development Center of
Ecology and Health Status, replaced Dr. Endang Mamahit as the
Director of the Center for Biomedical and Pharmaceutical Research
and Development. Please note that Dr. Trihono is not the same person
as Dr. Triono Soendoro, the Director of NIHRD. Dr. Trihono recently
indicated his interest in renewing the cooperative agreement with
CDC and adding projects with the Biosecurity Engagement Program
(BEP).


6. (U) Staff from the Indonesian Directorate General for Disease
Control and Environmental Hygiene briefed and received approval from
the Minister of Health for a work plan outlined in the renewed
cooperative agreement with CDC. Dr. Trihono from NIHRD indicated
his interest in renewing the cooperative agreement with CDC and has
prepared a brief outlining priority activities including some
projects related to the Biosecurity Engagement Program (BEP).

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Minister of Health Receives Bad Press
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7. (SBU) Over the past several months, Indonesian media outlets have
been critical of Minister Supari.

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Her reputation has suffered due to several unpopular moves and the
resultant press coverage. In the latest, she was blasted for
withholding information about bacteria in infant formula, and
several months prior, she earned very negative coverage for
expelling poor patients from hospitals.

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Minister of Health Gives another Speech about Her Book
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8. (U) On September 4, Minister Supari spoke about her book, "It's
Time for the World to Change," during a panel discussion at
Paramadina University. She initiated the discussion by describing
the system she stated was unfair: that the developing countries, who
supplied the H5N1 virus to the WHO for analysis and eventual vaccine
production by commercial companies, were unable to purchase those
same vaccines at a reasonable price. She stated that because
Indonesia and other small countries had lost faith in the current
GISN system, she had proposed a new mechanism, WHO Influenza Network
(WIN). The new mechanism would be more transparent, be acknowledged
under international law, include a user-friendly tracking system,
and include a material transfer agreement with monetary and
non-monetary benefits. At the conclusion of her speech, Supari
reiterated that her real desire was to increase transparency in
health and politics, and close the gap between developed and
developing countries.


9. (U) Other panelists, Anies Baswedan (Paramadina University
rector),Syafiq Basri (former Tempo reporter),Bima Arya Sugiarto
(Paramadina University International Relations faculty),and Makarim
Wibisono (former permanent representative of the Republic of
Indonesia to the United Nations in Geneva) praised Supari for
advocating on behalf of developing countries. Wibisono further
elaborated that developing countries must organize to make the
sample sharing process and GISN mechanism more transparent and
equitable.

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Pandemic Simulations and Reporting Workshops Scheduled
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10. (U) Part Two of the Bali pandemic simulation is scheduled for
mid-December. CDC has also partnered with the Japan International
Cooperation Agency (JICA),and the WHO on a pandemic early warning
system workshop 27-30 October, location to be determined.


11. (SBU) On 26-28 August, APHIS hosted a workshop to improve
coordination and communication between the government and the sector
1 poultry industry with the end goal of creating disease free farms
and zones. Attendees included 46 participants from 12 poultry
breeding companies and 40 government employees, including local
officers from West Java province. The Minister of Agriculture (for
political reasons) is pushing the team to have result - disease free
zones/compartments - by the end of 2008. As an intermediate goal,
the team will develop an assessment mechanism and train an
assessment team.


HUME