INDONESIA - DECEMBER 3 AVIAN INFLUENZA UPDATE

UNCLAS JAKARTA 002208

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 - DECEMBER 3 AVIAN INFLUENZA UPDATE


1. (SBU) Summary. Indonesia now has two new confirmed cases of avian
influenza. Ministry of Health authorities have reported one of
these cases to the World Health Organization (WHO) but has asked WHO
to keep this information confidential. The MOH has not made a
public announcement of either case report. The WHO representative
in Jakarta plans to discuss these cases with the Ministry of Health
when the Indonesian delegation returns from the December 8-13 Geneva
Intergovernmental meeting on Pandemic Influenza (IGM). The local
WHO office does not believe Indonesia is violating its obligations
under the International Health Regulations (IHR). We recommend that
Washington raise this issue with the WHO on the margins of the IGM.
WHO member states should be immediately notified of any avian
influenza cases. End Summary.


2. (SBU) In early November, local media reported the fatal case of a
15-year-old girl from Semarang. National Institute of Health
Research and Development (NIHRD) staff confirmed to Embassy staff
that the victim had tested positive for avian influenza. However,
Minister of Health Siti Fadilah Supari publicly denied the case
report. When local WHO authorities questioned NIHRD staff about the
laboratory results, NIHRD staff said that they were not authorized
to discuss the Semarang case report.


3. (SBU) During the week of November 24, the Ministry of Health
notified WHO of a new laboratory confirmed case report for a
nine-year-old girl from Riau province and asked that information on
this case report remain unofficial. The Ministry of Health has not
made a public announcement of this case report. Dr. Tjandra Yoga,
the new Director General of Communicable Diseases and Environmental
Health, told WHO that the Ministry will notify the WHO of new AI
cases in compliance with the international health regulations (IHR).
He requested, however, that the WHO keep this information
confidential until case reports are officially announced by the
Ministry of Health's media unit. Tjandra reported that the media
unit will notify the public monthly of all new cases. He refused to
discuss the Semarang case report. (Indonesia released its last
monthly report on September 10, 2008.)


4. (SBU) Over the past several months, Minister of Health Supari has
implemented other policies to control information about AI case
reports. Staff in the Ministry's Operations Center can no longer
discuss case reports with outside persons. The Ministry has also
notified WHO staff and other international staff that they can no
longer participate in case investigations of patients with suspected
AI.


5. (SBU) The local WHO office plans to discuss these restrictions
with the Ministry of Health following the delegation's return from
the IGM meeting in Geneva. But in conversations with Embassy staff,
the WHO reported they will comply with the Ministry of Health's
policy on not reporting AI cases until the cases are officially
announced by the Ministry. They stated that according to the IHR,
WHO is obliged to keep case reports confidential if requested unless
the cases represent a threat to other member states. We recommend
that the Avian Influenza Advisory Group raise this issue at a high
level with the WHO at next week's IGM meeting to make the case that
all AI cases are a global health threat and should be reported by
WHO to all member states immediately under IHR.

HUME