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