INDONESIA - NABARRO's VIEWS ON AI CHALLENGES

UNCLAS SECTION 01 OF 02 JAKARTA 000221 SIPDIS SENSITIVE SIPDIS DEPT FOR EAP/MTS, G/AIAG AND OES USAID FOR ANE/CLEMENTS AND GH/CARROLL DEPT ALSO PASS TO HHS/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH GENEVA FOR WHO/HOHMAN E.O. 12958: N/A TAGS: TBIO AMED CASC EAGR AMGT PGOV ID SUBJECT: INDONESIA - NABARRO's VIEWS ON AI CHALLENGES REF: A) Jakarta 137 B) Jakarta 68 and previous ¶1. (SBU) Summary. UN System Senior Coordinator for Avian and Human Influenza David Nabarro told the Ambassador on February 1 that he believes the avian influenza problem in Indonesia has grown more serious and that leading members of the Indonesian scientific community are increasingly alarmed about Minister of Health Supari's policies. Nabarro shared highlights of his meetings with Indonesian officials, including Minister Supari views that the gap between US and Indonesian positions over use of a Materials Transfer Agreement is closing. Nabarro also reported that President Yudhoyono had convened a meeting on January 30 with the Ministers of Health, Agriculture and People's Welfare to press them to get the AI problem immediately under control in the greater Jakarta area, including Tangerang. Ambassador Hume outlined his concerns that Ministry of Health officials are not appropriately briefing up and in some cases, have misled superiors on the facts surrounding avian influenza. He outlined possible US actions to expedite progress on ending the sample sharing impasse and on improving patient management for AI cases. Nabarro urged that the US pursue these ideas, noting that the time may be particularly right given President Yudhoyono's recent focus on AI and Supari's intention to resolve sample sharing by April. End Summary. Disease More Engrained, Scientists Frustrated -------------- ¶2. (SBU) Citing a series of meetings and phone conversations between January 29-31, Nabarro reported that he is increasingly concerned about the central authorities' failure to address the AI problem in Indonesia. The viral load among the poultry population remains high, particularly in Tangerang. Market studies show high levels of virus and large commercial poultry farms continue to operate outside regulatory authority. Nabarro stated Indonesian scientists are increasingly voicing their alarm at the Ministry of Health's refusal to share viruses, leaving both Indonesian and international scientists in the dark about genetic changes in the virus. ¶3. (SBU) In response to increased media attention on avian influenza in Indonesia, President Yudhoyono convened an emergency avian influenza meeting on January 30 among his ministers of Agriculture, Health and the People's Welfare and told the ministers to "fix the problem." Yudhoyono emphasized the ministers must first control the problem in the greater Jakarta area, including Tangerang, before fixing the rest of Indonesia. However, Nabarro also noted that although international AI donor funds are increasing, the Government of Indonesia's contributions have not changed. Nabarro suggested that the donor community might make more progress through working directly with district and provincial authorities. Supari Believes MTA Deal with USG Near -------------- ¶4. (SBU) In his meeting with Minister Supari, Nabarro recounted that Supari sounded optimistic that Indonesia and the US were close to resolving differences concerning use of a material transfer agreement for sample sharing and working out arrangements that would govern virus sharing. Supari cited a very positive meeting with a US official in Geneva, where she claimed an agreement was reached that both parties would work towards a satisfactory resolution of outstanding issues so that she could resume (and announce) sample sharing in April during a proposed HHS Secretary Leavitt visit to Indonesia. Supari was pushing her staff to resolve all outstanding issues before April. Supari asked Nabarro to convey her conversation to WHO Director Margaret Chan. Book Release "It's Time for the World to Change" -------------- --- ¶5. (SBU) Nabarro also reported that publishers will release Supari's book entitled "It's Time for the World to Change" during the week of February 2. The book recounts Supari's sample sharing odyssey beginning with the cluster of human cases in Karo in May 2006 through the November 2007 New Delhi talks. Throughout the book, Supari attributes her stance as something that she was "driven to do" after receiving "a calling from God." Nabarro noted that the JAKARTA 00000221 002 OF 002 book mentions WHO, US and other officials by name. The book also mentions assistance Supari has received from the Third World Network and the Government of Iran. Possible US Strategies -------------- ¶6. (SBU) The Ambassador noted that Indonesian ministries are not accurately briefing their leadership on the domestic AI situation and at times have deliberately misrepresented the facts. Senior officials including Coordinating Minister Aburizal Bakrie did not appear aware that the case fatality rate in Indonesia has increased nor grasped that the Tangerang outbreaks could eventually disrupt airline travel into Jakarta international airport. The Ambassador noted that he planned to be in Washington during the week of February 11 and would raise the following ideas: -- Washington considers immediately sending a negotiating team to Jakarta to expedite discussions between the Ministry of Health and the US to resolve remaining differences in the materials transfer agreement and other issues discussed in Geneva so that sample sharing can resume before April. -- Washington conducts an independent evaluation of USG-funded avian influenza programs in Indonesia to assure funds are optimally used. -- Avian Influenza Advisory Group recommends that President Bush send President Yudhoyono a sympathetic, private letter, offering assistance linked to immediate sharing of samples. Assistance could include helping Indonesia step up virus containment in Tangerang, improve clinical management of AI cases, and improve research and laboratory capabilities. ¶7. (SBU) Nabarro strongly agreed that these measures may be conducive to making progress in Indonesia. He urged the US to give these recommendations immediate consideration in order to capture the momentum created with President Yudhoyono's push for immediate control of the situation. Meeting Participants -------------- ¶8. (SBU) Other meeting participants included: -- Dr. Subhash Salunke, World Health Organization Representative -- John Holmes, Ambassador to Canada -- Louise Hand, Deputy Chief of Mission, Australian Embassy -- Warren Hauck, Economic Officer, Australian Embassy -- Anna Lehtinen, UN Regional Avian and Human Influenza Coordinator, Asia-Pacific Regional Hub -- Dr. Johnathan Agranoff, UN Office of the Humanitarian/Resident Coordinator. HUME