SCENESETTER FOR A/S LEAVITT'S APRIL 10 VISIT TO INDONESIA

UNCLAS SECTION 01 OF 02 JAKARTA 000710

SIPDIS

SENSITIVE
SIPDIS

DEPT FOR EAP/MTS, G/AIAG, AND OES
DEPT ALSO PASS TO HHS FOR A/S LEAVITT/WSTEIGER AND HHS/NIH
GENEVA FOR WHO/HOHMAN

E.O. 12958: N/A
TAGS: TBIO KHIV PREL EAGR PGOV ID
SUBJECT: SCENESETTER FOR A/S LEAVITT'S APRIL 10 VISIT TO INDONESIA

1.(SBU) Summary. Embassy Jakarta welcomes your visit and sees it as
an opportunity to underscore that, despite disagreement on avian
influenza sample sharing, both countries need to cooperate on
broader health issues. Our bilateral engagement on avian influenza,
which involves six USG agencies, goes beyond sample sharing. The
USG also supports programs on HIV/AIDs, tuberculosis, immunizations
and other infectious diseases. The Mission believes that increased
scientific collaboration could provide win-win opportunities for
both countries and, if played right, help us overcome the current
impasse.


2. (SBU) We have requested meetings with President Yudhoyono,
Foreign Minister Wirajuda, Minister Bakrie of the Coordinating
Ministry for People's Welfare, Health Minister Supari, and
Agriculture Minister Apriyantono. You will also participate in a
lunch with senior health officials and a field visit to a
U.S.-supported TB and HIV clinic. The Ambassador recommends that,
in all meetings, you stress the importance of our broad cooperation,
while explaining why it is essential for Indonesia to share all
samples with the international community. End summary.

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WE WANT TO RESOLVE THE SAMPLE SHARING ISSUE
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3. (SBU) Given Indonesia's widespread problem of avian influenza in
poultry and the global concern that a pandemic strain may emerge
here, we have to find a way to resolve the human avian influenza
sample sharing issue. Your visit with the President and the joint
ministerial meeting provide an opportunity to explain why it is
essential for all samples to be shared. While acknowledging that
Indonesia and other developing countries have other equities that
need to be addressed, you should patiently explain the scientific
requirement for sample sharing. The Indonesians will undoubtedly
call for increased access by developing countries to affordable
vaccines and for the WHO system to be made more "transparent and
equitable." While you should stress that our differences on this
issue should not affect our broader health collaboration, you should
point out the obvious fact that resolution of the sample sharing
issue would open up other areas for mutually beneficial
cooperation.

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WE SEE INDONESIA AS A PARTNER IN CONTROL OF AVIAN INFLUENZA
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4. (SBU) Indonesia needs to develop and implement a long-term,
sustainable program to control avian influenza for both poultry and
humans. Minister Bakrie, a businessman by background without health
expertise, is Chairman of the key inter-agency mechanism, the
National Committee for Avian Influenza Control and Pandemic
Influenza Preparedness (KOMNAS). KOMNAS coordinates Indonesia's
response to avian influenza and implements what there is of a
national avian influenza strategy.


5. (SBU) The United States devotes considerable resources (over $50
million to date) to help Indonesia respond to the current avian
influenza outbreak and plan for a possible pandemic. In June,
Embassy Jakarta plans to conduct an in-depth review of U.S.
government-supported control programs. This review will recommend
whether we need to adjust current efforts to meet the challenges
ahead. It will also provide KOMNAS a road map for better
utilization of other donor resources. KOMNAS is working on a
National Influenza Pandemic Preparedness Plan, but lacks significant
input from key ministries, as well as operational details of
Indonesia's response to an avian influenza pandemic. The United
States' interagency pandemic planning and simulation exercise
experience may be useful in filling these gaps.

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COOPERATION IN SCIENCE TECHNOLOGY EXCHANGE IS A HIGH PRIORITY
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6. (SBU) The U.S. Centers for Disease Control (CDC) and National
Institutes of Health (NIH) have a long history of collaboration with
partner institutions in Indonesia. In addition, U.S. academic
institutions have expressed interest in collaboration with

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Indonesian scientists and organizations. The sample sharing issue
has negatively affected this collaboration over the past year.
However, senior staff members in the Ministry of Health (including
the Minister) have recently expressed a renewed interest in
developing research ties and scientific exchanges with USG
institutions. Both CDC and NIH have offered to place senior
laboratory scientists at the recently opened Bio-Safety Level 3
(BSL-3) laboratory at the Eijkman Institute and the BSL-3 laboratory
currently under construction at the National Institute of Health
Research and Development (NIHRD). The Embassy recommends that, in
meetings with the Ministers of Health and People's Welfare,
Secretary Leavitt and his party discuss ways to revitalize bilateral

SIPDIS
science and technology exchange.

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OUR PRIORITY HEALTH PROGRAMS
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7. (SBU) USAID supports a range of health programs, all of which
address joint U.S.-Indonesian priorities. Activities focus on
maternal and child health care, and prevention and control of
priority infectious diseases, particularly HIV/AIDS, tuberculosis
and malaria. The recent UN Country Report indicates the HIV/AIDS
epidemic in Indonesia is one of the fastest growing in Asia with
both a concentrated epidemic in most-at-risk populations and a
generalized epidemic in Papua. There are currently 193,000
Indonesians living with HIV and epidemiological modeling estimates
there will be one million infections by 2015. Experts also predict
that the epidemic will continue to expand if coverage of programs
remains at current levels. It is essential to maintain PEPFAR
funding here to address this growing problem, particularly in the
area of civil society engagement which is critical to successful
outreach in this epidemic. Indonesia also ranks third in the world
in the global TB burden; of even more serious concern is the rising
prevalence of multiple drug resistant (MDR/XDR) TB. Your visit to
the an Indonesia Tuberculosis Control Association's clinic in
central Jakarta will highlight progress in addressing HIV and TB
services as well as overall challenges faced by the health system.

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GLOBAL FUND CHALLENGES
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8. (SBU) Indonesia is having significant difficulties implementing
its Global Fund for AIDS, TB and malaria programs at the Country
Coordinating Mechanism and the Principal Recipient levels. These
shortcomings threaten overall Global Fund funding levels and
negatively affect the credibility of Indonesia's Round 8 proposal
under development. Cuts in Global Fund funding would impact all
three national programs, but would particularly hit the HIV/AIDS
national program where the U.S. and other donors have cut funding.
You should stress the importance of improving Global Fund oversight
and implementation with Minister Bakrie.

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AI PRESS COVERAGE
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9. (SBU) The Secretary's visit has been mentioned in the press in
the context of avian influenza. Most press coverage centers around
vaccine development and related sample-sharing issues, as well as
ongoing H5N1 cases. The Mission expects that photographers and
press will follow your visit to the clinic and may be present
following your official meetings.

HUME