SAMPLE SHARING IMPASSE CREATES ADDITIONAL HEALTH RISKS

UNCLAS JAKARTA 000903

SIPDIS
SENSITIVE

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/ABHAT/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: SAMPLE SHARING IMPASSE CREATES ADDITIONAL HEALTH RISKS


1. (SBU) Summary. International public health officials are
focusing on the risks associated with Indonesia's refusal to share
avian influenza (AI) virus samples. Minister of Health Siti Fadilah
Supari's policies are damaging surveillance studies for other
emerging diseases and related scientific research. Current policies
impair surveillance studies for seasonal flu, diarrhea, dengue
fever, and other tropical diseases by barring NAMRU-2 from isolating
viruses or sending samples to international collaborators including
the World Health Organization (WHO) Collaborating Centers for
Influenza. This is having a direct impact on risk assessment
development of vaccines for seasonal influenza. We should continue
to negotiate in good faith with the Indonesians to resolve the avian
influenza sample sharing impasse. But stronger actions by the
international community may be necessary if sample sharing is not
resolved over the next two months. End Summary.

IMPACT FROM CURTAILMENT OF NAMRU-2 SAMPLES
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2. (SBU) Since August 1999, NAMRU-2 has collaborated with a network
of hospitals to conduct surveillance for patients with
influenza-like illness (ILI). Funded by US Centers for Disease
Control (CDC) and the Department of Defense (DOD) Global Emerging
Infections Surveillance System, the program aims to characterize
emerging and newly emerging strains of influenza and to build local
capacity to monitor patients with ILI. NAMRU shares information
gathered with the WHO Global Influenza Surveillance Network (GISN)
to make recommendations on composition of the annual tri-valent
influenza vaccine. Even with the best possible influenza vaccines,
experts estimate that seasonal influenza kills approximately
250,000-500,000 people annually worldwide, including 40,000-50,000
Americans.


3. (SBU) Since its inception, NAMRU-2 partner facilities have been
sending flu samples from approximately 500 patients per month to
NAMRU-2 for analysis and viral isolation. NAMRU-2 sends results to
partner facilities and the Indonesian National Institute of Health
Research and Development (NIHRD). Prior to the sample sharing
impasse, NAMRU-2 shipped isolated flu viruses to the CDC for
additional characterization. Between 2004 and 2008, over 15,000
patients were screened and 676 viruses were shipped to the CDC.
Since the impasse, 842 seasonal influenza viruses remain partially
characterized at NAMRU-2, but not shipped outside of Indonesia.


4. (SBU) Under the new policy, NAMRU-2 no longer receives any
biological samples. This means NAMRU-2 can no longer analyze or
ship the estimated 400 per month diarrhea samples or 500-600 per
month dengue samples it has in the past.


Two Month Negotiations
--------------


5. (SBU) With implementation of the Minister Supari's policies, the
global community is blind to newly-emerging diseases that arise in
Indonesia, including novel seasonal flu strains, drug-resistant
tuberculosis (Indonesia is #3 in the world for tuberculosis),or the
re-emergence of SARS. The Minister's approach of making all
biological samples subject to restrictions on further commercial use
brings the concept of open collaboration on public health to an end
and is a threat to global health security. As long as only
Indonesia takes this stance on sample sharing, the risks are serious
but contained. But if other nations turn away from the obligation
to share disease samples on timely basis, the risks to international
public health could become grave.


HUME