MGSF01: ASEAN+3 Flu Ministerial May 7-8

UNCLAS SECTION 01 OF 03 BANGKOK 001158

SIPDIS
SENSITIVE

DEPARTMENT FOR OES/IHB:JJONES,CPATTERSON; EAP FOR DHANNEMAN
DEPT FOR USAID/GBH
USDA FOR FAS AND APHIS
HHS FOR CDC
USCINCPACLO FOR AFRIMS

E.O. 12958: N/A
TAGS: KFLU AEMR ASEC CASC TBIO KSAF KPAO PREL PINR AMGT
MG, ECON, EAID, WHO, EAGR, ETRD, TH
SUBJECT: MGSF01: ASEAN+3 Flu Ministerial May 7-8

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SENSITIVE BUT UNCLASSIFIED


1. (SBU) SUMMARY: On May 8 Health Ministers from ASEAN + 3
(including China, Japan and South Korea) gathered in Bangkok for a
"Special Meeting on Influenza A(H1N1);" a senior officials meeting
took place on May 7. The resulting Joint Ministerial Statement
asserted that a pandemic was imminent, that the H5N11 avian
influenza virus was still a major threat. Participants described
Southeast Asia as the best prepared region to cope with an outbreak.
The ASEAN+3 ministers rejected imposition of travel restrictions
and committed to abiding by WHO recommendations, although the
lifting of bans on pork products was not discussed. The Ministers
noted ASEAN+3 capacity to manage an outbreak through its regional
stockpile of antiviral drugs, and committed to improving research
capacity and data sharing. CDC officials participated in DVCs, to
widespread acclaim on both days. Indonesia's participation was
notable for its opposition to mentioning CDC efforts in the Joint
Statement, and in its suggestion that CDC was not fully sharing
virus information. END SUMMARY.

BACKGROUND TO THE MINISTERIAL
--------------

2. (U) At the suggestion of the Cambodian Minister of Health, the
Thai Minister of Health agreed to host in Bangkok an ASEAN+3 H1N1
health ministerial, which the ASEAN Secretariat quickly organized
and billed the "Special Meeting on Influenza A(H1N1)." A May 7
Senior Officials Meeting preceded the Ministerial; the Philippines
chaired both meetings. Donor countries and press were invited as
observers and allowed in all sessions. All health ministers
participated except for those from Singapore, Japan and South Korea,
who sent senior officials, and Burma, represented by its Ambassador
to Thailand.


3. (U) Live speeches were made by the ASEAN Secretary General (SGY)
and the Thai Health and Prime Ministers. Digital Video Conference
presentations were made by the UN Influenza Director, the WHO
Director and Assistant Director General, and the Mexican Minister of
Health. Two officials from U.S. Centers for Disease Control and
Prevention (CDC),Dr. Anne Schuchat, Deputy Director for Science and
Richard Besser, Acting Director, made live DVC presentations that
were well-received. Each Senior Official gave a presentation on
respective national H1N1 responses.


4. (U) WHO and CDC presentations stressed the need for continuing
vigilance, drawing parallels to the mild beginning of the 1918
epidemic. The presentations recommended against closing borders or
mandating travel restrictions: containment was not possible while
the economic and social hardships would be too great. The Ministers'
Joint statement reflected agreement on these matters. The WHO
presentations emphasized that properly prepared swine products were
not a danger, but neither discussions nor the Statement touched on
the swine import prohibitions that many ASEAN members have
instituted.

ASEAN+3 PREPARED BUT NEEDS RESEARCH, VACCINE CAPACITY
-------------- --------------

5. (U) The ASEAN SGY summarized the ASEAN+3 future focus with five
points: establishing a hotline for enquiries and information
sharing; increasing coordinated surveillance; planning for exit
screening of persons with H1N1 cases leaving any member nation;
sharing laboratory research; and planning for regional vaccine and
oseltamivir production. ASEAN presenters described SE Asia as the
best prepared region in the world due to simulation exercises that
all of the ASEAN+3 had conducted as well as the communal stockpiling
of oseltamivir. Out of one million courses of treatment, 500,000
had been distributed among the members equally. Another 500,000
courses (450,000 oseltamivir and 50,000 zanamivir) remained
stockpiled in Singapore. Also stockpiled were 750,000 sets of
personal protective equipment (PPE),half distributed equally to the
ten ASEAN members (35,000 each) and 350,000 kept in Singapore. With
Japan's help, the Secretariat was working on outbreak logistics
training for all ASEAN countries.


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INDONESIAN NEGATIVITY TOWARDS CDC
--------------

6. (SBU) In an otherwise positive and forward-looking two days of
collaborative treatment of the H1N1 outbreak, Indonesian
representatives expressed concern about data sharing by, and the
role of CDC. Senior Advisor Widjaja Likito complained that CDC was
not releasing genetic sequencing for individual patients. Health
Minister Supari Siti Fadilah repeatedly tried to amend the already
agreed upon Ministerial Statement with a reference to the importance
of the Global Initiative on Sharing All Influenza Data (GISAID),and
then withdrew the proposed amendment when the Chinese Health
Minister suggested acknowledging CDC's role in H1N1 genetic
sequencing.

REMARKS PRAISE DONOR COOPERATION
--------------

7. (U) In various remarks by the ASEEAN Secretary General (SGY),the
Philippine Chair and Thai officials, all made a point of expressing
gratitude to the specific countries that had supported ASEAN
preparedness: Japan, Australia and the U.S. (CDC and USAID). The
resulting Joint Statement commits to strengthening collaborative
research and notes related efforts underway: ASEAN+3 Emerging
Infection Diseases (EID) Programme of the ASEAN secretariat (largely
funded by AusAid),the Mekong Basin Diseases Surveillance network
(MBDS) (officed in Bangkok, a partnership including CDC, USAID,
Rockefeller, Google, RAND, WHO, ADB and ASEAN) and the Asian
Partnership on Emerging Infectious Diseases Research (APAIR or
APEIR)(a partnership formed and supported by the Canadian
government's International Development Research Centre [IDRC]
Singapore office). In the final press conference, the ASEAN SGY
noted that with WHO and CDC help, ASEAN+3 would be able to meet the
technical challenges posed by H1N1.

JOINT MINISTER'S STATEMENT
--------------

8. (U) The Joint Ministers statement asserts that a "pandemic is
imminent" and noted that the H5N1 influenza virus was still a major
threat. As "imposing travel restrictions would have very little
effect on stopping the virus from spreading but would be highly
disruptive," social distancing and individual preventive measures
were preferred. The statement notes the concern that "most global
vaccine production capacity is in Europe/North American, and is
inadequate to respond to global pandemic...access to enough pandemic
vaccines is a major problem."


9. (U) In addition to the expected plans to improve preparedness and
capacity , the ASEAN +3 nations committed to complying with WHO
recommendations; considering a more formal ASEAN +3 information
sharing system; encouraging technology transfer related to
production of antivirals and vaccines; and establishing joint
outbreak teams. The Ministers committed on the national level to
"conclude the ongoing Inter-Governmental Meeting on sharing of H5N1
and other influenza viruses...and...equitable sharing of benefits."
The press release confirmed that the "meeting also touched
upon...enhancing fair and equitable share of benefits."


11. (U) POC is regional/bilateral ESTH officer Hal Howard,
howardhh@state.gov. The following documents were scanned and
emailed to the office of Ambassador to ASEAN Marciel: Schedule; List
of Participants; Press Release; Chairperson's Report; and national
presentations or speeches. The Joint Ministerial Statement can be
found at http://www.aseansec.org/22543.htm. ESTHoff emailed a
detailed report of the meeting to EAP ASEAN office and OES/IHB.
ESTHoff will email a detailed report of the meeting, including
country presentations to EAP ASEAN office and OES/IHB. The AusAid-
supported Network for Emerging Infectious Diseases in ASEAN Plus
Three tracks cases at www.aseanplus3-eid.info.

COMMENT:
--------------

12. (SBU) While the Indonesian representative's negative
interventions towards CDC marred a meeting otherwise characterized
by cooperation, virtually all other representatives repeatedly

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expressed to ESTHoff appreciation for USG efforts. Country
presentations and the Statement lacked mention of how members were
treating suspected cases, which has been controversial in some
member states. The meeting reinforced an existing mechanism for
responding to outbreaks: distributing a basic load of patient
courses of treatment to each member, and stockpiling a common
reserve that a member country can draw upon. The meeting and
Statement furthered a regional commitment to share research as well
as vaccine and drug production.


13. (SBU) Despite a few country presentations that mentioned
simulation exercises and national interagency coordination, most
focused only on health ministry efforts. Absent from the meeting
was a plan for having a regional simulation exercise to test
preparedness especially in sectors outside of the public health
ministries; USG best practices in these two areas might be an avenue
for further collaboration. USAID has been providing funding and
technical assistance since 2007 to ASEAN multi-sectoral pandemic
preparedness, including to ASEAN's Technical Working Group on
Multi-Sectoral Pandemic Preparedness. AusAid has spent $3 million
over three years on outbreak preparedness for ASEAN; the AusAid
observer told ESTHoff of a new trust fund under consideration for
outbreak preparation and response and that partnership with the USG
would be welcome.

JOHN