INDONESIA - MARCH 6 AVIAN INFLUENZA UPDATE

UNCLAS SECTION 01 OF 02 JAKARTA 000398 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 - MARCH 6 AVIAN INFLUENZA UPDATE ¶1. (SBU) Summary. On March 3, Bayu Krisnamurthi, head of the National Committee for Avian Influenza Control and Pandemic Preparedness (KOMNAS) announced that Indonesia has had four cases of bird flu since the beginning of 2009. However, Ministry of Health (MOH)officials have not provided permission for the World Health Organization (WHO) to post the results. Although the WHO Jakarta office was aware of these cases, officials revealed that Indonesia has not been reporting positive confirmed AI cases within 24 hours as required by International Health Regulations (IHR) nor publicly announcing cases each month. WHO plans to meet with the Ministry of Health over the next ten days to press for IHR compliance. WHO noted that a misunderstanding between the World Health Organization (WHO) and the Ministry of Health (MOH) on AI case confirmation has been resolved and may speed up reporting. The U.S. Department of Agriculture's Animal and Plant Health Inspection Service (USDA APHIS) continues to support biosecurity training in the commercial poultry sector. The Ministry of Agriculture's (MOA) Participatory Disease Surveillance and Control monthly reports show that data tracks with the up-tick in human AI infections common for this time of year. End Summary. -------------- Human Cases and IHR Compliance -------------- ¶2. (SBU) On March 3, Bayu Krisnamurthi, head of the National Committee for Avian Influenza Control and Pandemic Preparedness (KOMNAS) announced that Indonesia has had four cases of bird flu since the beginning of 2009. Although the data is limited, WHO states that under normal circumstances for the rainy season, it expects to see between six to eight cases in the month of January. Since the beginning of the year, the Directorate General of Communicable Disease and Environmental Health (DGCDEH) reported four positive cases of H5N1 to WHO. ¶3. (SBU) The reporting of cases to WHO was strained in February when the Minister of Health stated that the Government of Indonesia would not confirm H5N1 cases unless the neuraminidase (N1) was laboratory confirmed. Since the National Institute of Health Research and Development only tests for the hemagglutinin (H5),DGCDEH could not report the cases to WHO. In late February, WHO provided the Director General of DGCDEH with documentation stating that for International Health Regulations (IHR) compliance, WHO requires reporting of confirmed hemagglutinin (H5) -- regardless of the neuraminidase confirmation. Dr. Endang, the Chief AI scientist at NIHRD told WHO that reporting should be back to "normal" now that the neuraminidase issue was clarified. WHO officials also noted that although the MOH had committed to reporting positive cases to WHO within 24 hours and posting results monthly, MOH is now missing these deadlines. WHO plans to discuss this with MOH officials over the next two weeks and press for adherence to IHR requirements. -------------- Animal Health Activities -------------- ¶4. (SBU) USDA APHIS is working with the Ministry of Agriculture and the poultry industry on biosecurity. They supported two training workshops on Biosecurity Assessments in January: one with 40 members of the Poultry Breeder's association on January 20-23, and one with 20 government animal health inspectors on January 27-29. APHIS also sponsored a Regional workshop on Funding Mechanisms for Outbreak Containment and Compensation for 50 government and poultry industry participants from Indonesia and another 50 from ASEAN countries on February 24-25 in Jakarta. -------------- Status of Poultry AI Outbreaks -------------- ¶5. (SBU) The MOA's Participatory Disease Surveillance and Control Monthly Reports document the AI outbreak status of villages in the 331 (out of 444) districts covered by the Participatory Disease Surveillance and Response (PDSR) program. For the four month period from October 2008 through January 2009 the MOA reports village infection rates of 2.1%, 2.3%, 5.3%, and 8.5%, respectively. The increased infection rates in December and January track with the JAKARTA 00000398 002 OF 002 beginning of Indonesia's rainy season and mirror similar trends during the past three rainy seasons. Since May 2008, PDSR animal health officers have visited 14,086 villages (29.4% of the villages in the 331 districts). Over the past six months, the MOA reports implementing voluntary focal culling in 22.7% of infected villages. ¶6. (SBU) Although Indonesia is experiencing a seasonal upsurge in poultry outbreaks, MOA data indicates gradually decreasing poultry AI detection rates from 2006 to the present, even with increasing surveillance visits. The data further indicates decreasing geographic spread of AI, with no outbreaks in Kalimantan in well over a year, and greatly reduced outbreaks in East Java since mid-2007. However, Bali has experienced five incidents in February and East Java experienced clusters of increased outbreaks during January and February. Animal health experts in the MOA and the United Nations' Food and Agriculture Organization (UN FAO) are using the information gleaned from the improved data collection to focus and strengthen village-level AI control. ¶7. (SBU) AI remains entrenched in the western half of Java and southern Sumatra and concern continues about conditions in commercial poultry farms. USDA, the United States Agency for International Development, and other donors are implementing and expanding AI control efforts in partnership with commercial industry. Over the past year, the MOA has also increased efforts to partner with commercial industry; however, they will need to overcome significant, mutual distrust and gaps in partnership expectations. HUME