Currently released so far... 97115 / 251,287
Articles
Brazil
Sri Lanka
United Kingdom
Sweden
00. Editorial
United States
Latin America
Egypt
Jordan
Yemen
Thailand
Browse latest releases
2010/12/01
2010/12/02
2010/12/03
2010/12/04
2010/12/05
2010/12/06
2010/12/07
2010/12/08
2010/12/09
2010/12/10
2010/12/11
2010/12/12
2010/12/13
2010/12/14
2010/12/15
2010/12/16
2010/12/17
2010/12/18
2010/12/19
2010/12/20
2010/12/21
2010/12/22
2010/12/23
2010/12/25
2010/12/26
2010/12/27
2010/12/28
2010/12/29
2010/12/30
2011/01/01
2011/01/02
2011/01/04
2011/01/05
2011/01/07
2011/01/09
2011/01/11
2011/01/12
2011/01/13
2011/01/14
2011/01/15
2011/01/16
2011/01/17
2011/01/18
2011/01/19
2011/01/20
2011/01/21
2011/01/22
2011/01/23
2011/01/24
2011/01/25
2011/01/26
2011/01/27
2011/01/28
2011/01/29
2011/01/30
2011/01/31
2011/02/01
2011/02/02
2011/02/03
2011/02/04
2011/02/05
2011/02/06
2011/02/07
2011/02/08
2011/02/09
2011/02/10
2011/02/11
2011/02/12
2011/02/13
2011/02/14
2011/02/15
2011/02/16
2011/02/17
2011/02/18
2011/02/19
2011/02/20
2011/02/21
2011/02/22
2011/02/23
2011/02/24
2011/02/25
2011/02/26
2011/02/27
2011/02/28
2011/03/01
2011/03/02
2011/03/03
2011/03/04
2011/03/05
2011/03/06
2011/03/07
2011/03/08
2011/03/09
2011/03/10
2011/03/11
2011/03/13
2011/03/14
2011/03/15
2011/03/16
2011/03/17
2011/03/18
2011/03/19
2011/03/20
2011/03/21
2011/03/22
2011/03/23
2011/03/24
2011/03/25
2011/03/26
2011/03/27
2011/03/28
2011/03/29
2011/03/30
2011/03/31
2011/04/01
2011/04/02
2011/04/03
2011/04/04
2011/04/05
2011/04/06
2011/04/07
2011/04/08
2011/04/09
2011/04/10
2011/04/11
2011/04/12
2011/04/13
2011/04/14
2011/04/15
2011/04/16
2011/04/17
2011/04/18
2011/04/19
2011/04/20
2011/04/21
2011/04/22
2011/04/23
2011/04/24
2011/04/25
2011/04/26
2011/04/27
2011/04/28
2011/04/29
2011/04/30
2011/05/01
2011/05/02
2011/05/03
2011/05/04
2011/05/05
2011/05/06
2011/05/07
2011/05/09
2011/05/10
2011/05/11
2011/05/12
2011/05/13
2011/05/14
2011/05/15
2011/05/16
2011/05/17
2011/05/18
2011/05/19
2011/05/20
2011/05/21
2011/05/22
2011/05/23
2011/05/24
2011/05/25
2011/05/26
2011/05/27
2011/05/28
2011/05/29
2011/05/30
2011/05/31
2011/06/01
2011/06/02
2011/06/03
2011/06/04
2011/06/05
2011/06/06
2011/06/07
2011/06/08
2011/06/09
2011/06/10
2011/06/11
2011/06/12
2011/06/13
2011/06/14
2011/06/15
2011/06/16
2011/06/17
2011/06/18
2011/06/19
2011/06/20
2011/06/21
2011/06/22
2011/06/23
2011/06/24
2011/06/25
2011/06/26
2011/06/27
2011/06/28
2011/06/29
2011/06/30
2011/07/01
2011/07/02
2011/07/04
2011/07/05
2011/07/06
2011/07/07
2011/07/08
2011/07/10
2011/07/11
2011/07/12
2011/07/13
2011/07/14
2011/07/15
2011/07/16
2011/07/17
2011/07/18
2011/07/19
2011/07/20
2011/07/21
2011/07/22
2011/07/23
2011/07/25
2011/07/27
2011/07/28
2011/07/29
2011/07/31
2011/08/01
2011/08/02
2011/08/03
2011/08/05
2011/08/06
2011/08/07
2011/08/08
2011/08/10
2011/08/11
2011/08/12
2011/08/13
2011/08/15
2011/08/16
2011/08/17
2011/08/19
2011/08/21
2011/08/22
2011/08/23
2011/08/24
2011/08/25
Browse by creation date
Browse by origin
Embassy Athens
Embassy Asuncion
Embassy Astana
Embassy Asmara
Embassy Ashgabat
Embassy Apia
Embassy Antananarivo
Embassy Ankara
Embassy Amman
Embassy Algiers
Embassy Addis Ababa
Embassy Accra
Embassy Abuja
Embassy Abu Dhabi
Embassy Abidjan
Consulate Auckland
Consulate Amsterdam
Consulate Alexandria
Consulate Adana
American Institute Taiwan, Taipei
Embasy Bonn
Embassy Bujumbura
Embassy Buenos Aires
Embassy Budapest
Embassy Bucharest
Embassy Brussels
Embassy Bridgetown
Embassy Brazzaville
Embassy Bratislava
Embassy Brasilia
Embassy Bogota
Embassy Bishkek
Embassy Bern
Embassy Berlin
Embassy Belmopan
Embassy Belgrade
Embassy Beirut
Embassy Beijing
Embassy Banjul
Embassy Bangui
Embassy Bangkok
Embassy Bandar Seri Begawan
Embassy Bamako
Embassy Baku
Embassy Baghdad
Consulate Belfast
Consulate Barcelona
Embassy Cotonou
Embassy Copenhagen
Embassy Conakry
Embassy Colombo
Embassy Chisinau
Embassy Caracas
Embassy Canberra
Embassy Cairo
Consulate Curacao
Consulate Ciudad Juarez
Consulate Chiang Mai
Consulate Chennai
Consulate Chengdu
Consulate Casablanca
Consulate Cape Town
Consulate Calgary
Embassy Dushanbe
Embassy Dublin
Embassy Doha
Embassy Djibouti
Embassy Dili
Embassy Dhaka
Embassy Dar Es Salaam
Embassy Damascus
Embassy Dakar
DIR FSINFATC
Consulate Dusseldorf
Consulate Durban
Consulate Dubai
Consulate Dhahran
Embassy Guatemala
Embassy Grenada
Embassy Georgetown
Embassy Gaborone
Consulate Guayaquil
Consulate Guangzhou
Consulate Guadalajara
Embassy Helsinki
Embassy Harare
Embassy Hanoi
Consulate Hong Kong
Consulate Ho Chi Minh City
Consulate Hermosillo
Consulate Hamilton
Consulate Hamburg
Consulate Halifax
Embassy Kyiv
Embassy Kuwait
Embassy Kuala Lumpur
Embassy Kolonia
Embassy Kinshasa
Embassy Kingston
Embassy Kigali
Embassy Khartoum
Embassy Kathmandu
Embassy Kampala
Embassy Kabul
Consulate Krakow
Consulate Kolkata
Consulate Karachi
Consulate Kaduna
Embassy Luxembourg
Embassy Lusaka
Embassy Luanda
Embassy London
Embassy Lome
Embassy Ljubljana
Embassy Lisbon
Embassy Lima
Embassy Lilongwe
Embassy Libreville
Embassy La Paz
Consulate Leipzig
Consulate Lahore
Consulate Lagos
Mission USOSCE
Mission USNATO
Mission UNESCO
Mission Geneva
Embassy Muscat
Embassy Moscow
Embassy Montevideo
Embassy Monrovia
Embassy Mogadishu
Embassy Minsk
Embassy Mexico
Embassy Mbabane
Embassy Maseru
Embassy Maputo
Embassy Manila
Embassy Manama
Embassy Managua
Embassy Malabo
Embassy Madrid
Consulate Munich
Consulate Mumbai
Consulate Montreal
Consulate Monterrey
Consulate Milan
Consulate Merida
Consulate Melbourne
Consulate Matamoros
Consulate Marseille
Embassy Nouakchott
Embassy Nicosia
Embassy Niamey
Embassy New Delhi
Embassy Ndjamena
Embassy Nassau
Embassy Nairobi
Consulate Nuevo Laredo
Consulate Naples
Consulate Naha
Consulate Nagoya
Embassy Pristina
Embassy Pretoria
Embassy Praia
Embassy Prague
Embassy Port Of Spain
Embassy Port Moresby
Embassy Port Louis
Embassy Port Au Prince
Embassy Podgorica
Embassy Phnom Penh
Embassy Paris
Embassy Paramaribo
Embassy Panama
Consulate Ponta Delgada
Consulate Peshawar
REO Mosul
REO Kirkuk
REO Hillah
REO Basrah
Embassy Rome
Embassy Riyadh
Embassy Riga
Embassy Reykjavik
Embassy Rangoon
Embassy Rabat
Consulate Rio De Janeiro
Consulate Recife
Secretary of State
Embassy Suva
Embassy Stockholm
Embassy Sofia
Embassy Skopje
Embassy Singapore
Embassy Seoul
Embassy Sarajevo
Embassy Santo Domingo
Embassy Santiago
Embassy Sanaa
Embassy San Salvador
Embassy San Jose
Consulate Surabaya
Consulate Strasbourg
Consulate St Petersburg
Consulate Shenyang
Consulate Shanghai
Consulate Sapporo
Consulate Sao Paulo
Embassy Tunis
Embassy Tripoli
Embassy Tokyo
Embassy Tirana
Embassy The Hague
Embassy Tel Aviv
Embassy Tehran
Embassy Tegucigalpa
Embassy Tbilisi
Embassy Tashkent
Embassy Tallinn
Consulate Toronto
Consulate Tijuana
Consulate Thessaloniki
USUN New York
USMISSION USTR GENEVA
USEU Brussels
US Office Almaty
US Mission Geneva
US Mission CD Geneva
US Interests Section Havana
US Delegation, Secretary
US Delegation FEST TWO
UNVIE
UN Rome
Embassy Ulaanbaatar
Embassy Vilnius
Embassy Vientiane
Embassy Vienna
Embassy Vatican
Embassy Valletta
Consulate Vladivostok
Consulate Vancouver
Browse by tag
AF
ADANA
ASEC
AFIN
AMGT
AE
AORC
AID
AR
AO
AU
ASEAN
AGOA
AFGHANISTAN
AFFAIRS
AMED
APER
ASECARP
APEC
AEMR
AS
AA
ANET
AFLU
ABLD
AL
ASUP
AJ
APECO
AMER
ABUD
AODE
AM
AFSN
AESC
AND
AG
ALOW
AROC
AVIANFLU
ATRN
ACOA
AEGR
AMGMT
AADP
AFSI
ACABQ
APRM
AZ
AIDS
ASE
AGAO
ADCO
ABDALLAH
ARF
AIDAC
ACOTA
ASCH
AC
ASEG
AGR
ACS
AMCHAMS
AN
AMIA
ASIG
ADPM
ADB
ANARCHISTS
ALOWAR
ARM
AUC
AINF
AINT
AORG
AY
AVIAN
AMEDCASCKFLO
AK
ARSO
ARABBL
ASO
ANTITERRORISM
ARABL
AOWC
AGRICULTURE
ALJAZEERA
AMTC
AFINM
AOCR
ABER
ARR
AFPK
ASSEMBLY
ASSK
AZE
AORCYM
AINR
AGMT
AEC
ACKM
APRC
AIN
ASCC
AFPREL
ASED
APERTH
ASFC
ASECTH
AFSA
AOMS
AORCO
ANTXON
ARC
AFAF
ADIP
AIAG
AFARI
AEMED
AORL
AX
ASECAF
AOPC
ASECAFIN
AFZAL
APCS
AMB
AGUIRRE
AEMRASECCASCKFLOMARRPRELPINRAMGTJMXL
AIT
ARCH
AMEX
ALI
AQ
ATFN
AMBASSADOR
AORCD
AVIATION
ARAS
AINFCY
ACBAQ
AOPR
AREP
ALEXANDER
ATRD
AEIR
AOIC
ABLDG
ASEX
AFR
ASCE
ATRA
ASEK
AER
ALOUNI
AMCT
AVERY
APR
AMAT
AEMRS
ASPA
AFU
AMG
ATPDEA
ALL
AECL
ACAO
ASECKFRDCVISKIRFPHUMSMIGEG
AORD
AFL
AME
ADM
ASECPHUM
AGIT
ABT
ASECVE
AGUILAR
AT
ABMC
ALZUGUREN
ANGEL
ASR
ANTONIO
BMGT
BEXP
BM
BG
BL
BA
BR
BTA
BO
BY
BBSR
BLUE
BK
BF
BTIO
BELLVIEW
BE
BU
BN
BH
BD
BC
BTC
BILAT
BT
BX
BRUSSELS
BP
BB
BRPA
BUSH
BURMA
BMENA
BESP
BIT
BBG
BGD
BMEAID
BAGHDAD
BEN
BIO
BMOT
BWC
BLUNT
BURNS
BUT
BGMT
BAIO
BCW
BOEHNER
BFIF
BOL
BASHAR
BIMSTEC
BOU
BIDEN
BZ
BFIN
BTRA
BI
BHUM
BOIKO
BERARDUCCI
BOUCHAIB
BORDER
BEXPC
BTIU
BTT
BIOS
BEXB
BGPGOV
BOND
BLR
CE
CG
CH
CVR
CASC
CU
CI
CD
CO
CDG
CB
CJAN
CPAS
COM
CVIS
CMGT
CT
CENTCOM
CNARC
CTERR
COUNTER
CHIEF
CDC
CTR
CBW
COUNTRY
CLEARANCE
CY
CA
CM
CS
CWC
CN
CITES
CF
CWG
CIVS
CFIS
CASCC
CROATIA
CONS
COUNTERTERRORISM
CASA
COE
CJ
CHR
CODEL
CR
CBC
CACS
CHERTOFF
CAS
CONTROL
CONDITIONS
CONDOLEEZZA
CITEL
CV
CLINTON
CHG
CZ
CON
CTBT
CEN
CRIMES
COMMERCE
CLOK
CRISTINA
CFED
CARC
CND
CTM
CARICOM
COUNTRYCLEARANCE
CBTH
CHINA
CSW
CICTE
CJUS
CYPRUS
CW
CAMBODIA
CENSUS
CIDA
CRIME
CBG
CBE
CMGMT
CAIO
CEC
CARSON
CPCTC
CEDAW
COMESA
CVIA
CWCM
CEA
COSI
CAPC
CGEN
COPUOS
CGOPRC
COETRD
CKGR
CFE
CQ
CITT
CIC
CARIB
CVIC
CLO
CAFTA
CVISU
CHRISTOPHER
CACM
CIAT
CDB
CIS
CUL
CHAO
CNC
CL
CSEP
COMMAND
CENTER
COL
CAN
CAJC
CUIS
CONSULAR
CLMT
CIA
CBSA
CEUDA
CAC
CROS
CIO
CPUOS
CKOR
CVPR
CONG
CONTROLS
CEPTER
CVISCMGTCASCKOCIASECPHUMSMIGKIRF
CDCE
DPOL
DEMARCHE
DHS
DR
DA
DISENGAGEMENT
DEMOCRATIC
DEFENSE
DJ
DY
DARFUR
DHRF
DEA
DTRO
DPRK
DO
DARFR
DOC
DRL
DK
DOJ
DTRA
DOMESTIC
DAC
DOD
DEAX
DIEZ
DEOC
DELTAVIOLENCE
DCOM
DMINE
DRC
DCG
DPKO
DOMESTICPOLITICS
DE
DB
DOT
DEPT
DOE
DHLAKAMA
DHSX
DS
DKEM
DAO
DCM
DANIEL
DEM
DAVID
DCRM
ETRD
EAGR
ETTC
EAID
ECON
EFIN
ECIN
EINV
ELAB
EAIR
ENRG
EPET
EWWT
ECPS
EIND
EMIN
ELTN
EC
ETMIN
EUC
EZ
ET
ELECTIONS
ENVR
EU
EUN
EG
EINT
ER
ECONOMICS
ES
EMS
ENIV
EEB
EN
ECE
ECOSOC
EK
ENVIRONMENT
EFIS
EI
EWT
ENGRD
ECPSN
EXIM
EIAD
ERIN
ECPC
EDEV
ENGY
ECTRD
EPA
ESTH
ECCT
EINVECON
ENGR
ERTD
EUR
EAP
EWWC
ELTD
EL
EXIMOPIC
EXTERNAL
ETRDEC
ESCAP
ECO
EGAD
ELNT
ECONOMIC
ENV
ETRN
EIAR
EUMEM
ENRGPARMOTRASENVKGHGPGOVECONTSPLEAID
EREL
ECOM
ECONETRDEAGRJA
ETCC
ETRG
ECONOMY
EMED
ETR
ENERG
EITC
EFINOECD
EURM
EENG
ERA
EXPORT
ENRD
ECONEINVETRDEFINELABETRDKTDBPGOVOPIC
EGEN
EBRD
EVIN
ETRAD
ECOWAS
EFTA
ECONETRDBESPAR
EGOVSY
EPIN
EID
ECONENRG
EDRC
ESENV
ETT
EB
ENER
ELTNSNAR
ECHEVARRIA
ETRC
EPIT
EDUC
ESA
EFI
ENRGY
ESCI
EE
EAIDXMXAXBXFFR
EETC
ECIP
EIAID
EIVN
EBEXP
ESTN
EING
EGOV
ETRA
EPETEIND
ELAN
ETRDGK
EAIDRW
ETRDEINVECINPGOVCS
EPEC
ENVI
ELN
EAG
EPCS
EPRT
EPTED
ETRB
EUM
EAIDS
EFIC
EFINECONEAIDUNGAGM
EAIDAR
ESF
EIDN
ELAM
EDU
EV
EAIDAF
ECN
EDA
EXBS
EINTECPS
ENRGTRGYETRDBEXPBTIOSZ
EPREL
EAC
EINVEFIN
ETA
EAGER
EINDIR
ECA
ECLAC
ELAP
EITI
EUCOM
ECONEFINETRDPGOVEAGRPTERKTFNKCRMEAID
EARG
ELDIN
EINVKSCA
ENNP
EFINECONCS
EFINTS
ECCP
ETC
EAIRASECCASCID
EINN
ETRP
EAIDNI
EFQ
ECOQKPKO
EGPHUM
EBUD
ECONEINVEFINPGOVIZ
ENERGY
ELB
EINDETRD
EMI
ECONEFIN
EIB
EURN
ETRDEINVTINTCS
EIN
EFIM
ETIO
ELAINE
EMN
EATO
EWTR
EIPR
EINVETC
ETTD
ETDR
EIQ
ECONCS
EPPD
ENRGIZ
EISL
ESPINOSA
ELEC
EAIG
ESLCO
EUREM
ENTG
ERD
EINVECONSENVCSJA
EEPET
EUNCH
ECINECONCS
ETRO
ETRDECONWTOCS
ECUN
EFND
EPECO
EAIRECONRP
ERGR
ETRDPGOV
ECPN
ENRGMO
EPWR
EET
EAIS
EAGRE
EDUARDO
EAGRRP
EAIDPHUMPRELUG
EICN
ECONQH
EVN
EGHG
ELBR
EINF
EAIDHO
EENV
ETEX
ERNG
ED
FR
FREEDOM
FINREF
FJ
FI
FRELIMO
FOREIGN
FAA
FETHI
FAS
FTAA
FRB
FAO
FCS
FINANCE
FWS
FTA
FEMA
FDA
FLU
FRANCISCO
FBI
FORCE
FO
FARC
FK
FT
FCSC
FAC
FM
FMGT
FINV
FCSCEG
FARM
FERNANDO
FINR
FIN
FINE
FIR
FDIC
FOR
FOI
FCUL
FKLU
FMLN
FISO
FIXED
GM
GMUS
GG
GR
GE
GAZA
GT
GH
GZ
GJ
GLOBAL
GV
GABY
GOI
GA
GCC
GB
GY
GATT
GC
GUAM
GEORGE
GTIP
GOV
GOMEZ
GUTIERREZ
GL
GKGIC
GF
GU
GWI
GARCIA
GTMO
GN
GANGS
GIPNC
GAERC
GREGG
GUILLERMO
GASPAR
GERARD
GI
HK
HR
HUMANR
HUMAN
HO
HA
HUMANRIGHTS
HU
HHS
HIV
HUM
HRKAWC
HILLEN
HILLARY
HDP
HUMRIT
HSTC
HUMANITARIAN
HCOPIL
HADLEY
HURI
HL
HRETRD
HOURANI
HG
HARRIET
HESHAM
HI
HNCHR
HARRY
HRECON
HRC
HOSTAGES
HEBRON
HUMOR
HSWG
HYMPSK
HECTOR
HN
HYDE
HUD
HRPGOV
HIGHLIGHTS
ID
ILC
IS
IZ
ICAO
IMO
ITU
IR
IAEA
ICRC
IPROP
IT
IBRD
ISRAELI
IRAQI
ISSUES
ITRA
IV
IO
IGAD
IRAQ
IN
IMF
ICTR
ISCON
IADB
IDB
IEA
INR
IWC
ICCAT
ILO
INMARSAT
IOM
ICJ
IQ
ISPA
ITRD
IPR
INTELSAT
ISN
IAHRC
INTERNAL
IFAD
IICA
IHO
IRAN
IL
IRCE
IC
INTELLECTUAL
IRM
IE
ICTY
IDLI
IFO
ISCA
INF
INL
ISRAEL
INV
IBB
INFLUENZA
ISPL
ITER
ITIA
INRA
ISAF
IACHR
INTERPOL
IFR
IRS
INRB
IEF
ISAAC
ICC
INDO
IIP
IATTC
INAUGURATION
IND
INS
IZPREL
IACI
IEFIN
INNP
ILAB
IA
IMTS
ITALY
ITALIAN
IFIN
IRAJ
IX
ICG
IF
ITPHUM
ITA
IP
IACW
IK
IUCN
IZEAID
IRPE
IDA
ISLAMISTS
ITF
INRO
IBET
IDP
IRC
ISO
ICES
IRMO
ITPGOV
IQNV
IMSO
IRDB
IMET
INCB
IFRC
JA
JO
JP
JM
JCIC
JOHN
JE
JEFFERY
JS
JUS
JN
JOHNNIE
JAMES
JKUS
JOSEPH
JML
JAWAD
JSRP
JIMENEZ
JOSE
JKJUS
JK
JAPAN
KMDR
KPAO
KPKO
KJUS
KCRM
KGHG
KFRD
KWMN
KDEM
KTFN
KHIV
KGIC
KIDE
KSCA
KNNP
KHUM
KIPR
KSUM
KISL
KIRF
KCOR
KRCM
KPAL
KWBG
KN
KS
KOMC
KSEP
KFLU
KPWR
KTIA
KSEO
KMPI
KHLS
KICC
KSTH
KMCA
KVPR
KPRM
KE
KU
KZ
KFLO
KSAF
KTIP
KTEX
KBCT
KOCI
KOLY
KOR
KAWC
KACT
KUNR
KTDB
KSTC
KLIG
KSKN
KNN
KCFE
KCIP
KGHA
KHDP
KPOW
KUNC
KDRL
KV
KPREL
KCRS
KPOL
KRVC
KRIM
KGIT
KWIR
KT
KIRC
KOMO
KRFD
KUWAIT
KG
KFIN
KSCI
KTFIN
KFTN
KGOV
KPRV
KSAC
KGIV
KCRIM
KPIR
KSOC
KBIO
KW
KGLB
KMWN
KPO
KFSC
KSEAO
KSTCPL
KSI
KPRP
KREC
KFPC
KUNH
KCSA
KMRS
KNDP
KR
KICCPUR
KPPAO
KCSY
KTBT
KCIS
KNEP
KFRDCVISCMGTCASCKOCIASECPHUMSMIGEG
KNNB
KGCC
KINR
KPOP
KMFO
KENV
KNAR
KVIR
KDRG
KDMR
KFCE
KNAO
KDEN
KGCN
KICA
KIMMITT
KMCC
KLFU
KMSG
KSEC
KUM
KCUL
KMNP
KSMT
KCOM
KOMCSG
KSPR
KPMI
KRAD
KIND
KCRP
KAUST
KWAWC
KTER
KCHG
KRDP
KPAS
KITA
KTSC
KPAOPREL
KWGB
KIRP
KJUST
KMIG
KLAB
KTFR
KSEI
KSTT
KAPO
KSTS
KLSO
KWNN
KPOA
KHSA
KNPP
KPAONZ
KBTS
KWWW
KY
KJRE
KPAOKMDRKE
KCRCM
KSCS
KWMNCI
KESO
KWUN
KPLS
KIIP
KEDEM
KPAOY
KRIF
KGICKS
KREF
KTRD
KFRDSOCIRO
KTAO
KJU
KWMNPHUMPRELKPAOZW
KEN
KO
KNEI
KEMR
KKIV
KEAI
KWAC
KRCIM
KWCI
KFIU
KWIC
KCORR
KOMS
KNNO
KPAI
KBWG
KTTB
KTBD
KTIALG
KILS
KFEM
KTDM
KESS
KNUC
KPA
KOMCCO
KCEM
KRCS
KWBGSY
KNPPIS
KNNPMNUC
KWN
KERG
KLTN
KALM
KCCP
KSUMPHUM
KREL
KGH
KLIP
KTLA
KAWK
KWMM
KVRP
KVRC
KAID
KSLG
KDEMK
KX
KIF
KNPR
KCFC
KFTFN
KTFM
KPDD
KCERS
KMOC
KDEMAF
KMEPI
KEMS
KDRM
KEPREL
KBTR
KEDU
KNP
KIRL
KNNR
KMPT
KISLPINR
KTPN
KA
KJUSTH
KPIN
KDEV
KTDD
KAKA
KFRP
KWNM
KTSD
KINL
KJUSKUNR
KWWMN
KECF
KWBC
KPRO
KVBL
KOM
KFRDKIRFCVISCMGTKOCIASECPHUMSMIGEG
KEDM
KFLD
KLPM
KRGY
KNNF
KICR
KIFR
KM
KWMNCS
KAWS
KLAP
KPAK
KDDG
KCGC
KID
KNSD
KMPF
KPFO
KDP
KCMR
KRMS
KNPT
KNNNP
KTIAPARM
KDTB
KNUP
KPGOV
KNAP
KNNC
KUK
KSRE
KREISLER
KIVP
KQ
KTIAEUN
KPALAOIS
KRM
KISLAO
KWM
KFLOA
LE
LU
LH
LA
LG
LO
LY
LANTERN
LI
LABOR
LORAN
LTTE
LT
LAS
LAB
LAW
LVPR
LARREA
LEBIK
LAURA
LS
LOTT
LOVE
LR
LEON
LAVIN
LGAT
LV
LAOS
LOG
LN
LB
MOPS
MO
MARR
ML
MASS
MZ
MR
MNUC
MX
MV
MCC
MY
MEDIA
MTCRE
MG
MCAP
MOPPS
MP
MI
MK
MC
MD
MA
MU
MASC
MW
MT
MEPP
MN
MTCR
MH
MEPI
MIL
MNUCPTEREZ
MMAR
MICHAEL
MUNC
MDC
MPOS
MONUC
MAR
MGMT
MAS
MEPN
MENDIETA
MARIA
MONTENEGRO
MOOPS
MSG
MARITIME
MURRAY
MUKASEY
MOTO
MCA
MFO
MEX
MRSEC
MMED
MACP
MAAR
MINUSTAH
MCCONNELL
MAPP
MGT
MARQUEZ
MANUEL
MNUR
MCCAIN
MF
MOHAMMAD
MOHAMED
MNU
MFA
MILITANTS
MINORITIES
MTS
MLS
MILI
MIAH
MEETINGS
MERCOSUR
MED
MARAD
MNVC
MINURSO
MNUCUN
MIK
MARK
MBM
MPP
MILITARY
MAPS
MNUK
MILA
MTRRE
MACEDONIA
MICHEL
MASSMNUC
MUCN
MQADHAFI
MPS
MARRGH
MRCRE
MTRE
MORALES
MAP
MCTRE
MHUC
MOPSGRPARM
MOROCCO
MCAPS
NL
NU
NS
NI
NPT
NATO
NO
NG
NATEU
NSF
NZ
NAS
NP
NDP
NLD
NGO
NEPAD
NAFTA
NASA
NEA
NGUYEN
NIH
NK
NIPP
NONE
NR
NANCY
NEGROPONTE
NRR
NERG
NSSP
NSG
NSFO
NE
NATSIOS
NFSO
NATIONAL
NTDB
NT
NCD
NTSB
NRC
NELSON
NAM
NH
NPG
NEC
NSC
NFATC
NMFS
NATOIRAQ
NAR
NZUS
NARC
NCCC
NA
NC
NEW
NRG
NUIN
NOVO
NATOPREL
NEY
NV
NICHOLAS
NPA
NW
NARCOTICS
NORAD
NOAA
NON
NTTC
NKNNP
NMNUC
NUMBERING
ODIP
OIIP
OPRC
OSCE
OREP
OTRA
OPET
OSCI
OVIP
OECD
OCII
OUALI
OPDC
OEXC
OFPD
OPIC
OFDP
OPCW
OECV
OAS
OM
OMIG
ODAG
OPREP
ORA
OIC
OEXCSCULKPAO
OIG
OASS
OFFICIALS
ORTA
OSAC
OIL
OIE
OEXP
OPEC
OPDAT
OMS
OES
OHI
OMAR
OCRA
OFSO
OCBD
OSTA
OAO
ONA
OTP
ORC
OAU
OXEC
OA
ODPC
OPDP
OVIPPRELUNGANU
OASC
OSHA
OPCD
OTR
OPPI
OPCR
OF
OFDPQIS
OSIC
OHUM
OSTRA
OASCC
OBSP
OFDA
OPICEAGR
OIM
OGAC
OTA
OTRAORP
OPPC
OESC
OCEA
OVP
ON
OPAD
OTAR
OCS
ODC
OTRD
OCED
OSD
ORUE
OREG
PHUM
PINR
PTER
PGOV
PREL
PREF
PL
PM
PHSA
PE
PARM
PINS
PK
PUNE
PO
PALESTINIAN
PU
PBTS
PROP
PTBS
POL
POLI
PA
PGOVZI
POLMIL
POLITICAL
PARTIES
POLM
PD
POLITICS
POLICY
PAS
PMIL
PINT
PNAT
PV
PKO
PPOL
PERSONS
PING
PBIO
PH
PETR
PARMS
PRES
PCON
PETERS
PRELBR
PT
PLAB
PP
PAK
PDEM
PKPA
PSOCI
PF
PLO
PTERM
PJUS
PSOE
PELOSI
PROPERTY
PGOVPREL
PARP
PRL
PNIR
PHUMKPAL
PG
PREZ
PGIC
PBOV
PAO
PKK
PROV
PHSAK
PHUMPREL
PROTECTION
PGOVBL
PSI
PRELPK
PGOVENRG
PUM
PRELKPKO
PATTY
PSOC
PRIVATIZATION
PRELSP
PGOVEAIDUKNOSWGMHUCANLLHFRSPITNZ
PMIG
PREC
PAIGH
PROG
PSHA
PARK
PETER
POG
PHUS
PPREL
PS
PTERPREL
PRELPGOV
POV
PKPO
PGOVECON
POUS
PGOVPRELPHUMPREFSMIGELABEAIDKCRMKWMN
PWBG
PMAR
PREM
PAR
PNR
PRELPGOVEAIDECONEINVBEXPSCULOIIPBTIO
PARMIR
PGOVGM
PHUH
PARTM
PN
PRE
PTE
PY
POLUN
PPEL
PDOV
PGOVSOCI
PIRF
PGOVPM
PBST
PRELEVU
PGOR
PBTSRU
PRM
PRELKPAOIZ
PGVO
PERL
PGOC
PAGR
PMIN
PHUMR
PVIP
PPD
PGV
PRAM
PINL
PKPAL
PTERE
PGOF
PINO
PHAS
PODC
PRHUM
PHUMA
PREO
PPA
PEPFAR
PGO
PRGOV
PAC
PRESL
PORG
PKFK
PEPR
PRELP
PREFA
PNG
PGOVPHUMKPAO
PRELECON
PINOCHET
PFOR
PGOVLO
PHUMBA
PRELC
PREK
PHUME
PHJM
POLINT
PGOVPZ
PGOVKCRM
PGOVE
PHALANAGE
PARTY
PECON
PEACE
PROCESS
PLN
PRELSW
PAHO
PEDRO
PRELA
PASS
PPAO
PGPV
PNUM
PCUL
PGGV
PSA
PGOVSMIGKCRMKWMNPHUMCVISKFRDCA
PGIV
PRFE
POGOV
PEL
PBT
PAMQ
PINF
PSEPC
POSTS
PHUMPGOV
PVOV
PHSAPREL
PROLIFERATION
PENA
PRELTBIOBA
PIN
PRELL
PGOVPTER
PHAM
PHYTRP
PTEL
PTERPGOV
PHARM
PROTESTS
PRELAF
PKBL
PRELKPAO
PKNP
PARMP
PHUML
PFOV
PERM
PUOS
PRELGOV
PHUMPTER
PARAGRAPH
PERURENA
PBTSEWWT
PCI
PETROL
PINSO
PINSCE
PQL
PEREZ
PBS
RS
REFUGEES
RW
RP
RELFREE
RO
REGIONAL
RIGHTS
REACTION
REPORT
RU
RENAMO
RIGHTSPOLMIL
REFORM
RM
REFUGEE
REL
RELATIONS
ROW
RREL
REGION
RATIFICATION
RBI
RICE
ROOD
RODENAS
RUIZ
RODHAM
ROBERT
RGY
ROY
REUBEN
RELIGIOUS
RUEHZO
RODRIGUEZ
RUEUN
RELAM
RSP
RF
RSO
RCMP
REO
ROSS
RPTS
RENE
REID
RUPREL
RMA
RI
REMON
RPEL
RFE
RFIN
RA
RAFAEL
RAY
RUS
RPREL
ROBERTG
RECIN
RAMONTEIJELO
SNAR
SP
SN
SMIG
SL
SOCI
SU
SG
SF
SENV
SZ
SOE
SCUL
SY
SO
SR
SYR
SE
SA
SW
SIPDIS
SCIENCE
SADC
SI
SCI
SOCIETY
SC
SAARC
STR
SECRETARY
SANC
SSH
ST
SNA
SGWI
SEP
SOCIS
SETTLEMENTS
SPECIALIST
SK
SHUM
START
STET
SCVL
SREF
SCHUL
SCUIL
SYRIA
SECURITY
SPCE
SYAI
SMIL
SOWGC
STEPHEN
SNRV
SKCA
SENSITIVE
SECI
SNAP
SPP
SCUD
SOM
SPECI
SMIGBG
SENC
SCRM
SGNV
SECTOR
SENVEAGREAIDTBIOECONSOCIXR
SENVSXE
SASIAIN
SACU
SENVSPL
SWMN
STEINBERG
SOPN
SOCR
SCOI
SCRS
SILVASANDE
SWE
SARS
SNARIZ
SUDAN
SENVQGR
SM
SNARKTFN
SAAD
SD
SAN
SIPRNET
STATE
SENS
SUBJECT
SFNV
SECSTATE
SSA
SPCVIS
SOI
SOFA
SCULKPAOECONTU
SPTER
SKSAF
SENVKGHG
SHI
SEVN
SANR
SPSTATE
SMITH
SCOM
SH
SNARCS
SNARN
SIPRS
SNARM
SIPDI
SCPR
SNIG
SELAB
SULLIVAN
SENVENV
SECDEF
SOLIC
SOIC
SPAS
SASC
SOSI
SEC
SEN
SENVCASCEAIDID
TU
TH
TW
TSPA
TRGY
TPHY
TBIO
TIFA
TS
TZ
TX
TSPL
TT
TK
TC
TINT
TERFIN
TERRORISM
TIP
TURKEY
TI
TECHNOLOGY
TNGD
TRSY
TRAFFICKING
TOPEC
TPSL
TP
TD
TR
TA
TIO
TREATY
TO
THPY
TECH
TRADE
TPSA
TG
TAGS
TF
TRAD
THKSJA
TVBIO
TNDG
TN
TBIOZK
TWI
TV
TWL
TRT
TWRO
TSRY
TTPGOV
TAUSCHER
TRBY
TRBIO
TL
TPKO
TIA
TGRY
TSPAM
TREL
TNAR
TBI
TFIN
TPHYPA
TWCH
THOMMA
THOMAS
TERROR
TRY
TBID
TPP
TE
THANH
TJ
TBKIO
UNGA
USUN
UN
UG
UNSC
UK
UP
US
UNCTAD
UNVIE
UNHRC
USTR
UNAMA
UNCRIME
UNESCO
UV
UNDP
UNHCR
UNCSD
UNCHR
UZ
USAID
UNEP
UNO
UNPUOS
UY
UNDC
UNCITRAL
UNAUS
UNCND
UA
UNMIK
USTDA
USEU
USDA
UNICEF
UR
UNFICYP
USNC
USTRRP
UNODC
UNRWA
UNOMIG
USTRPS
USAU
USCC
UNEF
UNGAPL
UNFPA
UNSCE
USSC
UGA
UEU
UNMIC
UNTAC
UNION
UNCLASSIFIED
USPS
UNA
UMIK
USOAS
UNMOVIC
UNFA
UNAIDS
UNCHC
USGS
UNSE
UNRCR
UNTERR
USG
UE
UAE
UNWRA
UNCSW
UNSCR
UNCHS
UNDESCO
UNPAR
UNC
UB
UNSCS
UKXG
UNGACG
UNREST
UNHR
USPTO
UNFCYP
USCG
UNIDROIT
UNSCD
UPU
UNBRO
UNECE
USTRUWR
UNCC
UNESCOSCULPRELPHUMKPALCUIRXFVEKV
VM
VE
VT
VETTING
VN
VZ
VIS
VC
VTPREL
VIP
VTEAID
VTEG
VOA
VA
VTIZ
VANG
VISIT
VO
VENZ
VAT
VI
VEPREL
VEN
WFP
WTO
WHO
WTRO
WBG
WMO
WIPO
WA
WI
WSIS
WHA
WCL
WE
WMN
WEBZ
WS
WAR
WZ
WMD
WW
WILLIAM
WEET
WAEMU
WM
WWBG
WWT
WWARD
WITH
WMDT
WTRQ
WCO
WEU
WALTER
WRTO
WB
WHTI
WBEG
WCI
WEF
WAKI
WHOA
WGC
Browse by classification
Community resources
courage is contagious
Viewing cable 06JAKARTA12253, AN ENHANCED U.S. ROLE IN COMBATING AVIAN INFLUENZA (AI)
If you are new to these pages, please read an introduction on the structure of a cable as well as how to discuss them with others. See also the FAQs
Understanding cables
Every cable message consists of three parts:
- The top box shows each cables unique reference number, when and by whom it originally was sent, and what its initial classification was.
- The middle box contains the header information that is associated with the cable. It includes information about the receiver(s) as well as a general subject.
- The bottom box presents the body of the cable. The opening can contain a more specific subject, references to other cables (browse by origin to find them) or additional comment. This is followed by the main contents of the cable: a summary, a collection of specific topics and a comment section.
Discussing cables
If you find meaningful or important information in a cable, please link directly to its unique reference number. Linking to a specific paragraph in the body of a cable is also possible by copying the appropriate link (to be found at theparagraph symbol). Please mark messages for social networking services like Twitter with the hash tags #cablegate and a hash containing the reference ID e.g. #06JAKARTA12253.
| Reference ID | Created | Released | Classification | Origin |
|---|---|---|---|---|
| 06JAKARTA12253 | 2006-10-05 09:53 | 2011-08-24 01:00 | UNCLASSIFIED//FOR OFFICIAL USE ONLY | Embassy Jakarta |
VZCZCXYZ0000
RR RUEHWEB
DE RUEHJA #2253/01 2780953
ZNR UUUUU ZZH
R 050953Z OCT 06
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC 0930
RUEHPH/CDC ATLANTA GA
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RHMFIUU/BUMED WASHINGTON DC
RUEHBK/AMEMBASSY BANGKOK 7365
RUEHBY/AMEMBASSY CANBERRA 9973
RUEHRO/AMEMBASSY ROME 1942
UNCLAS JAKARTA 012253
SIPDIS
SENSITIVE
SIPDIS
DEPT FOR EAP/MLS, EAP/IET, MED/DASHO/EMR AND MED
DEPT FOR G/AIAG AND OES
DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ICD/LAIDIG
DEPT ALSO PASS TO USDA/FAS/FAA/DYOUNG AND USDA/APHIS/ANNELLI
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL
DEPT ALSO PASS TO HHS/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH
PARIS FOR FAS/AG MINISTER COUNSELOR
BANGKOK FOR APHIS/CARDENAS, RMO, CDC, USAID/RDM/A
CANBERRA FOR APHIS/EDWARDS
ROME FOR FAO
NSC FOR JMELINE
E.O. 12958: N/A
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID KFLU
SUBJECT: AN ENHANCED U.S. ROLE IN COMBATING AVIAN INFLUENZA (AI)
IN INDONESIA -- MONEY AND PEOPLE
REF: A) Jakarta 11582 B) Jakarta 11344
¶1. (U) This is an action request. Please see paragraph 3.
¶2. (SBU) Summary. After a slow start that led to the unchecked
spread of AI across much of Indonesia, the Government of
Indonesia (GOI) has developed a simplified AI strategy with re-
aligned priorities under a functioning National Committee for AI
Control and Pandemic Prevention. These developments represent an
important organizational advancement over the past year, and
offer donors a stronger foundation on which to base their AI
assistance efforts in the future. However, the GOI budget
including international donor assistance cannot meet the
requirements for its revised AI program, and the National
Committee has no committed funding beyond 2007.
¶3. (SBU) The moment is right for the USG to step up with a
significantly expanded AI assistance package to help the National
Committee implement its priorities--we estimate that a USG
contribution of $20 million a year in each of the next two years
would give Indonesia a real chance at permanently reducing the
level of AI in Indonesia's poultry population. Taking advantage
of an upcoming VVIP visit in late November to announce such an
assistance package would offer a superb opportunity to leverage
USG assistance into a stronger GOI public commitment to combating
AI. We also recommend promptly placing permanent staff from the
Centers for Disease Prevention and Control (CDC) and Animal and
Plant Health Inspection Service (APHIS) in Jakarta and
intensifying consultations with other donors so that GOI hears
concerted and coordinated guidance on managing AI. There may
also be an opportunity for the UN or other international
organizations to establish a data center to coordinate shared
resources for countries facing the onset of AI. End Summary.
¶4. (SBU) The USG has been a leader in the response to AI since
before Indonesia reported its first human outbreaks in June 2005.
Early on we developed a strategy that emphasized improving
surveillance, enhancing animal sector AI control, and stepping up
behavior change communications - the portions of Indonesia's
national strategy that the GOI has recently made its top three
priorities.
ROOTS OF GOI FAILURE FOR EARLY AI CONTROL
-----------------------------------------
¶5. (SBU) Indonesia was unprepared for the quick spread of AI
among its poultry population. Identified first in 2003, AI in
poultry has now spread to 29 of the country's 33 provinces.
Human infections have followed as a result of frequency of
contact, limited understanding of AI, social customs, and poor
poultry handling techniques. Numerous factors contributed to
creating an environment where the virus could pass quickly and
quietly to become epizoonotic within the avian populations.
--UNPREPARED, DECENTRALIZED GOVERNMENT. The GOI was slow to
grasp the enormity of its AI problem in 2004 and 2005.
Indonesia's highly decentralized government created overlapping
and unclear authority lines between central and district
governments that in turn resulted in non-standard operating
procedures and responses to outbreaks; inadequate surveillance
and failure to report outbreaks; inadequate culling and
vaccination procedures; and a lack of capacity to make proper
funding and policy decisions at the local level. The MOH and MOA
have not coordinated well. Nonetheless, community level programs
have produced strong results in surveillance, outbreak response,
and district level coordination between health and agriculture
officials. Community-based programs have also revealed a pool of
knowledge and concern about AI among villagers that can be
harnessed to create real change.
--INDONESIAN VILLAGE CULTURE. Indonesian village life is
conducive to creating disease conditions among poultry
populations. Indonesian families live in close proximity to their
uncaged poultry, raise chickens and ducks as a protein source,
and also keep pet birds. Children play with birds freely and
people sometimes sleep with birds in the house. Sensitive to
higher costs, residents ignore local regulations about bird
import and smuggle in birds from other markets when locally
supplied birds are too expensive.
--LACK OF TRUST BETWEEN MOA AND POULTRY PRODUCERS: A lack of
trust between larger poultry producers (Sectors 1 and 2) and the
MOA also severely inhibits efforts to combat AI. Outbreaks in
the Sectors 1 and 2 often go unreported, and MOA officials have
no authority to enter poultry production sites for animal health
reasons. Obtaining the buy in of large poultry producers will be
crucial for effectively controlling AI.
MORE RAPID PROGRESS IN 2006
---------------------------
¶6. (U) The GOI's national human health and animal health response
began to take shape in early 2006. In February, the GOI created
the National Committee for AI control and Pandemic Prevention
(National Committee) under Bayu Krisnamurthi. When a high
profile cluster of human cases occurred in North Sumatra in May
2006, key international partners (NAMRU-2, WHO, CDC, FAO)
proceeded to the site, resulting in rapid case confirmation,
epidemiologic assessment and subsequent genetic sequencing of
virus samples. In June, the GOI and WHO convened a panel of
international influenza and animal health experts on AI
management that made a set of important recommendations.
International experts complimented the GOI for convening the
meeting, but the MOH ultimately rejected the resulting report
because it was unwilling to admit that limited non-sustained
human-to-human transmission occurred during the outbreak.
¶7. (SBU) With USAID funding, FAO piloted an effective
Participatory Disease Surveillance and Participatory Disease
Response (PDS/PDR) program in 12 districts in the first quarter
of 2006. The program provided the first reliable reporting on
outbreaks in the backyard and informal poultry sector. An
International Expert panel identified the program as a model
program for district governments that offers the best hope yet to
reduce AI infection in Indonesia's poultry population. USAID,
AusAID and Japan provided funds to expand the program to 159
districts by June 2007.
¶8. (U) In August, the GOI launched the National Committee. Bayu
announced a refocused National strategy and animal control
program and also launched GOI's first national awareness
communication campaign. During the month, the National Committee
convened two donor meetings to map resources, identify funding
gaps and discuss animal control measures. The National Committee
announced a refocusing of Indonesia's AI strategy to focus on
three top priorities: 1) risk communication, information and
public awareness, 2) epidemiological surveillance on animals and
humans, and 3) AI control in animals. The GOI also made progress
in August and September implementing the Tangerang Trilateral
Project, but has a lot of bureaucratic hurdles to overcome, such
as working out a reimbursement mechanism. Since the August donor
meeting, international donors are expressing more confidence that
the GOI is on the right track and that Indonesia has turned the
corner on its struggle to control AI.
ROLE OF DONOR COMMUNITY
------------------------
¶9. (U) The U.S., Australia, Japan and World Bank are the major AI
donors in Indonesia. Australia is providing approximately $12
million to support WHO/MOH rapid response teams, stockpile
Tamiflu, and support the FAO's PDS/PDR program. In addition,
Australia is designing a new program covering detection,
prevention and management of AI in humans and animals. The
program will be part of an approximately $75 million Australian
commitment for emerging infectious diseases in the Asia Pacific
Region (the final amount that will go to Indonesia is unclear).
Japan provides the majority of its assistance through UNICEF for
communications, WHO for human health, and FAO/OIE for animal
health. The World Bank is finalizing a proposed $15 million, 2-
year program for animal surveillance and containment. This
program will include support for the PDS/PDR program,
compensation for culled birds, outbreak response vaccination, and
preventive vaccination. Other donor support includes $1.3
million from the Netherlands for animal vaccine trials and $6
million from Canada for human health, including purchase of
hospital equipment.
GAPS REMAIN
-----------
¶10. (SBU) The GOI is now on the right path to managing AI, but
Indonesia's enormous size makes tackling AI a huge task. Key gaps
include the following:
--MOH CAPACITY: The MOH needs a range of assistance to improve
its diagnostic capacity and response to human outbreaks. By
their own admission, the MOH lacks trained research technicians
and scientists who understand the scientific process or can
conduct assays. Only a long-term commitment to develop and
support the training of a cadre of scientists will alleviate this
problem. Moreover, rank and file health care workers have
critical training needs for patient diagnosis, case management,
and infection prevention.
--PUBLIC AWARENESS: Indonesia badly needs a more robust and
sustained AI public awareness campaign. The National Committee's
communications strategy is designed to increase public awareness
about AI so people can identify AI outbreaks in animals and AI
symptoms in people. In addition, the National Committee hopes to
change behavior to reduce the risk of and increase appropriate
responses to animal outbreaks and human infection. In August,
the GOI launched a national mass media campaign to reduce the
risk of human infection from animal outbreaks. Financial support
from UNICEF and the Government of Japan is sufficient to air
public service announcements (PSAs) through December 2006. USAID
is working with UNICEF to analyze results from the national
campaign and fine-tune messages. USAID is also supporting a
community level interpersonal communications effort to complement
the mass media campaign. USAID funding is sufficient to support
public awareness campaigns to cover 100 districts through July
¶2007. Additional funding is needed to purchase airtime for new
mass media messages to air in 2007 and 2008 ($6 million) and to
continue community level behavior change communications through
2007 ($2 million).
--SURVEILLANCE FOR ANIMALS AND HUMANS: The GOI needs increased
epidemiological surveillance of animals and humans including
active community-based surveillance for animal and human cases;
hospital based passive surveillance, and laboratory diagnostic
capacity. Capacity and skills within the GOI are severely
limited for surveillance. The USG is at the forefront of
surveillance efforts for both human and animals in Indonesia.
NAMRU-2, with financial support from CDC and DOD-GEIS, has
operated a hospital-based human influenza study in Indonesia
since 1999. In September 2005, USAID provided financial support
to NAMRU-2 to expand its study to include key AI risk areas. The
NAMRU-2 study has provided vital support to Indonesia in case
confirmation and to global AI research. NAMRU-2 has requested
authority to expand its human surveillance program to include
additional referral hospitals. Toward this end, almost a dozen
hospitals and/or health care centers have requested enrollment
into the surveillance network. However, officials at National
Institute of Health Research and Development (NIHRD) have not
approved this expansion.
USAID provided seed money to FAO's PDS/PDR program, which has
provided the first reliable reports of AI animal outbreaks and
improved rapid response and control measures. USAID is the
primary donor for this program, providing 2/3 of the funding, but
the success of the program has drawn support from other donors,
including AusAID, the Government of Japan, and the World Bank.
Additional funding is needed to support program operations in
currently covered districts over the next 2 years ($10 million
for 159 districts) and to expand the program to train and operate
the program in the remaining AI 150 endemic districts ($13
million).
--VACCINATION, CULLING AND COMPENSATION PROGRAMS: The GOI lacks
resources to fully implement the FAO guidance for animal control,
including focal culling with compensation and ring vaccination.
Over the next six months, USAID and the World Bank will pilot a
control plan for animal outbreaks. Experts will then use lessons
learned to further improve animal containment across Indonesia.
The USG strategy does not at this time fund compensation which,
under current endemic conditions, would cost about $150,000 per
district per year. Support for vaccination would help to free GOI
budget to more consistently pay compensation for culled birds.
Under current endemic conditions, an adequately resourced
targeted vaccination campaign would cost $50,000 per district per
year. The World Bank plans to support full vaccination coverage
of 12 districts over two years. Additional funding would be
necessary to cover the remaining 147 districts for one year ($7.3
million) and 288 districts for the second year ($14.4 million).
--MINISTRY OF AGRICULTURE LEADERSHIP AND INFRASTRUCTURE: Lack of
leadership and infrastructure within the Ministry of Agriculture
remains a critical gap in Indonesia's AI management. The MOA has
not consistently implemented standard operating procedures,
elevated AI as a priority for central and local agriculture
authorities, encouraged restructuring of the poultry industry,
and ensured adequate funding for AI surveillance and control.
Despite the fact that Indonesia is struggling with other animal
diseases, the MOA has not developed a cadre of animal health
extension officers. (Note: The strength of the FAO program is
that it is managed at the provincial level and implemented at the
district level.)
¶11. (SBU) The GOI also faces an across the board fiscal
sustainability problem that affects all of its anti-AI program.
The GOI's AI budget including international donor assistance
faces significant shortfalls in 2007, and the National Committee
has no committed funding beyond 2007.
THE PATH FORWARD
----------------
¶12. (SBU) With the National Committee up and running, and a
refocused AI strategy, and the piloting of a successful animal
surveillance and response program, the time is right for the USG
to step up with a significantly expanded AI assistance package.
We recommend Washington provide an additional $40 million in AI
funding ($20 million per year over a two-year period) to assist
the National Committee in implementing its priorities. Fully
funding the FAO PDS/PDR program in Indonesia's remaining AI-
endemic districts to manage the disease at the source is our top
priority. We would also use any new USG funds to support public
awareness programs and address other shortfalls that are
hindering the achievement of the National AI Committee's three
priorities. These programs offer the best hope yet to, over the
medium term, drive the "viral load" down in Indonesia's poultry
population, protect human health, and limit opportunity for the
virus to shift.
¶13. (SBU) In addition to sharply expanding USG assistance to the
National Committee, we also need more USG boots on the ground in
Indonesia. We are grateful for the continuing TDY assistance
from both CDC and APHIS. However, we need permanent animal and
human health experts assigned here quickly to build relationships
with key GOI staff and implement programs. If this is not
possible, we recommend CDC and APHIS develop rotations among a
small cadre of experts who have previously assisted in Indonesia.
The learning curve here is steep. Key GOI contacts work best
where relationships and trust are already developed. When APHIS
and CDC are fully operational in Jakarta, we expect that they
could draw on increased USG funding to expand their programs.
For example, APHIS could enlarge and fully fund planned
epidemiological training, laboratory training for sector 1 labs,
and pilot intensive area vaccination programs.
¶14. (SBU) Our strategy going forward should have a diplomatic
component as well. The recent European Union letter to the GOI
noting serious concerns with Indonesia's handling of AI
underscores the need to develop a coordinated diplomatic message
with other donor countries. This would ensure that senior GOI
officials are hearing concerted and coordinated guidance on
managing AI. This could benefit us directly. For example, the
GOI is resisting the idea of expanding NAMRU-2's hospital
surveillance program. A coordinated message from the donor
community about the need for additional human surveillance could
be very effective in persuading the GOI to allow NAMRU-2 to move
forward. A concerted diplomatic message, delivered both in
Jakarta and at major AI conferences, could also be helpful in
endorsing the success and importance of the National Committee,
securing additional GOI budgeted resources for AI, and convincing
the GOI to more openly share AI samples.
INDICATORS OF SUCCESS
---------------------
¶15. (SBU) Over the long term, we would be able to judge the
effectiveness of increased USG assistance by the number of human
infections and animal outbreaks. However, in the short-term,
improving the surveillance system would likely result in
increased reports of human cases and animal outbreaks. This was
the case when we expanded NAMRU-2's surveillance network and
piloted the FAO PDS/PDR program. Other factors, such as weather
conditions and cultural practices can also impact on the number
of reported outbreaks at any given time. The National AI
Committee, in collaboration with donors, is developing country
level indicators for Indonesia, and several USAID-funded programs
are jointly developing program specific performance indicators,
including intermediate indicators that can help inform program
impact. Examples include the level of active surveillance as
indicated by the number of health facilities engaged in
surveillance and reporting cases to MOH, the number of PDS/PDR
teams searching for AI outbreaks, the number of interviews
conducted by PDS/PDR teams, etc. Additional indicators could
include the level of outbreak/case response (e.g. the percentage
of reported suspect human cases or animal outbreaks investigated
within 24 hours).
LEARNING FROM INDONESIA
-----------------------
¶16. (SBU) The scale and complexity of Indonesia's struggle
against AI, and the size of the donor response, suggests that
Indonesia's experience may contain lessons for other AI-afflicted
countries. Indonesia could also surely benefit from real-time
knowledge of AI control efforts in other countries. Although
averting a pandemic is a scientific and medical challenge,
combating AI is also a long term management problem involving
coordination, logistics planning, organization and resources. We
recommend Washington consult closely with the UN, World Bank and
others to see what opportunities may exist to leverage technology
and institutional knowledge to develop tools for global
coordination. Such tools might have been very helpful to
Indonesia in its early efforts to contain AI. The UN or WHO
would likely be best positioned to lead the development of such
coordination tools, which might include some of the following:
--An international donor data base could provide an excellent
reference tool to not only monitor and record current donor
levels and functions but also to provide users with ideas for
additional programs. A government user in a country facing AI
for the first time might research other countries for ideas of
donor programs. An in-country user might pull off the latest
statistics in preparation of meetings. A Washington user could
sort donor efforts by country, by AI strategy, by year or any
other data element. The WHO might be a possible host for an
expansion of tools.
--A central website could also feature a range of useful
reference materials by country such as maps tracking bird and
human AI outbreaks, a who's who of key AI players for each
country, national strategic plans and a list of reference
materials.
--A central website could also feature useful templates and
descriptions of AI management best practices so that less time
and resources are spent in recreating the wheel in every country.
HEFFERN