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Viewing cable 07JAKARTA504, INDONESIA - FEB 23 AVIAN INFLUENZA (AI) UPDATE

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Reference ID Created Released Classification Origin
07JAKARTA504 2007-02-23 08:55 2011-08-24 01:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Jakarta
VZCZCXYZ0002
RR RUEHWEB

DE RUEHJA #0504/01 0540855
ZNR UUUUU ZZH
R 230855Z FEB 07
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC 3423
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 7730
RUEHBY/AMEMBASSY CANBERRA 0463
RUEHRO/AMEMBASSY ROME 1986
RUEHFR/AMEMBASSY PARIS 0983
UNCLAS JAKARTA 000504 
 
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/HWETZEL 
DEPT ALSO PASS TO USDA/FAS/FAA/DEVER AND USDA/APHIS/ANNELLI 
DEPT ALSO PASS TO USDA/FAS/OTCB/ROSENBLUM AND USDA/APHIS AUSTGEN 
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
SUBJECT: INDONESIA - FEB 23 AVIAN INFLUENZA (AI) UPDATE 
 
REF: A) Jakarta 00431    B) Jakarta 00310 and previous 
 
1. (SBU) Summary: Despite the February 16 joint media statement by 
the Ministry of Health (MOH) and World Health Organization (WHO), 
Indonesia has not yet resumed the sharing of AI samples.  Various 
Indonesian media outlets have quoted Minister of Health Fadillah 
Supari as saying Indonesia will not resume shipment of virus 
specimens to the WHO until a "new mechanism" for sample sharing is 
in place.  The inability of international laboratories to confirm 
MOH-diagnosed AI cases has led to a gap between the GOI's case count 
(85 AI cases with 65 deaths) and the counts of NAMRU-2 and the WHO 
(81 cases with 63 deaths).  According to an officer from the 
Singaporean Embassy in Jakarta, the Government of Indonesia (GOI) 
continues to make progress on the Tangerang trilateral project.  End 
Summary. 
 
Optimistic Joint Statement But Impasse Continues 
--------------------------------------------- --- 
 
2. (U) Following five hours of negotiations on February 16, WHO and 
MOH officials released a Joint Media Statement agreeing that 
"responsible, free and rapid sharing of influenza viruses with WHO, 
including H5N1, is necessary for global public health security" and 
that the MOH will "resume sharing viruses for this purpose."  The 
WHO team included David Heymann, Assistant Director-General of the 
WHO for Communicable Diseases; Dr. Keji Fukuda, flu epidemiology 
expert; and Georg Peterson, Director of WHO's Jakarta office. 
According to journalists present at the media event, Heymann 
commented that he trusted that the shipment of specimens would 
resume soon.  But according to the English-language version of the 
weekly magazine Tempo, Supari replied "Without the new regulations, 
until our last drop of blood, the answer is still no, no, no!" 
Director General for Infectious Diseases Nyoman Kandun echoed this 
sentiment in a February 22 meeting that was unrelated to sample 
sharing.  The MOH and WHO have agreed to convene a meeting of Asian 
Health Ministers in March to discuss mechanisms for jointly using AI 
virus samples. 
 
3. (U) Indonesian press continues to run stories on the sample 
sharing issue, including an interview in the Jakarta Post with Dr. 
Triono Soendoro, Director of Litbangkes and a two-page article in 
Tempo.  Most press stories have focused primarily on the need for 
developing countries to benefit from sharing virus samples, 
including access to quality pandemic vaccines at affordable prices. 
A variety of sources have indicated that the MOH has appointed a 
prominent local defense attorney and anti-corruption advocate, 
Todung Mulya Lubis, to handle the legal aspects of the issue. 
 
Conflicting AI Counts 
--------------------- 
 
4. (SBU) As a result of the sample impasse, NAMRU-2 and WHO now 
classify AI cases differently than the Ministry of Health.  NAMRU-2 
and WHO show the same numbers for Indonesia with 81 Human H5N1 cases 
and 63 deaths for a CFR of 78%.  The MOH counts four additional 
cases: 
 
(1) a 15 year-old surviving female from Jakarta.  NAMRU-2 data from 
separate samples suggest she had an H3 (normal flu) virus. 
 
(2) a 30 year-old surviving male from Bandung; 
NAMRU-2 data on separate samples suggest he was not infected. 
 
(3) a 20 year-old deceased female from Garut; NAMRU-2 does not have 
samples 
 
(4) a 9 year-old deceased male from Garut; NAMRU-2 does not have 
samples. 
 
5. (SBU) NAMRU-2 has encouraged NIHRD researchers to both share 
samples with NAMRU-2 and seek additional laboratory results from a 
WHO-reference laboratory.  In the cases of the surviving patients, 
virus isolation, full genome sequencing and microneutralization 
could resolve the case discrepancy. 
 
Tangerang Trilateral Project Update 
----------------------------------- 
 
6. (SBU) According to a Singaporean Embassy contact, Singapore has 
agreed to provide $600,000 worth of in-kind contributions (including 
vehicles, computers, other equipment) for use in the Tangerang 
trilateral project.  The Singaporean Government has also engaged 
Sembawang Logistics Company, a third party contractor to begin 
implementing the in-kind contributions.  Additionally, Singapore is 
prepared to transfer $900,000 before the end of March to the GOI to 
fulfill the remaining portion of their Tangerang funding commitment. 
 Although specific activities have not yet been identified nor the 
MOU finalized between Singapore and Indonesia, the MOH has agreed to 
begin using the funds and providing quarterly activity reports. 
 
HEFFERN