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courage is contagious
Viewing cable 07JAKARTA933, MARCH 28 HIGH-LEVEL MEETING ON AVIAN INFLUENZA SAMPLE
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| Reference ID | Created | Released | Classification | Origin |
|---|---|---|---|---|
| 07JAKARTA933 | 2007-04-01 22:55 | 2011-08-24 01:00 | UNCLASSIFIED//FOR OFFICIAL USE ONLY | Embassy Jakarta |
VZCZCXRO1181
RR RUEHCHI RUEHDT RUEHHM
DE RUEHJA #0933/01 0912255
ZNR UUUUU ZZH
R 012255Z APR 07
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC 4123
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC
INFO RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RUEHLO/AMEMBASSY LONDON 0781
RUEHKO/AMEMBASSY TOKYO 0441
RUEHUL/AMEMBASSY SEOUL 4029
RUEHBY/AMEMBASSY CANBERRA 0607
RUEHOT/AMEMBASSY OTTAWA 1306
RUEHFR/AMEMBASSY PARIS 0988
RUEHBJ/AMEMBASSY BEIJING 4015
RUEHRO/AMEMBASSY ROME 1990
RUEHBS/AMEMBASSY BRUSSELS 0297
RUEHEG/AMEMBASSY CAIRO 0067
RUEHAK/AMEMBASSY ANKARA 0113
RUEHTC/AMEMBASSY THE HAGUE 3315
RUEHSA/AMEMBASSY PRETORIA 0244
RUEHNE/AMEMBASSY NEW DELHI 1271
RUEHKB/AMEMBASSY BAKU
RUEHBD/AMEMBASSY BANDAR SERI BEGAWAN 0369
RUEHGV/USMISSION GENEVA 7546
UNCLAS SECTION 01 OF 08 JAKARTA 000933
SIPDIS
SENSITIVE
SIPDIS
DEPT FOR EAP/MTS AND G/AIAG
USAID FOR ANE/CLEMENTS AND GH/CARROLL
GENEVA FOR WHO/HOHMAN
E.O. 12958: N/A
TAGS: TBIO AMED CASC EAGR KFLU PGOV ID
SUBJECT: MARCH 28 HIGH-LEVEL MEETING ON AVIAN INFLUENZA SAMPLE
SHARING
¶1. (SBU) Indonesian Health Minister Dr. Fadilah Supari repeatedly
pledged to resume sharing avian influenza (AI) samples with the
international community during the March 29 "High Level Meeting on
Responsible Practices for Sharing Avian Influenza Viruses and
Resulting Benefit" in Jakarta. Supari made the same pledge at a
March 27 press conference in both English and Indonesian, and
repeated it the next morning in a session including President Susilo
Bambang Yudhoyono (SBY). The meeting adopted a "Jakarta
Declaration" that endorsed a set of technical recommendations
drafted at a March 26-27 experts meeting, the most noteworthy of
which is a recommendation to develop "detailed, technical Terms of
Reference" (TORs) for World Health Organization (WHO) collaborating
centers to use when sharing viruses. In his opening address to
conference participants, SBY did not mention the sample sharing
issue, but instead called on participants to put "equality between
countries at the center of our defense strategies" against AI.
Participants welcomed March 23 and 27 statements by Secretary of
Health and Human Services Mike Leavitt supporting the Government of
Indonesia's (GOI) decision to resume sample sharing and committing
$10 million to the WHO to expand the development and manufacturing
infrastructure for influenza vaccine in developing countries. Most
speakers at the March 28 meeting welcomed the GOI's decision to
resume sample sharing while emphasizing the validity of Indonesia's
concerns about the ability of developing countries to obtain
sufficient quantities of affordable AI vaccine. Canada, the United
Kingdom, and Japan also raised questions about the status of the
technical recommendations, with the latter two countries noting
their support for the document did not signify new financial
commitments. Supari told participants at the end of the meeting
that Indonesia intends to introduce a resolution at the May 2007
World Health Assembly containing the Jakarta Declaration, and asked
participating countries to co-sponsor it. The WHO and twenty five
countries participated in the meeting (para 14); the Embassy
represented the U.S. as an observer. End Summary.
GOI Breaks the Sample Sharing Deadlock
--------------------------------------
¶2. (SBU) After more than three months of negotiations with the WHO,
the GOI moved to end the deadlock over the sharing of Indonesian AI
samples with WHO Collaborating Centers during the March 26-28
meetings on responsible practices for sharing AI viruses and
resulting benefits in Jakarta. Health Minister Dr. Fadilah Supari
announced the decision at a March 27 press conference with
Indonesian and international journalists, and repeated it the next
morning in the presence of SBY. Supari explained to a skeptical
media that despite her provocative rhetoric on the issue in recent
weeks, Indonesia now trusts the WHO to move quickly to develop new
TORs for sample sharing, and is therefore willing to begin sharing
samples immediately. (Note: As of March 30, the GOI has not yet
shipped any AI samples overseas.)
¶3. (U) In his remarks opening the March 28 meeting, SBY recalled the
history of influenza pandemics in the 20th century, and said the
economic and social consequences of an AI pandemic would be
enormous. Noting that the H5N1 virus had advanced rapidly across
national boundaries, SBY said it is "our responsibility to ensure
that all the nations of the world are prepared to prevent and fight
it." But the efforts of countries to respond to AI are very uneven
depending on the capacity of countries, a discrepancy that "can be
harmful to global efforts to avoid a potential pandemic...The
deliberations in this High-Level Meeting must therefore focus on
realizing this equality by examining together...all possible ways to
JAKARTA 00000933 002 OF 008
bring countries up to par through a more altruistic approach to
sample and information sharing...." SBY emphasized that the key to
global pandemic preparedness is to encourage "home-grown research,
laboratory, and production capabilities" in developing countries,
and "assisting them in the production of their own vaccines and
drugs at affordable prices."
"Jakarta Declaration" and Experts Recommendations
--------------------------------------------- ----
¶4. (SBU) Under the chairmanship of Supari, the meeting adopted a
seven-point "Jakarta Declaration", the text of which is contained in
para 12 below. The GOI distributed the draft declaration late on
the evening of March 27. The revised version differed significantly
from a version the GOI had distributed in Geneva in early March.
The meeting adopted the declaration with very little discussion the
next day. The only difference between the March 27 draft and the
version adopted the next day was the insertion of the words "and the
Global Pandemic Influenza Action Plan to increase vaccine supply" in
point six, done at the request of Canada. WHO representatives at
the meeting clarified that although the WHO had convened the March
26-27 high-level technical meeting, it had not been a "formal
technical consultation" because not all countries were invited, and
the results are therefore considered only informal recommendations
to the WHO Director General.
¶5. (SBU) Importantly, the "Jakarta Declaration" also contained a
statement endorsing the recommendations of a high-level technical
meeting held March 26-27 (see para 13). The recommendations touch
on strengthening the global influenza surveillance system, capacity
building for developing countries, and improving access to safe,
effective, and quality H5N1 and other potential pandemic influenza
vaccines. Two aspects of the recommendations proved somewhat
controversial. The first is a recommendation to develop by the end
of June 2007 "detailed, technical Terms of Reference" (TORs) to
govern the sharing of influenza viruses with WHO Collaborating
Centers. According to the recommendations, the "TORs related to
virus sharing will be reflected in a standard material transfer
document that will be included as part of the shipping documents
sent with each specimen." The TORs should clearly define what may
done with the specimens through the generation of seed viruses for
future vaccine research development and production, with uses of the
viruses outside the TORs requiring the prior consent of the
originating country. The WHO will draft the TORs and follow
"appropriate participatory processes for approval."
¶6. (SBU) The technical recommendations' call for the WHO to "seek
the support of industrialized countries...for the stockpiling of
safe and effective H5N1 and other potential pandemic influenza
vaccines" sparked Japan and the UK to make clarifying remarks. The
two countries noted they are already major donors in the fight
against AI, and that neither section 4.3 of the recommendations or
point 7 of the "Jakarta Declaration" should be taken to imply any
additional obligations on the part of stakeholders at this stage.
Japan noted in its statement that item 4 in the "Jakarta
Declaration" should "not be interpreted as an actual financial
commitment."
¶7. (U) At the conclusion of the meeting, Supari told participants
that Indonesia intends to introduce a resolution at the May 2007
World Health Assembly containing the Jakarta Declaration, and asked
countries participating in the meeting to co-sponsor it.
JAKARTA 00000933 003 OF 008
Broadly Supportive Statements by Participants
---------------------------------------------
¶8. (SBU) Most participants, including some developed countries, were
broadly supportive of Indonesia's efforts to bring the issue of
equity in vaccine development and distribution to the fore. Dr.
David Salisbury, Chairman of the Technical Meeting, briefed on the
outcome of the technical meetings. He emphasized that getting the
world prepared for pandemic influenza needs to be done on an
equitable basis, but that it is also important to make seasonal
viruses quickly available. The vaccine manufacturing industry is
"part of our salvation," Salisbury said, given the need for vastly
larger quantities of vaccine. Noting that "getting viruses into the
most expert hands is the highest priority," Salisbury welcomed
Indonesia's decision to resume sample sharing. In subsequent
statements, the WHO, Australia, Philippines, Canada, Singapore,
Japan, and the UK also congratulated Indonesia for resuming sample
sharing.
¶9. (U) The WHO Representative noted his organization has initiated
programs to increase the production capacity for developing
countries, but they are insufficient. The WHO agrees with the
importance of the three areas of actions in the technical
recommendations, the representative noted, and will "do its best" to
implement them. "The WHO is committed to working immediately from
day one to translate our commitment into action," the representative
concluded.
¶10. (SBU) Australian Minister of Health and Aging Tony Abbott, one
of four health ministers who attended the meeting, noted it is a
"very natural and human reaction" for the GOI to try to benefit from
the presence of H5N1 in Indonesia. H5N1 is potentially a global
problem requiring a global solution, Abbott noted, and is a "problem
too important to be stymied by unseemly haggling over property
rights." Australia is "thrilled and grateful" that Indonesia will
resume sample sharing, but there is also a need for "fair and
reasonable access to vaccines produced from samples." Abbott
suggested that the WHO consider developing a system where a portion
of H5N1 vaccine be placed in a stockpile under WHO control, once
they are available. He noted the WHO Secretariat has a big job to
do through June 2007 in figuring out how the principles in the
technical recommendations should be reflected in the new TORs. He
concluded by noting the Jakarta meeting had represented an
"important clearing of the air, resolution of tension, and placing
on the table of legitimate concerns of countries representing
billions of people." The issues are now on their way to resolution,
Abbott added, and Australia stands ready to work with the WHO, APEC,
ASEAN, and other groups to fight the potential scourge of AI.
¶11. (SBU) Other noteworthy statements by delegations included the
following:
--Canadian Ambassador John Holmes stated that the recommendations
from the high-level technical meeting are an "important step
forward." They build on previous documents, have established a
timeline for resolving the issue, and set up a process with the WHO
in the lead. "For these reasons, Canada can support the
recommendations," Holmes said.
--Singapore said there is a need to strengthen the global health
community based on trust. Singapore doesn't want any single company
or group of scientists to have a monopoly, because this would slow
down vaccine development and production. The recent delay in sample
JAKARTA 00000933 004 OF 008
sharing had put some people at risk, but the Jakarta meeting had
initiated a global discussion about equity in vaccine development
and sharing.
--Japan: In addition to the concerns about resource implications
noted above, Japan acknowledged the world faces a need for an
updated mechanism for risk assessment and response. The Japanese
representative noted his country is encouraged that Health Minister
Supari had declared Indonesia will immediately resume sample sharing
in a spirit of trust, while the WHO puts an improved mechanism in
place.
--UK: Matthew Rous, DCM at the British Embassy, noted the
international community, working through the WHO, has established
two cornerstones of our efforts to tackle the risks of pandemic
influenza - the 2005 International Health Regulations and the Global
Vaccine Action Plan. The effective implementation of both is
essential, he said. Rous noted that the UK Government welcomes the
progress reported by the WHO this week in implementing the Global
Vaccine Action Plan, particularly those elements that address access
for developing countries. However, he cautioned these discussions
"cannot and should not be definitive" because they involve only one
group of countries. Further technical exchanges may be needed
before the World Health Assembly in May, where any new policy
decisions or commitments could appropriately be made.
--Thailand: Dr. Morakot Kornkasem, Deputy Minister for Public
Health, stated "the status quo is not acceptable. We need a new way
of thinking." Thailand is happy to endorse the Jakarta Declaration,
Kornkasem said, and fully supports a discussion of the issue at the
May 2007 World Health Assembly. Kornkasem also said the Thai
Government is in the process of approving a $45 million plan for the
development of an influenza vaccine production plant in Thailand.
The Thai cabinet should approve the plan in the next two weeks. It
had been difficult to find partners, Kornkasem said, but thanks to
China and the WHO, Thailand now has sources for technology transfer.
Thailand hopes to have the plant up and running within three years.
It will also update its National Pandemic Preparedness Plan to
included the issues raised in the Jakarta meetings.
--Brunei Darussalam, Laos, Cambodia, and Burma each endorsed the
Jakarta Declaration. Brunei applauded the WHO effort to develop a
mechanism that could promote a more equitable distribution of
vaccines, while Burma said the costs of differential pricing for
H5N1 vaccines should be born by developed countries. Vaccines sold
to developing countries should be priced at or near cost, the
Burmese representative said.
--Vietnam: The Vietnamese representative said organizations and
companies that use biological materials should share the
responsibilities, ask permission, and use the name of the
originating countries in publications and products.
Text of Jakarta Declaration
---------------------------
¶12. (U) Text of "Jakarta Declaration":
Jakarta Declaration on Responsible Practices for Sharing Avian
Influenza Viruses and Resulting Benefits
High-Level Meeting on Responsible Practices for Sharing Avian
Influenza Viruses and Resulting Benefits
JAKARTA 00000933 005 OF 008
Jakarta Declaration
¶1. We, the Health Ministers of affected and other related countries,
assembled in Jakarta on 28 March 2007 to explore the modalities of a
framework that strongly emphasizes the need for developing countries
to share in the benefits resulting from the open and timely and
equitable sharing and dissemination of information, data and
biological specimens related to influenza, and especially the
development and production of influenza vaccines that are accessible
and affordable for all countries in order to accelerate local,
regional and global preparedness and response to the threat of
pandemic avian influenza;
¶2. We underline that global risk assessment and risk response to the
threat of pandemic influenza including avian influenza require
concerted efforts among states, international partners, including UN
organizations, donor agencies, manufacturing industries, and civil
society organizations;
¶3. We acknowledge the need for open, timely, and equitable sharing
and dissemination of information, data and biological specimens
related to influenza and their benefits;
¶4. We endorse the "Recommendation on Responsible Practices for
Sharing Avian Influenza Viruses and Resulting Benefits", that was,
recently developed in the High-Level Technical Meeting that took
place in Jakarta, Indonesia, on 26-27 March 2007;
¶5. We urge all member states of the WHO to commit to support,
strengthen and improve the Global Influenza Surveillance Network
leading to a more transparent and equitable sharing of benefits from
the generation of information, diagnostics, drugs, vaccines, and
other technologies through the aforementioned framework;
¶6. We call upon all member states of the WHO to discuss the matters
in the 60th World Health Assembly in May 2007 in order to build on
the WHO Best Practices for Sharing Influenza Viruses and Sequence
Data, and the Global Pandemic Influenza Action Plan to increase
vaccine supply, which will ultimately result in stronger global
public health security;
¶7. We, the Health Ministers, request the WHO to convene the
necessary meetings, initiate the critical processes and obtain the
essential commitment of all stakeholders to establish the mechanisms
for more open virus and information sharing and accessibility to
avian influenza and other potential pandemic influenza vaccines for
developing countries.
Jakarta, 28 March 2007
Text of Recommendations of Technical Meeting
--------------------------------------------
¶13. (U) Begin text:
HIGH-LEVEL TECHNICAL MEETING ON RESPONSIBLE PRACTICES FOR
SHARING AVIAN INFLUENZA VIRUSES AND RESULTING BENEFITS
Jakarta, Indonesia
26 - 27 March 2007
Recommendations for consideration by High Level meeting on March 28,
JAKARTA 00000933 006 OF 008
2007
¶1. Global risk assessment and risk response to the threat of
pandemic influenza including avian influenza require concerted
efforts among states, international partners, including UN
organizations, manufacturing industry, and civil society
organizations. These efforts aim to address a broad spectrum of
intertwined activities that include: global influenza virus and
disease surveillance, sharing of viruses and associated genetic
sequence data, in-depth characterization of influenza viruses,
development of updated diagnostic test and selection of vaccine
strain candidates and vaccine production and distribution;
¶2. The WHO High-Level Technical Meeting on Responsible Practices for
Sharing Avian Influenza Viruses and Resulting Benefits held in
Jakarta, Indonesia, on 26-27 March 2007 explored the modalities of a
framework that emphasizes the need for developing countries to share
in the benefits resulting from sharing virus specimens. The
discussions covered the need for open, timely and equitable sharing
and dissemination of information, data and biological specimens
related to influenza. It also underscored the need to develop and
produce influenza vaccines that are accessible and affordable for
all countries in order to accelerate local, regional and global
response to the threat of pandemic avian influenza;
¶3. The High-Level Technical Meeting agreed to propose the
establishment of a framework for affordable and equitable access to
influenza vaccines, including pandemic influenza vaccines as part of
pandemic preparedness. This framework should also include
responsible influenza specimen and data sharing practices.
¶4. To this end, the High-Level Technical Meeting submitted these
recommendations for consideration at the High Level Meeting,
convened by the Ministry of Health of the Republic of Indonesia in
Jakarta on 28 March 2007.
All member countries of WHO should commit to support, strengthen and
improve the Global Influenza Surveillance Network leading to a more
transparent and equitable sharing of benefits from the generation of
information, diagnostics, drugs, vaccines, and other technologies.
These can be accomplished by pursuing three groups of concrete
actions:
4.1 The strengthening and improvement of Global Influenza
Surveillance Network for sharing of biological materials
Any international sharing of biological materials with WHO
Collaborating Centers will be conducted in accordance with existing
international and national regulations. For sharing of influenza
viruses, the "Best Practices for Sharing Influenza Viruses and
Sequence Data", should be followed, as well as detailed, technical
Terms of Reference (TORs) for the WHO Collaborating Centres, which
will be developed. The TORs related to virus sharing will be
reflected in a standard material transfer document that will be
included as part of the shipping documents sent with each specimen
by the country sharing virus.
Such detailed TORs will clearly define what may be done with the
specimens and include at least:
a. The identification, characterization, reporting of results,
development of essential diagnostics for public health use,
generation of seed viruses for future vaccine research development
JAKARTA 00000933 007 OF 008
and production and monitoring of influenza viruses, including avian
influenza viruses, for the purpose of assessing pandemic threats and
future vaccines production;
b. Any uses of the influenza viruses outside the specific TORs of
WHO Collaborating Centers will require the prior consent of the
originating country. However this should not hinder the development
of any essential health Technologies.
c. These new procedures should be drafted by the WHO Secretariat by
the end of June 2007 and go through the appropriate participatory
process for approval.
4.2 Capacity building for developing countries
a. WHO should make its best efforts to immediately intensify its
capacity building activities, appropriate to the situation in each
developing country. This is particularly important in those
countries affected by the H5NI viruses or those that have high risk
due to geographical vicinity. This capacity building could include,
but is not limited to:
(1) Virus identification
(2) Virus characterization
(3) Identification of new strain of viruses
(4) Generation and interpretation of influenza and avian
influenza associated data
(5) Generation of seed virus for vaccine production
WHO, in consultation with countries, will make the decision on which
capacity is appropriate to be strengthened or built within each
specific country.
b. WHO takes immediate actions to include more developing countries
particularly those who have been affected by the H5N1 or are at high
risk due to geographical vicinity, with additional capacity
building, to better contribute to WHO's global influenza
surveillance activities, and to be designated as WHO H5 influenza
reference laboratories.
4.3 Actions to improve access to safe, effective and quality H5N1
and other potential pandemic influenza vaccines
a. WHO should seek the support of industrialized countries, other
financial partners and vaccine manufacturers, to mobilize financial
and technical support for the stockpiling of safe and effective H5N1
and other potential pandemic influenza vaccines that may be used in
developing countries, particularly those that have been affected by
the viruses or have high risk due to geographical vicinity.
For countries with the capacity and existing regulatory
controls for filling and packaging of vaccines, consideration should
be given to local stockpiling of vaccines in bulk. These systems of
stockpiling should be accomplished and functional, either virtual or
more preferably real stockpiling, and should be available as soon as
possible.
b. WHO should seek additional support from developed countries,
funding partners and vaccine manufacturers to facilitate the
transfer of technology to countries with functional regulatory
agencies and vaccine manufacturers that comply with good
manufacturing practices to establish influenza vaccine production.
The production capacity in the committed countries should be
functional as soon as possible.
JAKARTA 00000933 008 OF 008
c. WHO should draft, through a participatory process, a guideline
for the equitable and appropriate distribution of effective pandemic
influenza vaccines, to be applied if a pandemic occurs. It should be
submitted to the World Health Assembly, through the Executive Board,
in May 2008.
It is also recommended that another meeting follow up the progress
of these recommendations be convened by WHO during the time of the
May 2007 World Health Assembly.
Meeting Participants
--------------------
¶14. (U) Participants in the "High-Level Meeting on Responsible
practices for sharing Avian Influenza Viruses and Resulting
Benefits" included Australia, Azerbaijan, Belgium, Brunei
Darussalam, Cambodia, Canada, People's Republic of China, Egypt,
France, Great Britain, India, Italy, Japan, Laos, Malaysia, Myanmar,
Netherlands, Philippines, Singapore, South Africa, South Korea,
Thailand, Turkey, Vietnam, and the World Health Organization. The
Embassy represented the United States as an observer. Indonesia,
Australia, Brunei Darussalam, and Laos were represented by their
ministers of health. Dr. Nancy Cox, Director of the Influenza
Division, Centers for Disease Control and Prevention, and Dr.
Patrick Blair, Naval Medical Research Unit-2, represented the U.S.
at the March 26-27 high-level technical meeting.
¶15. (U) Dr. Cox did not have an opportunity to review this report.
Heffern