VZCZCXRO4759
PP RUEHCHI RUEHDT RUEHHM
DE RUEHJA #3199/01 0691128
ZNR UUUUU ZZH
P 101128Z MAR 06
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 0946
RUEHPH/CDC ATLANTA GA PRIORITY
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RUENMED/BUMED WASHINGTON DC
RHEFDIA/DIA WASHINGTON DC
RUEKJCS/SECDEF WASHDC
RHHMUNA/CDR USPACOM HONOLULU HI
RUEKJCS/CJCS WASHDC
RUEHBY/AMEMBASSY CANBERRA 9182
RUEHFR/AMEMBASSY PARIS 0819
RUEHRO/AMEMBASSY ROME 1848
RUEHIN/AIT TAIPEI 1767
RUEHHK/AMCONSUL HONG KONG 2105
RUEHBJ/AMEMBASSY BEIJING 3315
RUEHHM/AMCONSUL HO CHI MINH CITY 0041
RUEHGZ/AMCONSUL GUANGZHOU 0201

UNCLAS SECTION 01 OF 04 JAKARTA 003199 
 
SIPDIS 
 
SIPDIS 
SENSITIVE 
 
DEPT FOR EAP/IET, A/MED AND S/ES-O 
DEPT FOR OES/FO, OES/EID, OES/PCI, OES/STC AND OES/IHA 
DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ICD/LAIDIG 
DEPT ALSO PASS TO USDA/FAS/FAA/DYOUNG AND USDA/APHIS 
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL 
DEPT ALSO PASS TO HHS/BILL STEIGER AND AMAR BHAT 
PARIS FOR FAS/AG MINISTER COUNSELOR 
CANBERRA FOR APHIS/DHANNAPEL 
ROME FOR FAO 
NSC FOR JMELINE 
BANGKOK FOR RMO, CDC, USAID/RDM/A 
USPACOM PASS to JO7 
 
 
E.O. 12958: N/A 
TAGS: TBIO AMED CASC EAGR AMGT KFLU ID
SUBJECT: INDONESIA - MARCH 10 AVIAN INFLUENZA UPDATE 
 
REF: A) Jakarta  02915 and previous 
 
JAKARTA 00003199  001.2 OF 004 
 
 
¶1. (SBU) Summary. A USAID Washington avian influenza (AI) 
team met with a range of stakeholders during a March 1-5 
visit to Indonesia, including the Ambassador and the 
Embassy's Avian Influenza Working Group (AIWG), to discuss 
USAID's USD 11 million FY 2006 AI allocation for Indonesia. 
Officials from Singapore, Indonesia, the United States, and 
other multilateral donors met March 3 in Singapore to 
discuss the proposed Avian Influenza Trilateral Project in 
Tangerang.  Media reports indicate continuing GOI interest 
in locally developing an AI vaccine for humans, although the 
U.S. firm Baxter International has reportedly denied it is 
cooperating with the GOI.  Indonesia has also reportedly 
expressed interest in producing the generic version of 
Tamiflu as part of a push to secure 22 million doses of the 
drug by 2007.  The Ministry of Agriculture (MOA) reportedly 
plans to start a 2-month mass vaccination program later in 
March under which it would distribute 55 million doses of 
poultry vaccine to 27 AI-affected provinces.  The total 
number of confirmed human AI cases in Indonesia rose to 29 
(with 21 deaths) on March 10 when the U.S. Centers for 
Disease Control and Prevention (CDC) confirmed the H5N1 
virus in a recently deceased 3-year-old boy from Semarang, 
Central Java.  End Summary. 
 
USAID AI Team Visit 
------------------- 
 
¶2. (U) USAID Washington Avian Influenza Director Dennis 
Carroll led a team to Indonesia March 1-3 to review and 
finalize USAID's draft spending plan for USD 11 million in 
FY 2006 supplemental resources.  The 2006 funds will help 
expand on-going animal and human health sector activities, 
including (a) support for the government's "National AI 
Commission" responsible for overseeing Indonesia's 
integrated national AI prevention and preparedness strategy; 
(b) the expansion of key agricultural sector prevention and 
control activities; (c) the scale-up of mass media outreach 
on AI; and (d) supporting operational costs for the 
critically needed investigation of human cases.  USAID 
Indonesia programmed USD 3.15 million in AI funds in 2005. 
 
¶3. (U) The AI team met with a range of key AI stakeholders, 
including the Mission's Avian Influenza Working Group 
(AIWG), the Food and Agricultural Organization (FAO), the 
Academy for Educational Development (AED) and the Naval 
Medical Research Unit (NAMRU-2).  They team also joined the 
FAO on a trip to investigate the latest report of poultry 
infections in Banten Province, and participated in a 3-hour 
meeting with the GOI and donors to discussed the status of 
AI strategy implementation in Indonesia.  Finally, the team 
provided out briefs to the Ambassador and USAID senior 
management. 
 
AI Trilateral Meeting in Singapore 
---------------------------------- 
 
¶4. (U) Officials from Singapore, Indonesia, the United 
 
JAKARTA 00003199  002.2 OF 004 
 
 
States, the World Bank, the WHO, the FAO and the World 
Organization for Animal Health (OIE) met March 3 in 
Singapore to flesh out details of the proposed Avian 
Influenza Trilateral Project in Tangerang Municipality, 
Banten Province, Indonesia.  Dr. Nyoman Kandun, Director 
General for Disease Control and Environmental Health at the 
Indonesian Ministry of Health (MOH), and Ms Yong Ying-I, 
Permanent Secretary of the Singaporean MOH co-chaired the 
meeting.  The U.S. delegation was lead by Dr. Chuck Lambert, 
Acting Under Secretary of Marketing and Regulatory Programs 
at the U.S. Department of Agriculture and Dr. Amar Bhat, 
Director of the Office of Asia and the Pacific in the 
Department of Health and Human Service (HHS). 
Representatives from Embassies Jakarta and Singapore and 
NAMRU-2 also participated. 
 
¶5. (U) As noted in the joint press release issued 
immediately after the meeting, Kandun said the goals of the 
pilot project are "to translate the GOI's national plan to 
control AI "in a defined, localized geographic area; reduce 
the prevalence of H5NI AI; replicate project from lessons 
learned; and strengthen local capability and capacity." 
Kandun stressed that the project was timely and should be 
dynamic (i.e., subject to revision).  He continued that it 
was not separate from the national AI plan and in fact 
should serve as a model for its implementation.  Kandun also 
provided an update on the AI situation in Indonesia, 
highlighting key challenges such as coordination, early 
warning systems, public awareness, funding, animal and human 
surveillance, poultry traffic and vaccination, and 
compensation for culling.  Kandun also noted that the 
National Committee on AI Control would soon be operational, 
which an Embassy contact later confirmed.  He added that the 
GOI plans to purchase four million doses of Tamiflu in the 
next two months and increase the number of national referral 
hospitals from 44 to 100. 
 
¶6. (SBU) Ying Li said Singapore is enthusiastic about the 
project and called for input from donors to refine its 
operational details.  She added that Singapore would donate 
USD 1.5 million to the project, as well as technical 
assistance, and asked what technical and financial 
assistance other participants planned to contribute.  USG 
representatives said they could not commit financial aid, 
but offered technical assistance as part of the overall USG 
assistance to the national effort to control avian 
influenza.  For instance, Dr. Lambert noted USDA/APHIS's 
plan to place as soon as possible a U.S. direct hire 
veterinarian and four locally recruited employees in 
Indonesia within the next year.  In addition, Dr. Bhat 
raised the possibility of HHS/CDC assigning someone to 
Indonesia in the near future.  The FAO and the World Bank 
also promised to consider technical aid but did not commit 
funds.  Participants agreed to implement the project in 
three phases beginning in April 2006. 
 
¶7. (SBU) Comment: A number of participants, including a 
representative from Indonesia's MOH, noted the strong bias 
toward human health in the project plan, a bias reflected in 
 
JAKARTA 00003199  003.2 OF 004 
 
 
MOH's heavy representation at the meeting (10 MOH officials 
attend compared to only once official from the Ministry of 
Agriculture).  Kandun acknowledged this imbalance and agreed 
to review the project.  Several participants told us on the 
sidelines of the meeting that they feared the project risks 
failure if the MOA participation is not significantly 
strengthened.  End Comment. 
 
Confusion About Vaccine Development 
----------------------------------- 
 
¶8. (U) The Surabaya daily newspaper Surya reported March 3 
the signing of a March 2 MOU between state-owned 
pharmaceutical firm PT Biofarma and Surabaya's Airlangga 
University (UNAIR) to develop an AI vaccine for humans.  A 
source told us UNAIR will provide technical experts and PT. 
Biofarma a production site, including laboratory facilities. 
The Tropical Disease Center (TDC) in Surabaya may also be 
involved in this effort.  In addition, MOH officials have 
reiterated the Ministry's intention to work with the U.S. 
vaccine producer Baxter International to produce a vaccine 
in Indonesia.  In a December 19, 2005 press release, 
Minister of Health Siti Fadilah reported the MOH would work 
on vaccine production with Baxter and PT. Bio Farma.  The 
Minister repeated this statement on February 28, when she 
told the press her ministry had "already signed a 
cooperation deal with Baxter."  However, Baxter Healthcare 
Corp., a Baxter subsidiary, denied this claim. 
 
Tamiflu Acquisition 
------------------- 
 
¶9. (SBU) With its tamiflu stockpile dwindling to 35,000 
doses, the MOH announced on March 2 an ambitious plan under 
which it would seek to buy 22 million doses of the drug by 
2007 to cover about 10 percent of Indonesia's 220 million 
population.  MOH officials have told the press they 
anticipate purchasing 4 million doses by April 2006, largely 
through Kimia Farma, state-owned pharmaceutical firm PT Indo 
Farma, and Roche.  Our contacts tell us that the latter is 
also in negotiations with the government to allow local 
production of Oseltamivir. 
 
Poultry Vaccination 
------------------- 
 
¶10. (U) According to a March 6 article in the local 
Indonesian language daily Koran Tempo, the MOA plans to 
provide 55 million doses AI vaccine for poultry as part of a 
national vaccination program.  The MOA will reportedly 
distribute the vaccine to Indonesia's 27 AI-affected 
provinces, with priority given to the six most affected 
provinces (Central Java, West Java, East Java, Banten, 
Jakarta, and Lampung).  The MOA hopes to start a mass 
vaccination program later this month and complete it in 
April. 
 
Human AI Case Profile 
--------------------- 
 
JAKARTA 00003199  004.2 OF 004 
 
 
 
¶11. (U) The U.S. Centers for Disease Control and Prevention 
(CDC) confirmed another human AI case on March 10, a 
recently deceased 3-year-old boy from the Central Java city 
of Semarang.  The MOH has also listed a 12-year old girl 
from Solo as a probable case based upon serology (the girl 
is still alive). 
 
¶12. (SBU) NAMRU-2 data indicates the following AI-related 
case profile as of March 10. 
 
-- Number of laboratory confirmed (positive PCR and/or 
serology) human AI cases: 29, of which 21 have been fatal 
(fatality rate of 72 percent). 
 
-- Number of probable AI cases: 5, with 4 deaths (fatality 
rate of 80 percent). 
 
-- Number of cases awaiting verification by the US CDC: 0. 
 
-- Number of possible AI cases under investigation (last 30 
days): approximately 54. 
 
-- Number of excluded AI cases: 218. 
 
PASCOE