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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