VZCZCXRO8720
RR RUEHCHI RUEHCN RUEHDT RUEHHM
DE RUEHJA #0221/01 0351027
ZNR UUUUU ZZH
R 041027Z FEB 08
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC 7889
RUEHPH/CDC ATLANTA GA
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RHHMUNA/HQ USPACOM HONOLULU HI
RHHMUNA/CDR USPACOM HONOLULU HI//J07/CATMED/CAT//
RUEHBK/AMEMBASSY BANGKOK 8311
RUEHBY/AMEMBASSY CANBERRA 1962
RUEHFR/AMEMBASSY PARIS 1083
RUEHGV/USMISSION GENEVA 7724

UNCLAS SECTION 01 OF 02 JAKARTA 000221 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR EAP/MTS, G/AIAG AND OES 
USAID FOR ANE/CLEMENTS AND GH/CARROLL 
DEPT ALSO PASS TO HHS/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH 
GENEVA FOR WHO/HOHMAN 
 
E.O. 12958: N/A 
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID
SUBJECT: INDONESIA - NABARRO's VIEWS ON AI CHALLENGES 
 
REF: A) Jakarta 137  B) Jakarta 68 and previous 
 
¶1. (SBU) Summary. UN System Senior Coordinator for Avian and Human 
Influenza David Nabarro told the Ambassador on February 1 that he 
believes the avian influenza problem in Indonesia has grown more 
serious and that leading members of the Indonesian scientific 
community are increasingly alarmed about Minister of Health Supari's 
policies.  Nabarro shared highlights of his meetings with Indonesian 
officials, including Minister Supari views that the gap between US 
and Indonesian positions over use of a Materials Transfer Agreement 
is closing.  Nabarro also reported that President Yudhoyono had 
convened a meeting on January 30 with the Ministers of Health, 
Agriculture and People's Welfare to press them to get the AI problem 
immediately under control in the greater Jakarta area, including 
Tangerang.  Ambassador Hume outlined his concerns that Ministry of 
Health officials are not appropriately briefing up and in some 
cases, have misled superiors on the facts surrounding avian 
influenza.  He outlined possible US actions to expedite progress on 
ending the sample sharing impasse and on improving patient 
management for AI cases. Nabarro urged that the US pursue these 
ideas, noting that the time may be particularly right given 
President Yudhoyono's recent focus on AI and Supari's intention to 
resolve sample sharing by April.   End Summary. 
 
Disease More Engrained, Scientists Frustrated 
--------------------------------------------- 
 
¶2. (SBU) Citing a series of meetings and phone conversations between 
January 29-31, Nabarro reported that he is increasingly concerned 
about the central authorities' failure to address the AI problem in 
Indonesia. The viral load among the poultry population remains high, 
particularly in Tangerang.  Market studies show high levels of virus 
and large commercial poultry farms continue to operate outside 
regulatory authority.  Nabarro stated Indonesian scientists are 
increasingly voicing their alarm at the Ministry of Health's refusal 
to share viruses, leaving both Indonesian and international 
scientists in the dark about genetic changes in the virus. 
 
¶3. (SBU) In response to increased media attention on avian influenza 
in Indonesia, President Yudhoyono convened an emergency avian 
influenza meeting on January 30 among his ministers of Agriculture, 
Health and the People's Welfare and told the ministers to "fix the 
problem."  Yudhoyono emphasized the ministers must first control the 
problem in the greater Jakarta area, including Tangerang, before 
fixing the rest of Indonesia.  However, Nabarro also noted that 
although international AI donor funds are increasing, the Government 
of Indonesia's contributions have not changed.  Nabarro suggested 
that the donor community might make more progress through working 
directly with district and provincial authorities. 
 
Supari Believes MTA Deal with USG Near 
-------------------------------------- 
 
¶4. (SBU) In his meeting with Minister Supari, Nabarro recounted that 
Supari sounded optimistic that Indonesia and the US were close to 
resolving differences concerning use of a material transfer 
agreement for sample sharing and working out arrangements that would 
govern virus sharing. Supari cited a very positive meeting with a US 
official in Geneva, where she claimed an agreement was reached that 
both parties would work towards a satisfactory resolution of 
outstanding issues so that she could resume (and announce) sample 
sharing in April during a proposed HHS Secretary Leavitt visit to 
Indonesia.  Supari was pushing her staff to resolve all outstanding 
issues before April. Supari asked Nabarro to convey her conversation 
to WHO Director Margaret Chan. 
 
Book Release "It's Time for the World to Change" 
--------------------------------------------- --- 
 
¶5. (SBU) Nabarro also reported that publishers will release Supari's 
book entitled "It's Time for the World to Change" during the week of 
February 2.  The book recounts Supari's sample sharing odyssey 
beginning with the cluster of human cases in Karo in May 2006 
through the November 2007 New Delhi talks. Throughout the book, 
Supari attributes her stance as something that she was "driven to 
do" after receiving "a calling from God."  Nabarro noted that the 
 
JAKARTA 00000221  002 OF 002 
 
 
book mentions WHO, US and other officials by name.  The book also 
mentions assistance Supari has received from the Third World Network 
and the Government of Iran. 
 
Possible US Strategies 
------------------------- 
 
¶6. (SBU) The Ambassador noted that Indonesian ministries are not 
accurately briefing their leadership on the domestic AI situation 
and at times have deliberately misrepresented the facts.  Senior 
officials including Coordinating Minister Aburizal Bakrie did not 
appear aware that the case fatality rate in Indonesia has increased 
nor grasped that the Tangerang outbreaks could eventually disrupt 
airline travel into Jakarta international airport. The Ambassador 
noted that he planned to be in Washington during the week of 
February 11 and would raise the following ideas: 
 
 -- Washington considers immediately sending a negotiating team to 
Jakarta to expedite discussions between the Ministry of Health and 
the US to resolve remaining differences in the materials transfer 
agreement and other issues discussed in Geneva so that sample 
sharing can resume before April. 
 
 -- Washington conducts an independent evaluation of USG-funded 
avian influenza programs in Indonesia to assure funds are optimally 
used. 
 
 -- Avian Influenza Advisory Group recommends that President Bush 
send President Yudhoyono a sympathetic, private letter, offering 
assistance linked to immediate sharing of samples.  Assistance could 
include helping Indonesia step up virus containment in Tangerang, 
improve clinical management of AI cases, and improve research and 
laboratory capabilities. 
 
¶7. (SBU) Nabarro strongly agreed that these measures may be 
conducive to making progress in Indonesia.  He urged the US to give 
these recommendations immediate consideration in order to capture 
the momentum created with President Yudhoyono's push for immediate 
control of the situation. 
 
Meeting Participants 
-------------------- 
 
¶8. (SBU) Other meeting participants included: 
 
 -- Dr. Subhash Salunke, World Health Organization Representative 
 -- John Holmes, Ambassador to Canada 
 -- Louise Hand, Deputy Chief of Mission, Australian Embassy 
 -- Warren Hauck, Economic Officer, Australian Embassy 
 -- Anna Lehtinen, UN Regional Avian and Human Influenza 
Coordinator, Asia-Pacific Regional Hub 
 -- Dr. Johnathan Agranoff, UN Office of the Humanitarian/Resident 
Coordinator. 
 
HUME