VZCZCXRO6938
OO RUEHCHI RUEHCN RUEHDT RUEHHM
DE RUEHJA #0710/01 0992325
ZNR UUUUU ZZH
O 082325Z APR 08
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 8596
RUEHPH/CDC ATLANTA GA IMMEDIATE
RUEAUSA/DEPT OF HHS WASHINGTON DC IMMEDIATE
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
INFO RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RUEHBJ/AMEMBASSY BEIJING 4886
RUEHBY/AMEMBASSY CANBERRA 2283
RUEHUL/AMEMBASSY SEOUL 4509
RUEHKO/AMEMBASSY TOKYO 1767
RUEHWL/AMEMBASSY WELLINGTON 2501
RHEHNSC/NSC WASHDC

UNCLAS SECTION 01 OF 02 JAKARTA 000710 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR EAP/MTS, G/AIAG, AND OES 
DEPT ALSO PASS TO HHS FOR A/S LEAVITT/WSTEIGER AND HHS/NIH 
GENEVA FOR WHO/HOHMAN 
 
E.O. 12958: N/A 
TAGS: TBIO KHIV PREL EAGR PGOV ID
SUBJECT: SCENESETTER FOR A/S LEAVITT'S APRIL 10 VISIT TO INDONESIA 
 
1.(SBU) Summary. Embassy Jakarta welcomes your visit and sees it as 
an opportunity to underscore that, despite disagreement on avian 
influenza sample sharing, both countries need to cooperate on 
broader health issues. Our bilateral engagement on avian influenza, 
which involves six USG agencies, goes beyond sample sharing.  The 
USG also supports programs on HIV/AIDs, tuberculosis, immunizations 
and other infectious diseases.  The Mission believes that increased 
scientific collaboration could provide win-win opportunities for 
both countries and, if played right, help us overcome the current 
impasse. 
 
¶2. (SBU) We have requested meetings with President Yudhoyono, 
Foreign Minister Wirajuda, Minister Bakrie of the Coordinating 
Ministry for People's Welfare, Health Minister Supari, and 
Agriculture Minister Apriyantono. You will also participate in a 
lunch with senior health officials and a field visit to a 
U.S.-supported TB and HIV clinic.  The Ambassador recommends that, 
in all meetings, you stress the importance of our broad cooperation, 
while explaining why it is essential for Indonesia to share all 
samples with the international community. End summary. 
 
------------------------------------------- 
WE WANT TO RESOLVE THE SAMPLE SHARING ISSUE 
------------------------------------------- 
 
¶3. (SBU) Given Indonesia's widespread problem of avian influenza in 
poultry and the global concern that a pandemic strain may emerge 
here, we have to find a way to resolve the human avian influenza 
sample sharing issue.  Your visit with the President and the joint 
ministerial meeting provide an opportunity to explain why it is 
essential for all samples to be shared.  While acknowledging that 
Indonesia and other developing countries have other equities that 
need to be addressed, you should patiently explain the scientific 
requirement for sample sharing.  The Indonesians will undoubtedly 
call for increased access by developing countries to affordable 
vaccines and for the WHO system to be made more "transparent and 
equitable."  While you should stress that our differences on this 
issue should not affect our broader health collaboration, you should 
point out the obvious fact that resolution of the sample sharing 
issue would open up other areas for mutually beneficial 
cooperation. 
 
--------------------------------------------- ---- 
WE SEE INDONESIA AS A PARTNER IN CONTROL OF AVIAN INFLUENZA 
--------------------------------------------- ---- 
 
¶4. (SBU) Indonesia needs to develop and implement a long-term, 
sustainable program to control avian influenza for both poultry and 
humans.  Minister Bakrie, a businessman by background without health 
expertise, is Chairman of the key inter-agency mechanism, the 
National Committee for Avian Influenza Control and Pandemic 
Influenza Preparedness (KOMNAS).  KOMNAS coordinates Indonesia's 
response to avian influenza and implements what there is of a 
national avian influenza strategy. 
 
¶5. (SBU) The United States devotes considerable resources (over $50 
million to date) to help Indonesia respond to the current avian 
influenza outbreak and plan for a possible pandemic.  In June, 
Embassy Jakarta plans to conduct an in-depth review of U.S. 
government-supported control programs.  This review will recommend 
whether we need to adjust current efforts to meet the challenges 
ahead.  It will also provide KOMNAS a road map for better 
utilization of other donor resources.  KOMNAS is working on a 
National Influenza Pandemic Preparedness Plan, but lacks significant 
input from key ministries, as well as operational details of 
Indonesia's response to an avian influenza pandemic.  The United 
States' interagency pandemic planning and simulation exercise 
experience may be useful in filling these gaps. 
 
--------------------------------------------- -------- 
COOPERATION IN SCIENCE TECHNOLOGY EXCHANGE IS A HIGH PRIORITY 
--------------------------------------------- -------- 
 
¶6. (SBU) The U.S. Centers for Disease Control (CDC) and National 
Institutes of Health (NIH) have a long history of collaboration with 
partner institutions in Indonesia.  In addition, U.S. academic 
institutions have expressed interest in collaboration with 
 
JAKARTA 00000710  002 OF 002 
 
 
Indonesian scientists and organizations.  The sample sharing issue 
has negatively affected this collaboration over the past year. 
However, senior staff members in the Ministry of Health (including 
the Minister) have recently expressed a renewed interest in 
developing research ties and scientific exchanges with USG 
institutions.  Both CDC and NIH have offered to place senior 
laboratory scientists at the recently opened Bio-Safety Level 3 
(BSL-3) laboratory at the Eijkman Institute and the BSL-3 laboratory 
currently under construction at the National Institute of Health 
Research and Development (NIHRD).  The Embassy recommends that, in 
meetings with the Ministers of Health and People's Welfare, 
Secretary Leavitt and his party discuss ways to revitalize bilateral 
 
SIPDIS 
science and technology exchange. 
 
---------------------------- 
OUR PRIORITY HEALTH PROGRAMS 
---------------------------- 
 
¶7. (SBU) USAID supports a range of health programs, all of which 
address joint U.S.-Indonesian priorities.  Activities focus on 
maternal and child health care, and prevention and control of 
priority infectious diseases, particularly HIV/AIDS, tuberculosis 
and malaria. The recent UN Country Report indicates the HIV/AIDS 
epidemic in Indonesia is one of the fastest growing in Asia with 
both a concentrated epidemic in most-at-risk populations and a 
generalized epidemic in Papua. There are currently 193,000 
Indonesians living with HIV and epidemiological modeling estimates 
there will be one million infections by 2015. Experts also predict 
that the epidemic will continue to expand if coverage of programs 
remains at current levels. It is essential to maintain PEPFAR 
funding here to address this growing problem, particularly in the 
area of civil society engagement which is critical to successful 
outreach in this epidemic. Indonesia also ranks third in the world 
in the global TB burden; of even more serious concern is the rising 
prevalence of multiple drug resistant (MDR/XDR) TB. Your visit to 
the an Indonesia Tuberculosis Control Association's clinic in 
central Jakarta will highlight progress in addressing HIV and TB 
services as well as overall challenges faced by the health system. 
 
---------------------- 
GLOBAL FUND CHALLENGES 
---------------------- 
 
¶8. (SBU) Indonesia is having significant difficulties implementing 
its Global Fund for AIDS, TB and malaria programs at the Country 
Coordinating Mechanism and the Principal Recipient levels. These 
shortcomings threaten overall Global Fund funding levels and 
negatively affect the credibility of Indonesia's Round 8 proposal 
under development.  Cuts in Global Fund funding would impact all 
three national programs, but would particularly hit the HIV/AIDS 
national program where the U.S. and other donors have cut funding. 
You should stress the importance of improving Global Fund oversight 
and implementation with Minister Bakrie. 
 
----------------- 
AI PRESS COVERAGE 
----------------- 
 
¶9. (SBU) The Secretary's visit has been mentioned in the press in 
the context of avian influenza.  Most press coverage centers around 
vaccine development and related sample-sharing issues, as well as 
ongoing H5N1 cases.  The Mission expects that photographers and 
press will follow your visit to the clinic and may be present 
following your official meetings. 
 
HUME