VZCZCXRO1360
PP RUEHCHI RUEHCN RUEHDT RUEHHM
DE RUEHJA #1733/01 2560704
ZNR UUUUU ZZH
P 120704Z SEP 08
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 0066
RUEHPH/CDC ATLANTA GA
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEAWJB/DOJ WASHDC
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RUEHGV/USMISSION GENEVA 7826

UNCLAS SECTION 01 OF 02 JAKARTA 001733 
 
SIPDIS 
UNCLASSIFIED 
 
DEPT FOR EAP/MTS, G/AIAG, L/DL, EAP/EX, AND OES/IHA 
USAID FOR ANE/CLEMENTS AND GH/CARROLL 
DEPT ALSO PASS TO HHS/WSTEIGER/MSTLOUIS AND HHS/NIH 
DEPT ALSO PASS TO DOJ for OFL 
GENEVA FOR WHO/HOHMAN 
USDA/FAS/OSTA BRANT, ROSENBLUM 
USDA/APHIS ANNELLI 
 
E.O. 12958: N/A 
TAGS: TBIO EAGR AMGT PGOV ID KLIG
SUBJECT: INDONESIA - SEPTEMBER 11 AVIAN INFLUENZA UPDATE 
 
¶1. (U) Summary. On 8 September, the Ministry of Health (MOH) 
publicly reported two avian influenza (AI) cases, and the World 
Health Organization (WHO) followed suit. MOH experienced staffing 
changes including a change in Director General of the Directorate of 
Disease Control & Environmental Hygiene (DCEH), Head of Biomedical 
and Pharmacy Research at the National Institute of Health Research 
and Development. Minister of Health Supari reviewed and approved the 
cooperative agreement between DCEH and the US Centers for Disease 
Control and Prevention. Minister Supari received negative press in 
recent weeks for some of her actions and continues to give speeches 
about her book and work on behalf of developing nations. The Animal 
and Plant Health Inspection Service hosted a workshop to better 
coordinate government and commercial farmers to develop an industry 
safety assessment mechanism to create disease free farms. End 
Summary. 
 
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Two Cases Reported by MOH, Featured on WHO Web Site 
--------------------------------------------- ------ 
 
¶2. (SBU) The Ministry of Health posted two new AI cases on its web 
site in Bahasa Indonesia the week of 8 September. On 10 September 
the WHO updated its web site to reflect those same cases. The WHO 
reports the total case count at 137 with 112 fatalities. Post was 
aware of these cases before the Ministry of Health and WHO 
officially announced them. 
 
¶3. (U) The first patient was a 38 year old male from Tangerang 
Municipality, Banten Province who developed symptoms on 4 July 2008, 
was hospitalized on 9 July, and died on 10 July. There were free 
roaming poultry throughout his neighborhood, including a commercial 
poultry pen owned by a neighbor. The second patient, a 20 year old 
male from Tangerang District, developed symptoms on 20 July, was 
hospitalized on 29 July, and died on 31 July. Reports indicate that 
chickens from the case's household had died in the week preceding 
the onset of his symptoms and that he had slaughtered and consumed 
some of his stock during this period. 
 
 
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Changes in Staffing Within the Ministry of Health 
--------------------------------------------- ---- 
 
¶4. (U) Dr. I. Nyoman Kandun, Director, Directorate of Direct 
Transmitted Disease Control, Directorate General of Disease Control 
& Environmental Hygiene, (P2M) retired 1 September. His interim 
replacement as is Dr. Tjandra Yoga Aditama, who is linked 
politically to Minister Supari. Dr. Tjandra previously worked as 
Head of the Subdirectorate of Directly Transmitted Diseases, and has 
a background in pulmonary medicine. CDC staff worked extensively 
with him on the pandemic simulation exercise in Bali in April 2008. 
 
¶5. (U) Management changes also occurred at the National Institute of 
Health Research and Development (NIHRD). Dr. Trihono, former Head of 
Program and Cooperation, in the Research and Development Center of 
Ecology and Health Status, replaced Dr. Endang Mamahit as the 
Director of the Center for Biomedical and Pharmaceutical Research 
and Development. Please note that Dr. Trihono is not the same person 
as Dr. Triono Soendoro, the Director of NIHRD. Dr. Trihono recently 
indicated his interest in renewing the cooperative agreement with 
CDC and adding projects with the Biosecurity Engagement Program 
(BEP). 
 
¶6. (U) Staff from the Indonesian Directorate General for Disease 
Control and Environmental Hygiene briefed and received approval from 
the Minister of Health for a work plan outlined in the renewed 
cooperative agreement with CDC.  Dr. Trihono from NIHRD indicated 
his interest in renewing the cooperative agreement with CDC and has 
prepared a brief outlining priority activities including some 
projects related to the Biosecurity Engagement Program (BEP). 
 
------------------------------------- 
Minister of Health Receives Bad Press 
------------------------------------- 
 
¶7. (SBU) Over the past several months, Indonesian media outlets have 
been critical of Minister Supari. 
 
JAKARTA 00001733  002 OF 002 
 
 
Her reputation has suffered due to several unpopular moves and the 
resultant press coverage. In the latest, she was blasted for 
withholding information about bacteria in infant formula, and 
several months prior, she earned very negative coverage for 
expelling poor patients from hospitals. 
 
--------------------------------------------- --------- 
Minister of Health Gives another Speech about Her Book 
--------------------------------------------- --------- 
 
¶8. (U) On September 4, Minister Supari spoke about her book, "It's 
Time for the World to Change," during a panel discussion at 
Paramadina University.  She initiated the discussion by describing 
the system she stated was unfair: that the developing countries, who 
supplied the H5N1 virus to the WHO for analysis and eventual vaccine 
production by commercial companies, were unable to purchase those 
same vaccines at a reasonable price.  She stated that because 
Indonesia and other small countries had lost faith in the current 
GISN system, she had proposed a new mechanism, WHO Influenza Network 
(WIN).  The new mechanism would be more transparent, be acknowledged 
under international law, include a user-friendly tracking system, 
and include a material transfer agreement with monetary and 
non-monetary benefits.  At the conclusion of her speech, Supari 
reiterated that her real desire was to increase transparency in 
health and politics, and close the gap between developed and 
developing countries. 
 
¶9. (U) Other panelists, Anies Baswedan (Paramadina University 
rector), Syafiq Basri (former Tempo reporter), Bima Arya Sugiarto 
(Paramadina University International Relations faculty), and Makarim 
Wibisono (former permanent representative of the Republic of 
Indonesia to the United Nations in Geneva) praised Supari for 
advocating on behalf of developing countries.  Wibisono further 
elaborated that developing countries must organize to make the 
sample sharing process and GISN mechanism more transparent and 
equitable. 
 
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Pandemic Simulations and Reporting Workshops Scheduled 
--------------------------------------------- --------- 
 
¶10. (U) Part Two of the Bali pandemic simulation is scheduled for 
mid-December. CDC has also partnered with the Japan International 
Cooperation Agency (JICA), and the WHO on a pandemic early warning 
system workshop 27-30 October, location to be determined. 
 
¶11. (SBU) On 26-28 August, APHIS hosted a workshop to improve 
coordination and communication between the government and the sector 
1 poultry industry with the end goal of creating disease free farms 
and zones. Attendees included 46 participants from 12 poultry 
breeding companies and 40 government employees, including local 
officers from West Java province. The Minister of Agriculture (for 
political reasons) is pushing the team to have result - disease free 
zones/compartments - by the end of 2008. As an intermediate goal, 
the team will develop an assessment mechanism and train an 
assessment team. 
 
 
HUME