P 251425Z MAR 09
FM SECSTATE WASHDC
TO USMISSION GENEVA PRIORITY 
INFO AMEMBASSY JAKARTA PRIORITY 
DEPT OF HHS WASHINGTON DC PRIORITY

UNCLAS STATE 028521 
 
 
E.O. 12958: N/A 
TAGS: AMGT EAGR ID KFLU PGOV TBIO WHO
SUBJECT: REPORTING OF INDONESIA HUMAN AVIAN INFLUENZA 
(H5N1) CASES - REQUEST FOR CLARIFICATION 
 
REF: A. JAKARTA 477 
     ¶B. JAKARTA 398 
 
 
1.(U) This is an action request; please see paragraphs 5 and 
¶6. 
 
2.(SBU) Per reftels, evidence of human cases of H5N1 Avian 
Influenza in Indonesia since the end of 2008 continues to 
mount. We understand that at least four cases have been 
reported to the World Health Organization (WHO) office in 
Jakarta, but we have not seen evidence that these cases have 
been reported to Memeber States by the WHO, either posted on 
the appropriate WHO website, or made public by either the 
Government of Indonesia (GOI) or the WHO. On the contrary, 
WHO staff in Indonesia have referred to an agreement with the 
GOI Ministry of Health not to share the information with 
other Member States until the Ministry of Health publicly 
announces the cases.  It would seem WHO risks subjecting 
public health transparency on human H5N1 cases to 
Indoniesia's national public health decisions. 
 
3.(SBU) Futhermore, various media, Internet and other reports 
indicate additional human H5N1 cases may have not been 
reported to the WHO office in Jakarta, to WHO Geneva, or 
otherwise made known. Such lack of clear, substantiated 
reporting fuels rumors and limits the international 
community's ability to assess the severity of the H5N1 
situation for humans in Indonesia. 
 
4.(SBU) According to the International Health Regulations, a 
human case of H5N1 influenza is both a notifiable event and a 
public health event of international concern. We believe WHO 
needs to report human H5N1 influenza cases to the 
international community to meet its commitment to protect 
public health. 
 
Action Requested: 
 
¶5. Mission is instructed to approach WHO at an appropriate 
level to express our concern. Mission should urge the World 
Health Organization to the need for WHO to produce regularly 
updated reporting on human cases of H5N1 by country. The U.S. 
encourages all countries to report such cases to the 
international community according to the International Health 
Regualtions, and for the GOI and other member states to 
comply with this need for information-sharing. 
 
6.(SBU) If the WHO does not believe it needs to be reporting 
regularly on cases in Indonesia or elsewhere, we would 
appreciate further information regarding the WHO position. 
 
¶7. We appreciate the Mission's help. Please slug replies for 
OES/IHB - Patterson and Shapiro. 
 
 
CLINTON