VZCZCXRO1929
OO RUEHAST RUEHCHI RUEHDH RUEHDT RUEHHM RUEHLN RUEHMA RUEHNH RUEHPB
RUEHPOD RUEHTM RUEHTRO
DE RUEHBK #1158/01 1321004
ZNR UUUUU ZZH
O 121004Z MAY 09
FM AMEMBASSY BANGKOK
TO RUEHC/SECSTATE WASHDC IMMEDIATE 6986
INFO RUEHCHI/AMCONSUL CHIANG MAI 6544
RUEHBJ/AMEMBASSY BEIJING 7022
RUEHUL/AMEMBASSY SEOUL 5475
RUEHKO/AMEMBASSY TOKYO 1596
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHKT/AMEMBASSY KATHMANDU 7492
RUEHSV/AMEMBASSY SUVA 0460
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEKJCS/USCINCPACLO WASHDC
RUEHPH/CDC ATLANTA GA
RUEHRC/USDA FAS WASHDC

UNCLAS SECTION 01 OF 03 BANGKOK 001158 
 
SIPDIS 
SENSITIVE 
 
DEPARTMENT FOR OES/IHB:JJONES,CPATTERSON; EAP FOR DHANNEMAN 
DEPT FOR USAID/GBH 
USDA FOR FAS AND APHIS 
HHS FOR CDC 
USCINCPACLO FOR AFRIMS 
 
E.O. 12958: N/A 
TAGS: KFLU AEMR ASEC CASC TBIO KSAF KPAO PREL PINR AMGT
MG, ECON, EAID, WHO, EAGR, ETRD, TH 
SUBJECT:  MGSF01: ASEAN+3 Flu Ministerial May 7-8 
 
BANGKOK 00001158  001.2 OF 003 
 
 
SENSITIVE BUT UNCLASSIFIED 
 
¶1. (SBU) SUMMARY:  On May 8 Health Ministers from ASEAN + 3 
(including China, Japan and South Korea) gathered in Bangkok for a 
"Special Meeting on Influenza A(H1N1);" a senior officials meeting 
took place on May 7. The resulting Joint Ministerial Statement 
asserted that a pandemic was imminent, that the H5N11 avian 
influenza virus was still a major threat.  Participants described 
Southeast Asia as the best prepared region to cope with an outbreak. 
 The ASEAN+3 ministers rejected imposition of travel restrictions 
and committed to abiding by WHO recommendations, although the 
lifting of bans on pork products was not discussed.  The Ministers 
noted ASEAN+3 capacity to manage an outbreak through its regional 
stockpile of antiviral drugs, and committed to improving research 
capacity and data sharing.  CDC officials participated in DVCs, to 
widespread acclaim on both days.  Indonesia's participation was 
notable for its opposition to mentioning CDC efforts in the Joint 
Statement, and in its suggestion that CDC was not fully sharing 
virus information.  END SUMMARY. 
 
BACKGROUND TO THE MINISTERIAL 
----------------------------- 
¶2. (U) At the suggestion of the Cambodian Minister of Health, the 
Thai Minister of Health agreed to host in Bangkok an ASEAN+3 H1N1 
health ministerial, which the ASEAN Secretariat quickly organized 
and billed the "Special Meeting on Influenza A(H1N1)."  A May 7 
Senior Officials Meeting preceded the Ministerial; the Philippines 
chaired both meetings.  Donor countries and press were invited as 
observers and allowed in all sessions.  All health ministers 
participated except for those from Singapore, Japan and South Korea, 
who sent senior officials, and Burma, represented by its Ambassador 
to Thailand. 
 
¶3. (U) Live speeches were made by the ASEAN Secretary General (SGY) 
and the Thai Health and Prime Ministers.  Digital Video Conference 
presentations were made by the UN Influenza Director, the WHO 
Director and Assistant Director General, and the Mexican Minister of 
Health.  Two officials from U.S. Centers for Disease Control and 
Prevention (CDC), Dr. Anne Schuchat, Deputy Director for Science and 
Richard Besser, Acting Director, made live DVC presentations that 
were well-received. Each Senior Official gave a presentation on 
respective national H1N1 responses. 
 
¶4. (U) WHO and CDC presentations stressed the need for continuing 
vigilance, drawing parallels to the mild beginning of the 1918 
epidemic.  The presentations recommended against closing borders or 
mandating travel restrictions: containment was not possible while 
the economic and social hardships would be too great. The Ministers' 
Joint statement reflected agreement on these matters.  The WHO 
presentations emphasized that properly prepared swine products were 
not a danger, but neither discussions nor the Statement touched on 
the swine import prohibitions that many ASEAN members have 
instituted. 
 
ASEAN+3 PREPARED BUT NEEDS RESEARCH, VACCINE CAPACITY 
--------------------------------------------- -------- 
¶5. (U) The ASEAN SGY summarized the ASEAN+3 future focus with five 
points: establishing a hotline for enquiries and information 
sharing; increasing coordinated surveillance; planning for exit 
screening of persons with H1N1 cases leaving any member nation; 
sharing laboratory research; and planning for regional vaccine and 
oseltamivir production.  ASEAN presenters described SE Asia as the 
best prepared region in the world due to simulation exercises that 
all of the ASEAN+3 had conducted as well as the communal stockpiling 
of oseltamivir.  Out of one million courses of treatment, 500,000 
had been distributed among the members equally.  Another 500,000 
courses (450,000 oseltamivir and 50,000 zanamivir) remained 
stockpiled in Singapore.  Also stockpiled were 750,000 sets of 
personal protective equipment (PPE), half distributed equally to the 
ten ASEAN members (35,000 each) and 350,000 kept in Singapore.  With 
Japan's help, the Secretariat was working on outbreak logistics 
training for all ASEAN countries. 
 
 
BANGKOK 00001158  002.2 OF 003 
 
 
INDONESIAN NEGATIVITY TOWARDS CDC 
--------------------------------- 
¶6. (SBU) In an otherwise positive and forward-looking two days of 
collaborative treatment of the H1N1 outbreak, Indonesian 
representatives expressed concern about data sharing by, and the 
role of CDC. Senior Advisor Widjaja Likito complained that CDC was 
not releasing genetic sequencing for individual patients.  Health 
Minister Supari Siti Fadilah repeatedly tried to amend the already 
agreed upon Ministerial Statement with a reference to the importance 
of the Global Initiative on Sharing All Influenza Data (GISAID), and 
then withdrew the proposed amendment when the Chinese Health 
Minister suggested acknowledging CDC's role in H1N1 genetic 
sequencing. 
 
REMARKS PRAISE DONOR COOPERATION 
-------------------------------- 
¶7. (U) In various remarks by the ASEEAN Secretary General (SGY), the 
Philippine Chair and Thai officials, all made a point of expressing 
gratitude to the specific countries that had supported ASEAN 
preparedness: Japan, Australia and the U.S. (CDC and USAID). The 
resulting Joint Statement commits to strengthening collaborative 
research and notes related efforts underway: ASEAN+3 Emerging 
Infection Diseases (EID) Programme of the ASEAN secretariat (largely 
funded by AusAid), the Mekong Basin Diseases Surveillance network 
(MBDS) (officed in Bangkok, a partnership including CDC, USAID, 
Rockefeller,  Google, RAND, WHO, ADB and ASEAN) and the Asian 
Partnership on Emerging Infectious Diseases Research (APAIR or 
APEIR)(a partnership formed and supported by the Canadian 
government's International Development Research Centre [IDRC] 
Singapore office). In the final press conference, the ASEAN SGY 
noted that with WHO and CDC help, ASEAN+3 would be able to meet the 
technical challenges posed by H1N1. 
 
JOINT MINISTER'S STATEMENT 
------------------------- 
¶8. (U) The Joint Ministers statement asserts that a "pandemic is 
imminent" and noted that the H5N1 influenza virus was still a major 
threat.  As "imposing travel restrictions would have very little 
effect on stopping the virus from spreading but would be highly 
disruptive," social distancing and individual preventive measures 
were preferred. The statement notes the concern that "most global 
vaccine production capacity is in Europe/North American, and is 
inadequate to respond to global pandemic...access to enough pandemic 
vaccines is a major problem." 
 
¶9. (U) In addition to the expected plans to improve preparedness and 
capacity , the ASEAN +3 nations committed to complying with WHO 
recommendations; considering a more formal ASEAN +3 information 
sharing system; encouraging technology transfer related to 
production of antivirals and vaccines; and establishing joint 
outbreak teams.  The Ministers committed on the national level to 
"conclude the ongoing Inter-Governmental Meeting on sharing of H5N1 
and other influenza viruses...and...equitable sharing of benefits." 
The press release confirmed that the "meeting also touched 
upon...enhancing fair and equitable share of benefits." 
 
¶11. (U) POC is regional/bilateral ESTH officer Hal Howard, 
howardhh@state.gov.  The following documents were scanned and 
emailed to the office of Ambassador to ASEAN Marciel: Schedule; List 
of Participants; Press Release; Chairperson's Report; and national 
presentations or speeches.  The Joint Ministerial Statement can be 
found at http://www.aseansec.org/22543.htm.  ESTHoff emailed a 
detailed report of the meeting to EAP ASEAN office and OES/IHB. 
ESTHoff will email a detailed report of the meeting, including 
country presentations to EAP ASEAN office and OES/IHB. The AusAid- 
supported Network for Emerging Infectious Diseases in ASEAN Plus 
Three tracks cases at www.aseanplus3-eid.info. 
 
COMMENT: 
-------- 
¶12. (SBU) While the Indonesian representative's negative 
interventions towards CDC marred a meeting otherwise characterized 
by cooperation, virtually all other representatives repeatedly 
 
BANGKOK 00001158  003.2 OF 003 
 
 
expressed to ESTHoff appreciation for USG efforts.  Country 
presentations and the Statement lacked mention of how members were 
treating suspected cases, which has been controversial in some 
member states.  The meeting reinforced an existing mechanism for 
responding to outbreaks: distributing a basic load of patient 
courses of treatment to each member, and stockpiling a common 
reserve that a member country can draw upon.  The meeting and 
Statement furthered a regional commitment to share research as well 
as vaccine and drug production. 
 
¶13.  (SBU) Despite a few country presentations that mentioned 
simulation exercises and national interagency coordination, most 
focused only on health ministry efforts.  Absent from the meeting 
was a plan for having a regional simulation exercise to test 
preparedness especially in sectors outside of the public health 
ministries; USG best practices in these two areas might be an avenue 
for further collaboration.  USAID has been providing funding and 
technical assistance since 2007 to ASEAN multi-sectoral pandemic 
preparedness, including to ASEAN's Technical Working Group on 
Multi-Sectoral Pandemic Preparedness.   AusAid has spent $3 million 
over three years on outbreak preparedness for ASEAN; the AusAid 
observer told ESTHoff of a new trust fund under consideration for 
outbreak preparation and response and that partnership with the USG 
would be welcome. 
 
JOHN