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Cablegate: Indonesia - Nabarro's Views On Ai Challenges

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

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