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Cablegate: Indonesia - June 18 Avian Influenza Update

VZCZCXRO2125
PP RUEHCHI RUEHCN RUEHDT RUEHHM
DE RUEHJA #1189/01 1700821
ZNR UUUUU ZZH
P 180821Z JUN 08
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 9323
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 7792

UNCLAS SECTION 01 OF 02 JAKARTA 001189

SIPDIS
SENSITIVE

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 - JUNE 18 AVIAN INFLUENZA UPDATE

1. (SBU) Summary. On June 16, Dr. Sangkot Marzuki, Director of the
Eijkman Institute confirmed that the Eijkman Institute was now
conducting full sequencing of samples H5N1 virus. Eijkman staff have
isolated virus in the BSL3 laboratory after culture in embryonated
eggs. He also outlined potential plans to move the Eijkman
Institute from the Ministry of Research and Technology to the
President's Office, with coordination to occur with the Ministry of
Health (MOH). World Health Organization (WHO) officials noted that
Dr. Subhash Salunke, WHO Representative for Jakarta will meet with
Minister of Health Fadilah Supari during the week of June 22 to
discuss Indonesia's obligations under the International Health
Regulations (IHR) to report avian influenza occurrences within 24
hours. The avian influenza (AI) review team concluded a full week
of meetings with donor partners, government animal and human health
officials, hospital and agricultural laboratories, and USAID funded
programs in Jakarta and West Java. On June 11-12, the Regional
Emerging Disease Intervention (REDI) Centre sponsored a workshop
attended by physicians from AI referral hospitals and the private
sector. Although the Ministry of Health Press Office still has not
officially announced the last two AI Cases, the MOH "unofficially"
reports 135 cases, with 110 fatalities. End Summary.


EIJKMAN INSTITUTE STARTS FULL AI SEQUENCING
-------------------------------------------

2. (SBU) In meetings last week, Dr. Sangkot Marzuki, Director told
us that Eijkman Institute had begun full sequencing of a limited
number of samples of avian influenza virus. Marzuki reported that
the Eijkman Institute has signed a cooperative agreement with the
Indonesian CDC and Indonesian National Institutes of Health Research
and Development (NIHRD) outlining the roles of Eijkman, CDC, and
NIHRD in AI surveillance. Eijkman is responsible for "genomic risk
assessment" and maintaining an archive of H5N1 virus isolates.
Eijkman has not received any funding from the MOH or the Ministry of
Science and Technology to support work on AI samples and is seeking
support from the US Centers for Disease Control and Prevention. CDC
is trying to support Eijkman through ongoing cooperative agreement
with the Indonesian CDC. Marsuki noted it will take several months
to process archived samples from 60 patients identified in 2007-08.


3. (SBU) Marzuki also explained that President Yudhoyono's office
will decide whether to move the Eijkman Institute from the Ministry
of Research and Technology to the President's Office, under the
coordination of Ministry of Health, in a plan originally developed
by former Indonesian President Habibie. Marzuki noted that
coordination through the Ministry of Health would offer the Eijkman
Institute better access to MOH funding and reduce interagency
politics but would still preserve Institute independence. The
Ministry of Health has proposed that the Eijkman Institute be moved
directly under MOH, with no reporting relationship to the
President's Office.

WHO REPRESENTATIVE TO DISCUSS IHR CONCERNS
------------------------------------------

4. (SBU) Local WHO representatives noted that Dr. Subhash Salunke,
WHO Jakarta Representative, plans to meet with Minister Supari
during the week of June 22 to address Indonesia's obligations to
report Avian Influenza cases within 24 hours as required under the
IHR. Officials characterized Salunke's current working relationship
with Minister Supari as "excellent" and noted hope that the problem
will be resolved following the meeting.

REVIEW TEAM VISITS GOVERNMENT, DONORS, PROJECTS
--------------------------------------------- --

5. (U) The AI Review team continued efforts to review USG programs
in Indonesia. Field trips outside Jakarta included a tour to a
Tangerang poultry market and a briefing about the Tangerang
Trilateral project as well as a visit to the agriculture research
laboratory (Balitvet) in Bogor. In addition to visiting provincial
and district health and veterinary offices and laboratories in
Bandung, the team toured poultry processing facilities (traditional
and modern), and a sector three poultry farm. Review team members
met with community volunteers from the CBAIC program, and observed a

JAKARTA 00001189 002 OF 002


participatory disease surveillance and response (PDS/R) team
conducting a follow-up activity after a previous outbreak of poultry
deaths.

6. (U) In Jakarta, the team met with central government health and
veterinary counterparts as well as donor partners, including the
World Health Organization (WHO), the United Nations Children's Fund
(UNICEF), the UN Food and Agriculture Organization (FAO), the World
Bank (WB), and AusAid.

PRIVATE PHYSICIANS RECEIVE AI TRAINING
--------------------------------------

7. (U) Responding to a need for private physician training on AI
case management, approximately 30 private physicians participated in
a case management follow-up workshop for AI referral hospitals
sponsored by the REDI Centre on June 11-12 in Jakarta.

HUME

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