Indonesia’s Health Minister, Siti Fadillah Sapari, on Monday, 18 September, told ANTV viewers that poultry in 30 provinces out of Indonesia’s total 33 provinces have been infected with the H5N1 Avian Flu virus, while infection to humans have occurred in 8 provinces. Until today, the Minister assures, infection is still caused by the same virus that has not mutated, while reason for infection is still from sick poultry to humans through direct contact or through manual handling of fertilizers contaminated with the virus. 

Forty Nine deaths from Avian influenza have been confirmed in Indonesia, which makes this country now having the highest number of deaths from Bird Flu in the world. The Karo highlands in North Sumatra, has also been registered as the area with the highest number of persons in a “cluster” – or members of one family - having died of this deadly disease. However, again assures Minister Fadillah, the spread of Avian Flu in the Karo Highlands has been successfully contained, as so far, thank God, no further cases have occurred. 

One must be clear, says Fadillah that in Indonesia, avian flu does not “spread”, as from a centre outwards, but occurs from island to island, carried by migrating birds. Therefore, the cases of avian flu in Tangerang, near Jakarta, for example was not “spread” from the Karo Highlands in Sumatra, but migrating birds have brought the same virus to Java, and vice versa. These are characteristics of Indonesia as an archipelago. Indonesia has a total poultry population of 1.3 billion, with the largest number reared in people’s backyards. It is therefore not possible to stamp out the poultry population on all the islands. 

The government, however, has been meticulous in combing the country side for infected fowl and vaccinate poultry to further prevent the spread of the disease. Similarly, health officials have subscribed tamiflu tablets or vaccinated villagers living next to sick victims. In response, when villagers found a number of chickens or other birds suddenly dead with the symptoms, they have voluntarily killed and burned their entire stock to a one-kilometer radius. The government now urges poultry markets to be located outside, or on the outskirts of urban areas.

Earlier, Unicef admitted that Indonesia’s geography of  17,000 islands sprawling across the equator and the hundreds of ethnic groups that make up the222 million population of Indonesia, makes the work of “socializing” a far from easy undertaking.

Indonesia needs International Support 

Last Friday, 15 September, a senior United Nations official however, reminded that despite enormous progress made, bird flu remains a major problem in Indonesia, and called for international financial aid to combat the disease. 

"I have been informed about the enormous progress that is taking place in Indonesia's war on bird flu, particularly in the last eight to 12 weeks," David Nabarro, senior UN system coordinator for avian and human influenza, told a press conference, according to Kyodo News as quoted by Indonesia’s Trade and Investment News published by the Coordinating Ministry for the Economy. 

"I'm very pleased to see an increased focus on animal health services and on what we call behavior change communication," he said.

Nabarro stressed that bird flu remains a major problem in Indonesia and expressed particular concern about the time approaching for birds to migrate from north to south, which will be an issue of global significance. 

"I'm not at all saying it's under control," he said. "We have come a long way in recent weeks, but we have got a long way to go still to make sure that the risks caused by avian influenza can be brought properly under control in Indonesia." 

"We agreed today that from now on, there will be a checklist to describe how we will expand these new efforts so they do cover the whole of the country, but of course, the expansion of animal health services and behavior change communications needs money," he added.

Nabarro said he had agreed to cooperate with Coordinating Minister for People's Welfare Aburizal Bakrie to get additional resources from national and international sources. 

"I am, like you, frustrated that we still have not been able to get to Indonesia resources that you need to enable you to fight against bird flu with all the energy that is necessary," Nabarro said. 

The World Health Organization on Thursday announced that it had registered two more cases of bird flu in Indonesia, including one fatality, which had earlier not been recognized by the body, raising the death toll to 49 out of 65 cases. 

The first case, according to the WHO, occurred in a five-year-old boy from Bekasi in the suburbs of Jakarta . The boy developed symptoms on 4 March 2006, was admitted to hospital on 6 March, and died on 19 March. 

Indonesia Receives US$47 Million of US$ 250 Million Needed to Overcome Bird Flu 

Meanwhile, Indonesia has received a committed loan of US$47 million (RM172.49 million) to prevent the avian influenza from developing into the next stage, ANTARA reported.

Antara quoted the Coordinating Minister for People’s Welfare, Aburizal Bakrie, that the government's top bird flu priorities are vigorous and sustained action to control the H5N1 virus at its source particularly in animals.

He was speaking to reporters after receiving senior UN System Coordinator for Avian and Human Influenza David Nabarro and other delegates.

H5N1 virus is still primarily an animal disease, but experts believe it could mutate into a form which spreads easily among humans, possibly setting off a global pandemic.

Meanwhile, Chief Executive of the National Committee for Avian Influenza Control and Influenza Pandemic Preparedness (Komnas FBPI) Bayu Krisnamuthi said: "The objective is to prevent the avian influenza from developing into the next state. Culling, compensation, vaccination and bio-security are clearly vital to reducing the threat."

Animal control measures are now a top priority, along with risk communications, information and public awareness and disease surveillance in animals and humans.

"We have the right strategy," Krisnamurthi said, adding that since the June meeting of International experts, Indonesia have been re-doubling its efforts to confront this virus.

Dr Naborro, the top UN official for bird flu, is in Jakarta to find out what more the international community should do to support the Indonesian government's refocused national bird flu strategy.

He also noted that the Indonesian Agriculture Ministry had made great progress in recent months, setting up new systems for early detection of disease outbreak and coordinated response measures, including programs like participatory disease surveillance and participatory disease response.

These programs are being expanded to more than 150 districts in Java, Sumatra and Bali with the support of the UN Food and Agriculture Organization (FAO) and donor agencies including USAID, AusAID and the government of .

The United Nations (UN) special envoy said here Friday that the international aid for fighting bird flu in Indonesia was slow and urged donors to speed up their aid disbursement. "We are not close enough to what is required of 250 million U.S. dollars, but we have made a step forward to create condition, under which more money can be made available," he said. 

The envoy cited that avian influenza in Indonesia was a problem of the whole world. Indonesian Coordinating Minister of People Welfare and Poverty Alleviation Aburizal Bakrie said that Indonesia had raised its budget of fighting avian influenza by more than 300 million U.S. dollars. 

The country has only received over 47 million U.S. dollars so far, according to Bayu Krishnamurthy, head of national agency for bird flu control and pandemic preparedness.

The United States aid agency USAID Friday promised to increase 3.2 million U.S. dollars to its 14.6 million U.S. dollars already committed and the World Bank also considered assisting 15 million U.S. dollars grants, Krisnamurthi said. 

"Indonesia gets the world appreciation for fighting avian influenza," said Bakrie, adding that the methods used by the country to fight the H5N1 was also approved by international experts. 

Bakrie said that there are 1.3 billion chickens in the country. The authorities had vaccinated over 400 million in three phases and prepares to vaccinate the rest.
The Jakarta government has agreed to use some of the hundreds of millions of dollars it has set aside for natural-disaster relief and poverty-reduction programs for prevention and containment, said Aburizal Bakrie, Indonesia's coordinating minister for people's welfare. 

"Indonesia is very serious ... in taking down this problem," Bakrie told the press conference, noting that the country has a myriad of other health problems that kill thousands of people each month. 

In order to prevent the virus from mutating into a human-to-human form that could create a pandemic and kill millions, the Jakarta government agreed to rapidly expand animal-control measures, by vaccinating and culling poultry as needed and also compensating chicken farmers. 

Indonesia's Agriculture Ministry will also triple the number of early surveillance and response programs to 150 provincial districts across the country. 

Nabarro said Indonesia had "come a long way" in the past three months, but noted that its planned animal-control expansion hinges on donor money. "That is our objective. To get the money to start to flow," he said. 

The US Agency for International Development announced during Friday's meetings that it would give 3.2 million dollars in new aid, and the World Bank discussed a possible 15 million dollar grant to control the virus and provide funds for culling and compensation. 

(Sources: Indonesia’s Trade and Industry News, Kyodo News, Antara, Bernama, Xinhua)       
(Tuti Sunario)