Richel Dursin

JAKARTA, Jan 2 2006 (IPS) – While the death of a man with bird-flu symptoms Monday is seen as a warning that Indonesia continues to live under the threat of a pandemic, authorities have reason to believe they are now on top of the situation.
Mahalis (one name) died shortly after he was admitted to a hospital here and will be the 12th victim of the avian flu virus if tests confirm suspicions based largely on the fact that he came from Tangerang, a town due southwest of Jakarta, where outbreaks among fowl were previously reported.

The Indonesian government has become aware of threats from the avian flu strain and it has started to implement a national strategic plan to avert a pandemic, Steven Bjorge, technical officer of the World Health Organisation (WHO) told IPS.

On Dec.19, the government announced a three-year national strategic plan to contain the spread of the H5N1 virus, involving such aspects as bio-security, vaccination, culling and community-based surveillance of dead or dying birds.

We hope to see a reduction of bird flu cases in the country with the implementation of the strategic plan, said Dedi Masykur Riyadi, deputy to the state minister of national development planning, whose office formulated the national strategic plan.

However, the plan may not be comprehensive enough as it does not include measures to control the spread of the virus in the small and backyard segments of the poultry industry.
The strategic plan only focuses on the large holders of the poultry sector which are well- under control, Bjorge said, adding that Indonesia needed to look at the responses of the Thai government to the avian flu virus, particularly its culling policy.

According to the WHO and other agencies the avian flu virus thrives in chickens which live in and around houses and the government needs to take immediate measures to contain the virus from spreading.

Act as though a pandemic influenza will start tomorrow. Don t think that we can wait around and not worry that it won t start for six months or one year. Once it starts, it is too late to prepare, David Nabarro, United Nations System Senior Coordinator for Avian and Human Influenza, told health and agriculture officials during his visit to Jakarta on Dec. 19.

Nabarro cautioned that children were highly susceptible and called on the United Nations Children s Educational Fund (UNICEF) to take measures to prevent children from getting infected.

Responding to Nabarro s remarks, UNICEF regional adviser Stephen Atwood said the organisation is working on an extensive communications strategy for communities to make sure that families are well-educated on containing the spread of the avian flu virus.

We are educating families not only on measures against avian flu pandemic, but also on basic primary health care precautions, such as washing hands and isolating infected individuals, Atwood said.

Most bird flu victims have come from densely-populated Jakarta, where many people still live in close proximity to poultry, providing ideal conditions for the H5N1 virus to pass to humans.

Until we clean up the virus in chickens on household farms, we can expect to continue having human cases, Bjorge said.

The coordinating ministry for people s welfare, which was assigned responsibility for organising the national effort to prevent a bird flu pandemic, stresses that the awareness of the public, including health workers, remains low.

Indonesia, which is on the front-line of avian flu, is facing a number of constraints, coordinating minister Aburizal Bakrie said pointing out that the government is struggling to prevent the spread of a virus, which has claimed around 16 million chickens.

Compared to other countries, Indonesia is facing bigger challenges, as it is a large country and the systems of government are decentralised, he added.

Indonesia faces financial constraints and funding is not available from the national budget although about 1.5 billion US dollars is needed by the government from 2006 to 2008 to stop the spread of the avian flu virus, according to the National Development Planning.

All we have at present is 150 million dollars, which was agreed upon during the last WHO meeting in Geneva and the government will add another 10 to 20 million dollars, Bakrie said.

Bakrie, who is also a prominent businessman, urged the public to take part in the massive programme to stop the spread of the avian flu virus and appealed to the business community to take a lead role.

Regional authorities may not be aware of the presence of bird flu in their jurisdictions, Health Minister Siti Fadilah Supari said calling on health workers nationwide to be on full alert for the spread of the avian flu virus.

Please be vigilant for patients who suffer severe pneumonia. Check whether there have been poultry deaths around them, Supari said in a public appeal.

Scientists and experts have warned that although the highly pathogenic H5N1 virus affects birds, prolonged exposure and contact with sick birds could lead to the mutation of the virus into a form that could pass easily among humans.

In case a pandemic occurs, the Indonesian government will isolate areas in which 80 percent of the population is infected and will mobilise manpower, including soldiers and police officers, to help limit the reach of the deadly disease, according to the national strategic plan.

Based on the plan, the government will also increase the stockpile of antiviral drugs such as Tamiflu and organise research on bird flu vaccines.

So far, the government has stockpiled 800,000 Tamiflu tablets and it plans to import two million more from the Swiss drug company Roche Holding AG besides production of the drug under license from the patent holders.