News Focus: BIRD FLU CASES DECLINING IN INDONESIA, BUT PREVALENCE STILL SEEN HIGH INTERNATIONALLY By Eliswan Azly

Jakarta, June 22 (ANTARA) - It is a debatable question if we wish to see the progress made by Indonesia in eradicating the fatal bird flu virus (H5N1 in this largest archipelagic country.

It depends on where we start in seeing the progress and performance of eradicating the bird flu virus. At national level, it is true the number of bird flu cases in this country has declined compared to last year's, but at international level, it is still high.
Health Minister Siti Fadilah Supari during her visit to Medan, North Sumatra, last week said that in the beginning of the second semester of 2008, the number of birdflu cases on human beings has dropped, and even reached a record low both in 2005, 2006 and even 2007.

The main cause of the decline is the increasing awareness of the people on bird flu, namely that one should immediately do something as soon as the person noticed some symptoms of the fatal disease.
At present each regional administration has a guidebook on bird flu for distribution to all layers of the society.

"Thank God we already have a handbook on bird flu, and we also have the support from some other countries, including Australia, Germany, India, and China," she said.

The minister also said that as the result of foreign media reports in 2006 that birdflu in Indonesia had already been transmitted from people to people after a whole family in Karo Regency, North Sumatra, had been affected by the bird flu virus, Indonesia had been avoided by the international community.

However, whatever containment efforts made by national authorities and the international community in dealing with the spread of the H5N1 virus, FAO in its report in March, 2008, still listed Indonesia as a country worst hit by avian influenza.

Perhaps, this country has made some progress in lowering the number of bird flue cases, but the progress is much smaller than the number of bird flu cases which attacked other countries in the world.

FAO Chief Veterinary Officer Joseph Domenech as quoted from the FAO News Room through emailed message said the human mortality rate from bird flu in Indonesia is the highest in the world. There will be more human cases if we do not focus more on containing the disease at the source in animals.

"Furthermore, I am deeply concerned that the high level of virus circulation in birds in the country could create conditions for the virus to mutate and to finally cause a human influenza pandemic," Domenech warned.

The avian influenza situation in Indonesia is grave and all international partners and national authorities need to step up their efforts for halting the spread of the disease in animals and making the fight against the virus a top priority.

More saddening, it was also reported that avian influenza had become deeply entrenched in Indonesia with 31 out of 33 provinces being infected. The virus is endemic in Java, Sumatra, Bali and southern Sulawesi with sporadic outbreaks reported from other areas.

Since the first outbreaks in 2003 avian influenza has spread rapidly across Java into Bali, Kalimantan and Sumatra. In 2006 the virus spread further east infecting Papua and much of Sulawesi.

About twenty percent of the chicken population of 1.4 billion is scattered in around 30 million backyards, where people raise poultry for food or income. "Despite major control efforts taken by Indonesian authorities, the country had not succeeded in containing the spread of avian influenza in poultry," Domenech said.

Indonesia is facing an uphill battle against a virus that is difficult to contain. Major human and financial resources, stronger political commitment and strengthened coordination between the central, province and district authorities are required to improve surveillance and control measures.

According to him, a highly decentralized administration, under-resourced national veterinary services, lack of engagement with commercial poultry producers, insufficient international and national financial and human resources for control campaigns and the challenges of implementing a comprehensive communication strategy are the major constraints the country is facing.

"We have also observed that new H5N1 avian influenza virus strains have recently emerged creating the possibility that vaccines currently in use may not be fully protecting poultry against the disease. This issue is being addressed by the Indonesian Ministry of Agriculture with technical assistance from OFFLU (OIE/FAO Influenza Network of Laboratories) and funding provided by USAID and AusAID. Also required are more investigations and the development of better poultry vaccines," Domenech further stressed.

The major challenge is to immediately apply the main components of a successful national avian influenza control strategy, based on effective surveillance, emergency culling and compensation, vaccination, improved biosecurity, effective laboratory and quarantine procedures, and movement controls of poultry and poultry products.

To overcome this problem, FAO is supporting the Indonesian authorities in most of these areas. In addition, the agency has helped to train local teams of animal health professionals in participatory disease surveillance and response (PDS/R).

So far, more than 350 local government PDS/R officers have been trained and are actively working with village communities to prevent and control avian influenza. Surveillance and response teams are currently working in 193 out of 448 districts in Indonesia.

By June 2008, over 2,000 surveillance and response teams will be active in more than 300 districts in disease-endemic areas of the country.

In the meantime, Chairul A. Nidom, an Indonesian microbiologist who first identified the virus in Indonesia, a decline in bird flu cases as mentioned by health minister was undoubtedly true, as the government of Indonesia had acted actively to stamp the spread of the disease to human beings.

Compared to the beginning of the pandemic outbreak in 2003, the government had taken serious efforts in cooperation with foreign experts to deal with epidemic and there was no effort by Indonesia any more to cover the cases up and to neglect the spread of the virus until it began to sicken human beings.

If Indonesia was a worry to U.N. and other international experts in particular, it was only natural because partly it had Southeast Asia's largest population of both people and poultry, Nidom said.