HHS official reports on Southeast Asia issues

Apr 22, 2008 (CIDRAP News) – A US Department of Health and Human Services (HHS) official today shared wrap-up perspectives on HHS Secretary Mike Leavitt's recent trip to Southeast Asia, which included discussions on virus-sharing and restrictions on the US Navy laboratory in Indonesia, updates on avian influenza collaborations, and talks on import safety.

The tour included stops in Indonesia, Vietnam, and Singapore. In Indonesia, Leavitt met with government officials to address virus-sharing issues and Indonesia's recent move to restrict the work of US Naval Medical Research Unit 2 (NAMRU-2) in Jakarta.

Bill Steiger, special assistant for international affairs at HHS, told CIDRAP News that highlights of the trip also included an update on the United States' joint venture with a regional emerging-disease center in Singapore and meetings in Vietnam to gauge how US support is assisting the country's progress on its own human H5N1 influenza vaccine.

Lab 'severely' affected
Steiger, who accompanied Leavitt on the tour, said the NAMRU-2 lab has functioned in Indonesia for several years. Like other Department of Defense labs in foreign nations, NAMRU-2 originally focused on investigating diseases affecting US troops stationed abroad but has grown into a larger mission, he said.

"Over time, the labs have evolved into collaborative public health assets, often in consultation with the World Health Organization (WHO) and host governments," he said.

The NAMRU-2 lab is situated near other government buildings in Jakarta and has been integrated into the country's health system, Steiger added. The lab has connections to several private and public hospitals in Indonesia and has played a key role in tracking pathogens in the country.

However, Indonesia's health minister recently prohibited all tissue samples—not just those containing H5N1 influenza viruses—from being sent to NAMRU-2, he said.

"This latest directive quite severely affects the lab's work," Steiger said. HHS officials hoped that the order was not linked to the international virus-sharing impasse, but he said Indonesia's government appears to be connecting the two issues. Some of the research at the lab, which employs both US military personnel and Indonesian citizens, is continuing, he said.

Leavitt has asked Steiger and Ambassador John Lange, the State Department's special representative for avian and pandemic influenza, to spend the next 2 months working on a solution to the virus-sharing issue. Since early 2007, Indonesia has shared very few H5N1 virus samples with the WHO, asserting that the samples are used by drug companies to make vaccines that developing countries can't afford.

Steiger said negotiations will probably resume electronically at first, and then move toward person-to-person talks in advance of the WHO's World Health Assembly in May. He said a small contingent of the WHO's virus-sharing working group met in early April and that the larger group's next formal meeting is in November.

"Hopefully, we can wrap up our understanding with Indonesia before that," Steiger said.

Stops in Singapore and Vietnam
In Singapore, Leavitt visited the health ministry and spent time at the Regional Emerging Diseases Intervention (REDI) Center, a joint venture of the United States and Singapore that opened in 2004 to serve as an early-warning and research center for infectious diseases in Asia.

Steiger said the REDI Center shares a building with other research institutes, which fosters collaboration. For example, he said a trilateral project between Singapore, Indonesia, and the United States is focusing on the H5N1 outbreaks in Tangerang, a suburb of Jakarta that has been a hot spot for human cases.

"This is very much a regional effort that leverages Singapore's technical expertise with avian influenza," he said.

In Vietnam, Leavitt had similar talks with health and agriculture officials, Steiger said. One of the topics was US support of Vietnam's human H5N1 vaccine programs. These include a project at the National Institute of Hygiene and Epidemiology in Hanoi that is currently in phase 1 clinical trials and a smaller vaccine research project based in Nha Trang in southern Vietnam.

Leavitt also traveled to chicken farms in Ben Tre province, where he met with villagers, farmers, and veterinary officials, Steiger said. HHS officials learned how the local officials plan on handling human cases and how they have contained poultry outbreaks, he said.

In other activity, Leavitt and his staff discussed food-related topics during import safety talks with officials in Singapore and Vietnam, Steiger said. While in Vietnam, Leavitt negotiated an agreement whereby Vietnam will work on the safety of exports to the United States. Steiger said that though the agreement isn't as aggressive as a recent memorandum of understanding with China, it is intended to address concerns about seafood contamination.

See also:

Apr 17 CIDRAP News story "HHS secretary blogs on impasse with Indonesia"

Apr 14 HHS press release

Nov 26, 2007, CIDRAP News story "Virus-sharing pact eludes WHO group, but work will continue"

Nov 30, 2005 US State Department press release on renewed support for REDI Center

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