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14th November 2005

Vaccination of poultry takes priority over humans

As a physician and veterinarian, Mangku Sitepoe is active in his two areas of expertise in animal and human health. The former member of the Veterinary Public Commission of the Ministry of Agriculture has also written several articles about bird flu issues. He shared his views and knowledge with The Jakarta Post's Kornelius Purba about the disease.
Question: The government is very slow in containing the bird flu virus and the public also seem indifferent. What is really going on?
Answer: Bird flu cases had actually been found in August 2003, but the government announced it only on Jan. 24, 2004, which was followed by the government's decision that bird flu had become a pandemic. But because it only affected poultry farms people just did not care. The voice of the veterinarians was unheard. Only when the virus spread and infected humans then people suddenly woke up.
This disease belongs to the zoonosis category, which means it can spread from animals to humans.
There are two patients here: Animals and humans. And there are two authorities here: First the health and medical authorities for humans through physicians and the veterinary authorities for the animals. These two authorities must work closely.
Do you mean that only humans are getting attention?
People are scared because the disease has affected humans. But actually we must find the root and the source of the problem. We must prioritize the animals. But it does not happen like that. We only treat humans while it is extremely important to treat the source of the disease. Bird flu has claimed seven lives but people do not realize that about 15 millions chickens have died from the virus.
What does the government have to do then?
We must stop the transmission from poultry to humans, that is the first step. After that we must prepare to treat humans. We should not buy the vaccine first for humans but for poultry.
Why does the government not conduct a mass cull?
There are several reasons. When bird flu of sub type H5N1 spread in Hong Kong and killed six people local authorities culled about two million chickens. But in 1999 and in 2003 the disease returned. That was why when I was with the commission we recommended not to cull poultry. In early 2004 it had affected eight provinces. How could we stamp it out totally? It is impossible to cull about 400 million chickens. In addition we also do not have the funds. Now the situation is even worse where 22 provinces have been affected. What we can do is only selective culling. We must make an early warning system.
What has the government done to stop the pandemic?
The Ministry of Agriculture, in this case the Directorate General of Husbandry has taken four measures: Vaccination, selective culling, bio-security and surveillance. It has shown a declining trend as of May this year. We have been quite successful with the vaccination program, although it is not aimed at preventing the disease but just to halt it. According to research, however, we are still facing problems with backyard farming where humans have very close contact with their chickens. We need to educate the farmers.
But WHO opposes the vaccination policy, doesn't it?
Yes, until now, WHO does not agree at all with vaccination. Why? The world body is now worried about the mutation of the bird flu from humans to humans. When the disease outbreak is so widespread, which is called virus reassortment in poultry, then it may infect humans and then from one human to another. This is the third of six phases to become a pandemic. WHO worries about this. Culling is WHO's preference, especially in anticipation of the rainy season.
Do we have previous experience in handling such a pandemic?
I myself was involved in 1983 when then president Soeharto instructed a total culling of cows at any cost when foot-and-mouth disease spread here. Farmers received compensation and at that time Australia helped us financially. What I mean is we need strong leadership. And it worked at that time and since then we are free of the disease.
Why has the government refused foreign assistance this time?
I just don't know. In my view we must accept the assistance. There is nothing wrong in it, it is not interference by foreign countries. The most important thing is that we use it with accountability and effectively. This disease is not only the concern of the Indonesian people but people all over the world.