FT.com / International economy / Bird flu - Foreign policy hits US medical lab in Jakarta

FT.com / International economy / Bird flu - Foreign policy hits US medical lab in Jakarta: "For more than 30 years the US Naval Medical Research Unit Number 2, or NAMRU-2, has researched emerging tropical diseases in Indonesia and, via satellite offices in Cambodia and Vietnam, elsewhere in south-east Asia.

For the past six, though, its future has been in doubt as Indonesia’s military has sought to have it shut in retaliation for Washington’s 1999 suspension of military-to-military relations following the debacle in East Timor. This year Indonesian officials sent a letter to the lab asking it to cease operating when the bilateral agreement governing it expires on December 31.

But as Mr Leavitt’s visit signalled, NAMRU-2’s fate has added significance these days. In recent years it has been intimately involved in the fight against the virulent H5N1 bird flu in south-east Asia, where it has killed more than 60 people. In countries such as Indonesia it is among the first to conduct tests on suspected human H5N1 cases, giving the US what could be a front row seat at the unfolding of a possible pandemic.

Most of a $7.1bn (€5.9bn; ?4bn) Bush administration pandemic preparedness plan unveiled this week is focused on the domestic front and the stockpiling of antiviral drugs and vaccines. Also included, however, is $251m to help other countries improve their capacity to detect bird flu outbreaks.

'Early detection is our first line of defence,' President George W. Bush said in his speech on Tuesday.

Labs such as NAMRU-2 will play a key role in that early detection, experts say, and their presence in south-east Asia gives the US an unparalleled disease surveillance network.

During Mr Leavitt’s visit officials in Jakarta were told NAMRU-2 and a similar facility in Bangkok would receive an additional $10m in funding between them, a considerable sum when NAMRU-2’s current annual budget is just $8m.

But as Washington turns to those labs it is also facing what some see as post-Iraq limits of its influence.

Western health experts and local officials say the Indonesian military have long seen NAMRU-2’s researchers as spies. But at a time when many in the world’s largest Muslim nation express anger about US policy in Iraq and beyond, diplomats and health officials say there is, rightly or wrongly, an added element of suspicion of NAMRU-2’s military status among Indonesian officials.

Its own website, they point out, lists NAMRU-2’s primary mission as to “enhance the health, safety and readiness of [US] Navy and Marine Corps personnel” so they can conduct “missions in south-east Asia”.

That mission is often overtaken by work with very real civilian applications.

NAMRU-2 and the Armed Forces Research Institute of Medical Sciences (AFRIMS) in Bangkok each year send data back to the US identifying emerging influenza strains, and so help determine the composition of flu shots.

Colonel Bonnie Smoak, AFRIMS’ American commander, said the lab’s flu surveillance has always been done with a flu pandemic partly in mind. “Among scientists, the threat of the epidemic has always been there,” she says. “Even before avian influenza, there were little voices yelling in the woods, ‘It’s coming’.”

AFRIMS is expanding its H5N1-related work, Col Smoak says. It wants to extend its surveillance to US diplomats to monitor strains circulating in a highly-mobile expatriate population. It also wants to conduct house-to-house studies in Thailand modelled on those it has done for dengue fever.

Similar work is under way at NAMRU-2, albeit more quietly.

Researchers there test specimens from 500 Indonesian patients a month, people familiar with the situation say. Because of that - and because the World Health Organisation does not have its own dedicated lab in the country – NAMRU-2 amounts to what is now the only “active” surveillance system searching out H5N1 cases in Indonesia, health experts say."