TORONTO - A senior official of the World Health Organization says the global health agency has been assured Indonesia will continue to report human cases of, and deaths from, H5N1 avian flu as they occur.
The WHO had sought clarification from Indonesia after Health Minister Siti Fadilah Supari said last week that her country would in future only report H5N1 deaths sporadically, perhaps at six month intervals.
The suggestion was met with dismay and with warnings that Indonesia would be in violation of the International Health Regulations if Supari carries through on her threat.
That international treaty requires prompt reporting of cases of diseases such as H5N1 that have been designated as global health threats. Indonesia is a signatory to the treaty.
"We've received official notice at our WHO office in Jakarta that the minister will continue - as she has been - notifying WHO on confirmed infections under the International Health Regulations," Dr. David Heymann, assistant director general for health security and environment, said from Geneva.
"She's been clear ... that she has no intention of not conforming to the International Health Regulations. She knows what they are. She's been told what those regulations require."
Despite the assurances, it seems Indonesia may not have formally notified the WHO yet of an H5N1 death that occurred nearly a month ago.
In an interview with the Associated Press last week, Supari revealed that a teenage girl died on May 14, but the government decided not to announce her death right away.
"How does it help us to announce these deaths?" she asked in the interview.
The most recent death Indonesia reported to the WHO occurred on April 23. As of Thursday, the WHO's official case count for Indonesia was 108 deaths out of 133 confirmed cases - the highest toll of any country afflicted with the H5N1 virus.
Heymann said the WHO's country office in Jakarta may have been notified Thursday of the death and was putting the information through channels. But if that's not the case, the WHO will be asking questions.
"If that was a confirmed case, we will have to work to understand what went wrong" in the notification process, he said.
The International Health Regulations stipulate that countries must report new H5N1 cases within 24 hours of confirmation and must report important related information, such as deaths, in a timely manner.
The WHO needs the information to make an assessment of the risk the event poses. Changes in the H5N1 death rate, for instance, could signal that the virus has mutated and experts would want to study sample viruses to look for what triggered the shift.
Indonesia has been enmeshed in a dispute with the WHO for more than a year, refusing to allow outside scientists to study sample viruses until it receives assurance it will get a share of any vaccine produced from Indonesian viruses.
