JAKARTA, INDONESIA — Economists are raising concerns about the viability of Indonesian President Prabowo Subianto’s program launched this year to combat child nutrition.

According to an Indonesian Ministry of Health Nutritional Status Study report, 21.6% of children ages 3 and 4 experienced stunting caused by malnutrition in 2022.

The first stage of the Free Nutritious Meal Program, extending through March, is intended to provide around 20 million Indonesian school children, pregnant women and breastfeeding mothers meals to improve their health and prevent stunting.

The effort was initially projected to cost $28 billion over five years. However, Coordinating Minister for Food Zulkifli Hasan said on Jan. 9 during a meeting on food security that the $4.4 billion budgeted for this year will run out in June and that $8.5 billion more will be requested to fund the program through December.

China, Japan, the United States and India have expressed support for the program, although it is unclear how much money will be provided or what form that support will take. Japan and India have said their help will be in the form of training.

Officials plan to implement the program in stages, eventually reaching 83 million people — more than a quarter of Indonesia’s 280 million population — by 2029, Muhammad Qodari, deputy chief of the presidential staff told reporters on Feb. 3.

The program is part of a long-term strategy to develop the nation’s youth to achieve a “Golden Indonesia” generation, referring to a plan to make Indonesia a sovereign, advanced and prosperous nation by its 2045 centennial.

The program’s cost could make Prabowo politically vulnerable, according to Dinna Prapto Raharja, a professor of international relations at Jakarta’s Bina Nusantara University and a senior policy adviser at Jakarta consulting firm Synergy Policies.

“In order to finance this program, Prabowo has taken steps to implement major cutbacks in his government budget with some ministries seeing 50% cuts,” Dinna said.

“Now he is forced to seek financial assistance from overseas sources.” she told VOA on Jan. 31.

The Finance Ministry said the spending cuts would amount to $18.7 billion, 8% of this fiscal year’s approved spending.

While other nations said they would support the program, officials from the National Nutrition Agency — which manages the program — said internal talks about the level of foreign aid, type of assistance and technical aspects of its implementation have not begun.

Support from China, Japan, US and India

In November, China committed to supporting free nutritious meals but did not pledge a specific amount.

The Chinese Embassy in Jakarta did not respond to VOA requests for further information on the value and form of the assistance. It remains unclear whether China’s financial assistance will be in the form of a loan or grant.

The United States is providing training to Indonesian dairy farmers to support the program, which has increased the demand for locally produced milk. Indonesia, so far, can provide milk only two to three times a week to school children, according to Deddy Fachrudin Kurniawan, CEO of Dairy Pro Indonesia and project leader of U.S. Dairy Export Council training.

Deddy told VOA on Jan. 8 that Indonesia has had to import 84% of its milk in the past, and that demand will double because of the food program.

In January, Japanese Prime Minister Shigeru Ishiba announced Japan will support the meal program by helping the Indonesian government increase its ability to combat childhood malnutrition.

Ishiba offered Japan’s support by training Indonesian cooks and sending Japanese chefs to assist. Prabowo added that Japan will also assist in improving the fishery and agriculture sectors, based on Japan’s experience.

More recently, India reaffirmed support for the program through the sharing of knowledge of the government’s Food Corporation of India and other institutions with Indonesian officials.

“India shares its experiences in the fields of health and food security, including the [free] lunch scheme and public [service] distribution system to the Indonesia government,” Prime Minister Narendra Modi said on his YouTube channel on Jan. 25.

Other support and reaction

Other countries have said they support the program. France and Brazil expressed their support on the sidelines of the recent G20 Leaders Summit in Rio de Janeiro.

Prabowo instructed his team to arrange a visit of an Indonesian delegation to Brazil to take notes from the South American country’s similar program. France, which has a similar school feeding program, intends to share its expertise and help Indonesia modernize its agricultural sector.

Teuku Rezasyah, an associate professor of international relations at Bandung’s Universitas Padjajaran, noted that India exported 20,000 metric tons of water buffalo meat to Indonesia last year while Brazil exported 100,000 metric tons of beef to Indonesia.

British Deputy Prime Minister Angela Reynar showed similar interest during her meeting with Prabowo in London in November. However, it remains unclear what type of support the U.K will offer.

Mohammad Faisal, executive director of the Center of Reform on Economics, told VOA in Jakarta on Jan. 31 that countries offering support will have their own interests in mind, as well.

“I believe there’s no free lunch,” Faisal said. “The donations may be partly altruistic, but not entirely. Donor countries consider it as strengthening bilateral ties, but they may also expect to reap the benefits in the future, such as enjoying ease of investing in Indonesia through incentives and getting better penetration of export markets as a reward.”

Rezasyah agreed.

“Donor countries are probably hoping Indonesia will import more products from their countries to support this multibillion-dollar supplemental food program,” he said. “On the other hand, they see Indonesia becoming a middle power that could contribute to finding solutions to global affairs.”
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NEW YORK — All live poultry markets in New York City and some of its suburbs were ordered Friday to close for a week after the detection of seven cases of avian flu, which has also hit farms nationwide.

Governor Kathy Hochul said that there was no immediate threat to public health and that the temporary closure of bird markets in the city and its Westchester County and Long Island suburbs came out of an abundance of caution. No cases of avian flu have been detected among humans in New York, officials said. 

The birds infected with the virus were found during routine inspections of live bird markets in the New York City boroughs of the Bronx, Brooklyn and Queens. 

The U.S. Centers for Disease Control and Prevention has said the virus poses low risk to the general public. The agency said there have been 67 confirmed cases of bird flu in humans in the U.S., with illnesses mild and mostly detected among farmworkers who were exposed to sick poultry or sick dairy cows. 

The first bird flu death in the U.S. was reported last month in Louisiana, with health officials saying the person was older than 65, had underlying medical problems and had been in contact with sick and dead birds in a backyard flock. 

In New York, live bird markets where the virus was detected have to dispose of all poultry in a sanitary manner, according to the state’s order. Other bird markets that do not have cases will have to sell off remaining poultry within three days, clean and disinfect their operations, and then remain closed for at least five days and be inspected by state officials before reopening. 

Ahead of the mandatory disposal order for markets with no cases, employees at La Granja, a halal-certified poultry market in Manhattan’s Harlem neighborhood, raced to sell the remaining inventory: around 200 live chickens of different varieties, along with turkeys, quail, ducks, roosters, pigeons and rabbits. 

Any remaining animals would be slaughtered and given to employees and longtime customers, according to Jose Fernandez, the owner. 

“We’re going to lose money, for now,” he said. “But the law is the law. They know what they’re doing.” 

The H5N1 strain of bird flu has been spreading among wild birds, poultry, cows and other animals. Officials have urged people who come into contact with sick or dead birds to wear respiratory and eye protection and gloves when handling poultry. 

More than 156 million birds nationwide have been affected by the outbreak, many at large farming operations that have had to slaughter their entire flocks. 

Despite growing attention on the avian flu, New York City’s poultry markets appeared to be doing brisk business Friday. 

Outside the Wallabout Poultry market in Brooklyn, a line of customers took numbers and picked their chickens, which employees snatched from crowded cages, weighing them upside down, before taking them to a back room to be slaughtered. 

“I’m not worried about any bird flu,” said Stan Tara, 42, of Brooklyn, as he purchased a large chicken for $22.50. “It’s the same as you buy from the supermarket. A little more expensive, but at least it’s fresh.” 

Some animal rights groups, meanwhile, questioned the purpose of a state order that allowed the markets to continue selling fowl, rather than shutting them down immediately. 

“The public is going into markets where no one knows if there are outbreaks of avian flu, then taking home dead birds that may or may not be infected,” said Edita Birnkrant, executive director of NYCLASS, which has long raised alarms about conditions within the city’s roughly 70 live animal markets. “It’s ludicrous.” 

U.S. egg prices are likely to remain high past Easter and well into 2025, largely because of avian flu, according to CoBank, a Denver-based provider of loans and other financial services to the agriculture sector. 

The highly contagious virus has affected nearly 100 million egg-laying hens in the U.S. since 2022. 

But CoBank said other factors are also causing supply constraints and driving up prices, such as skyrocketing consumer demand for eggs in recent years. Fast-growing breakfast and brunch chains are also eating up supplies. 
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NEW YORK — The U.S. winter virus season is in full force, and by one measure is the most intense in 15 years.

One indicator of flu activity is the percentage of doctor’s office visits driven by flu-like symptoms. Last week, that number was clearly higher than the peak of any winter flu season since 2009-10, according to data posted Friday by the U.S. Centers for Disease Control and Prevention.

Of course, other viral infections can be mistaken for flu. But COVID-19 appears to be on the decline, according to hospital data and CDC modeling projections. Available data also suggests another respiratory illness, RSV, or respiratory syncytial virus, has been fading nationally.

The flu has forced schools to shut down in some states. The Godley Independent School District, a 3,200-student system near Fort Worth, Texas, last week closed for three days after 650 students and 60 staff were out Tuesday.

Jeff Meador, a district spokesman, said most illnesses there have been flu, plus some strep throat. He called it the worst flu season he could remember.

So far this season, the CDC estimates, there have been at least 24 million flu illnesses, 310,000 hospitalizations and 13,000 deaths — including at least 57 children.

Traditionally, flu season peaks around February.

Overall, 43 states reported high or very high flu activity last week. Flu was most intense in the South, Southwest and Western states.

In Rochester, New York, the flu season has been intense but not necessarily worse than at the peak of other years, said Dr. Elizabeth Murray, a pediatric emergency medicine doctor at the University of Rochester Medical Center.

She said there is a lot of flu, but there is also still a lot of RSV and a surprising number of babies with COVID-19.

“All of the respiratory illnesses are around, with a vengeance,” Murray added.

The CDC declined to let an Associated Press reporter speak to an agency flu expert about recent trends. The Trump administration ordered a temporary “pause” on health agency communications and has continued to refuse interview requests that were routinely granted in the past.

U.S. health officials recommend that everyone 6 months and older get an annual flu vaccination.

About 44% of adults got flu shots this winter, the same as last winter. But coverage of children is down, at about 45% this winter. It’s usually around 50%, according to CDC data.

About 23% of U.S. adults were up to date on their COVID-19 vaccinations as of late January, up from about 20% at the same point in time the year before. COVID-19 vaccination rates for kids were about the same, at around 12%.

The government has not yet reported its estimates of how well this season’s flu vaccine is working.

Testing results from patients indicate that two strains of seasonal flu are causing the most illnesses: type A H1N1 and H3N2. Health officials are closely watching a third strain — H5N1 bird flu — that has sickened tens of millions of animals and is known to have infected 67 people in the U.S.

To avoid seasonal viruses, doctors say you should avoid touching your eyes, nose and mouth because germs can spread that way. You should also wash your hands with soap and water, clean frequently touched surfaces, and avoid close contact with people who are sick.
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JOHANNESBURG, SOUTH AFRICA — Some South African organizations that assist people with HIV are in limbo, after the United States put a 90-day freeze on most foreign aid. The U.S. State Department later added a waiver for “lifesaving” aid, but NGOs that have already shut their doors say the next steps aren’t clear, and they are worried this could set back years of progress.

South Africa has the highest number of HIV-positive people in the world — about 8 million — but has also been a huge success story in terms of treatment and preventing new infections.

That’s largely due to the money poured into expert HIV care here, 17% of which comes from a U.S. program called the President’s Emergency Plan for AIDS Relief, also known as PEPFAR.

But, a 90-day foreign aid funding freeze is in effect, following an executive order by U.S. President Donald Trump last month to check if U.S.-funded programs overseas are aligned with U.S. policies. This has caused some confusion in South Africa with health care organizations and their patients.

Thamsanqa Siyo, an HIV-positive transgender woman in South Africa, is anxious.

“People are frustrated, they’re living in fear, they don’t know what’s going to happen,” said Siyo. “They don’t know if it’s stopped temporarily or not temporarily.”

The Cape Town clinic that Siyo used to go to has now been closed for two weeks.

While the State Department has issued a waiver to continue paying for “lifesaving” services, what that includes remains unclear to many South African organizations that receive funding from PEPFAR.

U.S. Secretary of State Marco Rubio said this week that the waiver was clear.

“If it saves lives, if it’s emergency lifesaving aid — food, medicine, whatever — they have a waiver,” said Rubio. “I don’t know how much clearer we can be.”

The State Department also issued written clarification and guidance on February 1 regarding which activities are and are not covered by the waiver for PEPFAR programs.

The South African government said it was blindsided by the U.S. aid freeze, according to Health Minister Aaron Motsoaledi, who convened a meeting about PEPFAR on Wednesday.

Motsoaledi also said he has sought clarity on the waiver.

“If you say American money cannot be used for LGBTQWI+ and we do the counseling and testing and somebody who falls within that category, transgender, tests positive, can they not be helped?” he asked. “Even if it’s lifesaving?”

Linda-Gail Bekker is a doctor and scientist who heads the Desmond Tutu HIV Center in South Africa.

“This is not one homogenous picture,” said Bekker. “In some places, it’s parts of services that have been stopped. In other places, the whole clinic, if it was supplied by PEPFAR, has been closed down.”

She also said that some transgender health services have been completely closed, and in other areas, counselors haven’t been able to come in.

In addition, she said some services and drugs are no longer available, such as community-based testing and pre-exposure prophylaxis, a medicine that prevents people at high risk from contracting HIV.

Ling Sheperd, who works for Triangle Project, an nongovernmental organization that provides services for the queer community, said there’s a risk of “undoing decades of progress.”

“The impact is devastating,” said Sheperd. “The PEPFAR funding has been a lifeline for millions and it ensures access to HIV treatment, prevention services, and of course community-based health care. And without it we are seeing interruptions in medication supply, clinics are scaling back services, and community health workers have literally been losing their livelihoods.”

About 5.5 million South Africans are on anti-retroviral medication for HIV. Motsoaledi noted that most of that is funded by the government here.

However, he said, a PEPFAR shortfall will affect training, facilities and service delivery. The government said it is working on contingency plans that would reduce dependence on foreign aid in the HIV sector.

On Wednesday, a group of health organizations sent a letter to the South African government saying at least 900,000 patients with HIV were directly affected by the U.S. stop-work orders.
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U.S. dairy cattle tested positive for a strain of bird flu that previously had not been seen in cows, the U.S. Department of Agriculture said on Wednesday, ramping up concerns about the persistent spread of the virus. 

The H5N1 virus has reduced milk output in cattle, pushed up egg prices by wiping out millions of hens, and infected nearly 70 people since April as it has spread across the country. 

Genome sequencing of milk from Nevada identified the different strain, known as the D1.1 genotype, in dairy cows for the first time, the USDA said. Previously, all 957 bird flu infections among dairy herds reported since last March had been caused by another strain, the B3.13 genotype, according to the agency. 

Reuters reported news of the detection of the second strain on Wednesday ahead of USDA’s announcement. 

The second strain was the predominant genotype among wild birds this past fall and winter and has also been found in poultry, the USDA said. It was identified in dairy cattle through an agency program that began testing milk for bird flu in December. 

“We’re seeing the H5N1 virus itself be smarter than all of us,” said Beth Thompson, South Dakota’s state veterinarian.  

“It’s modifying itself so it’s not just staying in the poultry and the wild waterfowl. It’s picking up a home in the mammals.”  

Wild birds likely transmitted the second strain to cattle in Nevada, said J.J. Goicoechea, Nevada’s agriculture director. Farmers need to ramp up safety and security measures to protect their animals, he said. 

“We obviously aren’t doing everything we can and everything we should or the virus wouldn’t be getting in,” he said. 

The Nevada Department of Agriculture said on Jan. 31 that herds in two counties had been placed under quarantine because of bird flu detections.  

It is important for the USDA to contain the outbreak in the state quickly, so the strain does not spread to dairy cattle elsewhere, said Gail Hansen, a veterinary and public health consultant. 

Last year, bird flu spread across the country as infected cattle were shipped from Texas after the virus first leapt to cows from wild birds. 

“We didn’t get a hold on it before,” Hansen said. “We want to avoid that same scenario from happening in Nevada.” 

Dairy herds that were formerly infected may be at risk again from the second strain, experts said. 

“Now it looks like we have new strains of virus that may escape some of the immunity associated with the other strains of viruses that could exacerbate the epidemics among animals and wildlife,” said Gregory Gray, a University of Texas Medical Branch professor studying cattle diseases.  

“It’s alarming.”
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BUENOS AIRES — President Javier Milei has ordered Argentina’s withdrawal from the World Health Organization due to profound differences with the U.N. agency, a presidential spokesperson said Wednesday.

Milei’s action echoes that of his ally, U.S. President Donald Trump, who began the process of pulling the United States out of the WHO with an executive order on his first day back in office on Jan. 21.

Argentina’s decision is based on “profound differences in health management, especially during the [COVID19] pandemic,” spokesperson Manuel Adorni said at a news conference in Buenos Aires. He said that WHO guidelines at the time had led to the largest shutdown “in the history of mankind.”

He also said that the WHO lacked independence because of the political influence of some countries, without elaborating which countries.

Argentina will not allow an international organization to intervene in its sovereignty “and much less in our health,” Adorni said.

The WHO is the United Nations’ specialized health agency and is the only organization mandated to coordinate global responses to acute health crises, particularly outbreaks of new diseases and persistent threats such as Ebola, AIDS and mpox.
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Scientists are testing a novel technique to deter poachers targeting endangered rhinoceroses for their prized horns. As part of a pilot study in South Africa, researchers have injected small, radioactive pellets into the horns of live rhinos. The goal is to make the horns radioactive so there is less demand for them on the black market. Marize de Klerk reports from the UNESCO Waterberg Biosphere Reserve.
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