Catastrophe on Australia's doorstep (essay)


Catastrophe on Australia's doorstep

Whilst Papua New Guinea is a melanesian nation of welcoming and open-hearted people, generous and family oriented, in a spectacular and beautiful tropical setting, the nation itself is exhibiting many of the symptoms of decay of a small developing country.

A small manufacturing base, employment-light resource extraction projects, and a neo-liberal small government approach have not helped. PNG suffers from high unemployment, a low skills base, poor government services, and seriously under-developed infrastructure, due in part to low company taxation, a culture of political favours, corruption, and foreign exploitation.

PNG is a nation-state facing numerous serious problems—many basic public services are run into the ground, and the health system is decrepit and the worst in the region. With this background, it is the spread of HIV/AIDS that has developed into perhaps the country’s biggest test, with the potential to kill thousands and wreak havoc with its economy.
The statistics are truly shocking, and the stream of stories becoming known is alarming. The Australian government’s latest research into the impact of HIV/AIDS on PNG reveals it may be leading to the possible collapse of the PNG economy. Based on current trends, AusAID forecasts a potential decline in the PNG labour force of 37.5 per cent by 2020—a devastating effect on the country.

Already the number of confirmed HIV cases in PNG far exceeds that of here, despite its population being just one-quarter of Australia’s. The breadth of this unfolding catastrophe has been barely reported in the Australian media.

The numbers:
Official statistics state more than 16,000 people in PNG have been diagnosed with HIV/AIDS, since the first case was reported in 1987. Australia, with four times the population of PNG, has 12,000 HIV-positive people. The increase in infection rates, at up to 60 per cent a year, is the highest in the Pacific

The estimates of HIV infection vary: 22,000 says AusAID; 50,000 says World Bank; 67,000 says Caritas Australia; possibly 100,000 says the National AIDS Council.

The Medical Journal of Australia says it is now the major cause of death at Port Moresby Hospital—greater than tuberculosis and malaria. Each month the hospital sees over 100 new HIV/AIDS cases.

AusAID’s latest research by Dr Jenny Gordon, predicts the crippling economic impact the epidemic will have on PNG. Dr Gordon estimates that based on present trends, by 2020 the labour force could decline by 37.5 per cent, GDP could be reduced by 7.5 per cent, and the budget could increase by 21 per cent. Subsistence agriculture could decline by 24 per cent.

The AusAID report states that in 10 years time, at present rates of increase, PNG could have over one million people infected with HIV/AIDS; that is 20 per cent of the population. AusAID states PNG faces a potential HIV/AIDS disaster on the scale of sub-Saharan Africa.

The poverty trap:

As a percentage of GNP, PNG has the lowest spending on health services in the Pacific region and the lowest levels of doctors and nurses. Many rural health centres have no drugs or staff. The public hospital system is stretched to breaking.

The number of people living in poverty in PNG doubled in the 90s rising to 30 per cent of the population, according to ANU research. The World Bank estimates that 76 per cent do not have access to safe drinking water. Life expectancy is already the lowest in the Pacific region.

Most Papua New Guineans cannot afford the price of retro-viral drugs—despite a recent drop in the price of drugs to $190 per month. Many rural households have a cash income below $20 per year. The PNG National Health Plan states that if HIV/AIDS continues to rise at the current rate, “70 per cent of the hospital beds in the country would be occupied by AIDS patients in 2010."

AusAID predictions show that HIV has the potential to worsen poverty in PNG, with measures of economic welfare falling between 12 and 48 per cent by the year 2020.

Who’s transmitting:

In PNG the disease is mainly in the heterosexual population, which implies a rapid onset and growth of the epidemic. A quarter of people infected in PNG are wives. Of prostitutes tested in Port Moresby, 17 per cent were found to be HIV-positive, according to the Institute of Medical Research.

It is estimated by health authorities that 20 per cent of serving soldiers in the PNG Defence Force may be HIV-positive. The PNGDF has recently had its first overseas deployment in many years, sending a contingent of soldiers as peacekeepers to the Solomons, thereby potentially helping export AIDS to the Pacific region.

A survey of HIV-positive males in Goroka found that most had had as many as 40 partners over the previous two years. Illustrative of the tasks that AIDS educators face was the finding that, after diagnosis, one in 20 men admit to going on sexual sprees.

Many of the partners are aged as young as 13, being procured for sex in return for food money in local bars and discos. According to National AIDS Council statistics, there are 371 children aged under 10 years confirmed with HIV/AIDS.

Stigma and faith:

PNG has one of the highest rates of sexually transmitted diseases in the world at 106 per 10,000 population. So the issue of condoms has become crucial—and controversial.

Some members of the Catholic Church are fighting a running internal battle over this with the conservative elements of the church. This has implications because the Catholic Church is one of the largest overseas aid donors to PNG.

Australia’s Cardinal, George Pell, opposes the church supporting condom use, saying “When the main emphasis is on condoms, irresponsible sexual activity is encouraged… No such human crisis can be solved by a rubber contraption.”

The PNG Council of Churches strongly opposed a recent proposal to decriminalise prostitution that had been intended to facilitate measures for preventing the spread of HIV. Instead the Council advocated giving training and education to women.

The stigma associated with HIV/AIDS in PNG is often deadly—sorcery is often blamed for the illness, with several women reportedly having been murdered as a result. Reports have been heard of several instances of villagers burying alive people believed to be infected, and the use of infected people to introduce the disease into rival villages.

The way out:

The PNG government in July 2006 launched its new National Strategic Plan for HIV/AIDS. After some 15 years of NGOs, UN agencies, churches and overseas aid bodies taking the lead—and making many mistakes—the PNG government has announced it is “taking ownership” of dealing with HIV/AIDS.

PNG has set for itself a very high target. The overall goal of the Strategic Plan is “to reduce the HIV/AIDS prevalence rate in the general population to below 1 per cent, and by at least 1 per cent by 2008, to improve care for those infected, and to minimize the social and economic impact of the epidemic on individuals, families and communities”.

Australia's present main response to HIV/AIDS in PNG is the $65 million "National HIV/AIDS Support Project" in conjunction with the National AIDS Council. This project provides funds for education and awareness raising; counselling and care; policy development; surveillance systems; clinical services; and strengthening capacity within the National AIDS Council.

Australia also provides a $25 million contribution over three years to the Global Fund to fight HIV/AIDS, tuberculosis and malaria.

The World Health Organisation’s Global Fund is subsidising the usage of some anti-retroviral drugs. But PNG has fallen way behind the initial target numbers. With a target of 3,000, only about 600 people have been put on the program to date. Lack of staffing and training, as well as serious supply-line problems, have been the causes of this lethal delay.

Health Minister Sir Peter Barter, during an August field visit, found the HIV prevalence rate among 15-29 year-olds in one town in the Southern Highlands was 40 per cent—much greater than the official figures of the national prevalence rate. Barter said: “I had tears in my eyes when I addressed students at a school there. I’ve realised we have lost a generation to HIV and AIDS.”

Peter Cronau is a producer with the Four Corners program on ABC TV. He recently visited Papua New Guinea with colleague Matthew Carney for a story on AIDS. Any views expressed in this article are those of the author and not necessarily of the ABC. The fee for the photo essay and article has been donated to PNG AIDS groups providing direct grass-roots support to AIDS victims.



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Existing comments

It's scandalous that a neighbour of a rich country like Australia should have its health system so poorly resourced. Australia could remedy these deficiencies (for East Timor too). It wouldn't be painless; it would be the sort of effort we'd make in wartime, but we should do it.

Gavan Breen | 05 October 2006  

This country needs a lot of attention. I believe the media in the country could help give the issue more light. The people are probably ignorant, iliterate, or they just don't know the statistics. It would be nice to know how to help. Shock advertising might help, eg. the speed can kill ads on Australian TV.

Jenny | 18 October 2006  

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