Papua New Guinea

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Tuberculosis management in Western Province

Wall of concrete blocks partially constructed, with frame laying on top waiting to be erected. 6 April 2013: Main entry to ward general wing.
  Wall of concrete blocks partially constructed, with frame laying on top waiting to be erected. 5 April 2013: Framing in place, patient ablutions, isolation wing. Photos: AusAID. More pictures below

AusAID support to the Government of PNG to manage TB in the Western Province of PNG is leading to better detection, treatment and management of TB. With AusAID’s assistance, drug-resistant TB mortality rates have been dramatically reduced—from 25 per cent to just 5 per cent in one year.

The challenge

PNG has the highest TB burden in the Pacific region with over 14,749 new cases diagnosed a year and a total prevalence rate of 534 per 100,000 people (World Health Organization 2011). From January 2011 to July 2012, 63 cases of drug resistant TB were diagnosed in Western Province (Daru Hospital 2012). With AusAID’s support, the Government of PNG is putting in place a comprehensive, best practice approach to detection and treatment of TB in Western Province.

What Australia is doing to support PNG to manage TB in Western Province

AusAID has committed $31 million to help support the Government of PNG to improve health services in Western Province, including detecting and treating TB. This includes $11 million over four years for provision of TB specialist staff, training for community health workers and volunteer treatment supporters. It will also provide medical equipment, drugs, a sea ambulance, and funding for high-level laboratory diagnosis in Australia of drug resistant TB, with work on a new TB isolation ward now nearing completion.

AusAID is also providing an additional $20 million over five years [video, external website]. This includes up to $10 million for the rehabilitation of Daru Hospital; up to $5 million for the rehabilitation of the Mabaduan Health Centre, which is less than five kilometres from Queensland’s Saibai Island; and a $5 million contribution to support the Middle and South Fly Health Development Program, which is a $37 million initiative jointly funded by the Ok Tedi Fly River Development Program and AusAID.

In addition, AusAID supports the Global Fund to Fight AIDS, TB and Malaria, which is investing USD19 million (2007-2013) in supporting the Government of PNG manage TB nationally.

Photos: Construction of the permanent TB ward at Daru hospital


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Photos: TB management in Western Province


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AusAID’s support is delivering results

AusAID support has helped PNG authorities to establish better surveillance, detection, diagnosis and treatment for TB. This provides a real and sustainable alternative to seeking treatment in Australia. Daru Hospital is now successfully identifying and treating more cases. In the South Fly district in August 2012, 34 new TB cases were detected and commenced treatment; compared with 48 patients in the last quarter of 2011 (World Vision 2012). Daru Hospital records show that TB mortality rates have been dramatically reduced in Western Province—from 25 per cent to just 5 per cent in one year.

We’re making a difference to the lives of Papua New Guineans with TB

This assistance is already making a difference to Papua New Guineans, such as Duba, who is the first pediatric patient and the youngest ever to be treated at Daru General Hospital for multi-drug resistant TB. It also means that people in Western Province can now access TB treatment in their communities.

A comprehensive, best practice approach

The World Health Organization (WHO)—the global authority on TB—has endorsed PNG’s approach to managing TB [external website]. This is being implemented with AusAID assistance. Ensuring that patients take the full course of TB drugs at the right time over the full duration of treatment is recommended as the most effective way to treat TB and prevent the development of drug resistance. The Commonwealth Government’s Chief Medical Officer, Professor Chris Baggoley, has also stated that the approach being taken in Western Province will improve outcomes for communities in Daru and South Fly and will also better manage risks to Torres Strait communities. Queensland’s Chief Health Officer [external website], Dr Jeanette Young, supports the approach being taken and has stated that Queensland is not at risk of drug-resistant TB spreading from PNG nationals who come to the state's far north for treatment.

Torres Strait Health Issues Committee

The Torres Strait Health Issues Committee (HIC) is an intergovernmental forum for addressing cross-border health issues between Australian and PNG. It is comprised of senior representatives from the PNG National Department of Health, Western Province Health Administration, Australian Department of Health and Ageing, Queensland Health, Department of Foreign Affairs and Trade, Department of Immigration and Citizenship, the Australian Agency for International Development (AusAID) and the Australian Customs and Border Protection Service.

At its October 2012 meeting in Cairns, HIC members commended PNG on progress made in implementing programmatic management of TB in Western Province. The Government of PNG presented the study Evaluation of Risks of Tuberculosis in Western Province PNG conducted by Associate Professor Emma McBryde. HIC members noted that the report provides data and analysis for a better understanding of incidence and prevalence of TB in PNG and the risks related to transmission and management of TB at the PNG-Australia border region. The HIC reaffirmed its commitment to working with traditional inhabitants through the Government of PNG, to ensure development assistance programs continue to address priority needs.

Evaluation of Risks of Tuberculosis in Western Province Papua New Guinea

At its October 2012 meeting in Cairns, the HIC considered an independent risk assessment of TB spreading in Western Province, conducted by Associate Professor Emma McBryde, Head of the Victorian Government Infectious Diseases Service. The report says PNG’s approach of treating people with TB in their own communities is right—and the risk of drug resistant TB spreading to Australia from PNG, and becoming endemic, remains low as long as contact amongst residents in of short duration and is confined to outdoor activities. It recommends doing more to expand TB control throughout Western Province, including increasing staff support and boosting human resources; strengthening infection control measures at Daru Hospital; and accelerating the roll out of community treatment outside Daru.

AusAID and PNG have jointly responded to the report and agree with all the recommendations, which are being implemented.

More information

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AusAID information

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Last reviewed: 24 April, 2013