HIV/AIDS Casts A Shadow Over PNG

HOSPITAL SEES INCREASE IN HIV CASES: Approximately 1 percent of women between the ages of 15-24 attending the Port Moresby General Hospital’s antenatal clinic are HIV positive. PHOTO: LORRIE GRAHAM/Focus

The dark shadow of an HIV/AIDS epidemic is slowly engulfing Papua New Guinea as statistics released by national health authorities point to a rapid increase in infections. The perceived inadequacy of PNG government funding to fight the deadly virus has worried local churches, non-government organizations, PNG bureaucrats and donors.

Surveillance by health officials at STI (sexually transmitted infections) clinics and hospitals show a fast increase in HIV cases especially among young women between the ages of 15-24.

PNG now has the Pacific region's highest number of HIV/AIDS carriers. The epidemic is concentrated among heterosexuals practicing high-risk behavior (at over 70 percent) followed by mother-to-child transmission (during birth or through breast-feeding), unsafe injection practices, transfusion of contaminated blood or blood products, injecting drug users and men who have sex with men.

People often compare the HIV epidemic in PNG to the epidemic in Africa where some countries have infection rates of around 30 percent. The World Bank has estimated that there may be up to 50,000 people infected with HIV living in PNG. The World Health Organization's western Pacific regional office has named PNG, China, Vietnam and Cambodia as countries needing priority action.

The director for monitoring, research and evaluation in the PNG Health Department, Dr. Gilbert Hiawalyer, says more than 16,000 people in PNG have been diagnosed with HIV/AIDS since the first case was reported in 1987. He says there has been an eight per cent increase in HIV prevalence among people aged 15-24, and approximately 1 percent of women in the same age group who went to the antenatal clinic at the Port Moresby General Hospital were HIV positive.

While Port Moresby had the highest number of HIV/AIDS patients between 1987 and September last year with 4,983 there were also 700 reported cases in the Western Highlands province followed by several hundred in Morobe, Eastern Highlands and Enga provinces.

"Men in PNG should change their behavior because they are responsible for spreading the HIV virus. Women, most of them get it under unfortunate circumstance because it is the behavior of men that spreads the virus," said Dr Hiawalyer.

"Churches can be more proactive, I think they should allow people to become more active and talk about sexual behavior more freely rather than treat it as taboo. Everybody feels that AIDS is just a problem for the Health Department. It is not, it is a problem for everybody."

In its 2004 national budget, the government allocated just over $AU298,000 to the National AIDS Council, which was established to prevent the transmission of HIV and STIs in PNG. The allocation drew the ire of people in the forefront of the HIV/AIDS battle, including veiled criticism from donors, and the council's director, Dr. Ninkama Moiya, who decried what he calls, the government's continuous practice of under-funding his office.

But PNG government minister, Dr. Puka Temu, who served as the national health secretary for six years before taking up politics, says the PNG government is providing adequate funding.

Dr. Temu says the PNG national government was concerned about the level of commitment from provincial governments, which he believes have the resources to contribute more and should take the leading role.

"I think we (PNG) are not moving as fast as we should because countries like Uganda, Cambodia and other countries that had the epidemic trend like us are now seeing the downward trend," he says.

"And we are the only country that is seeing the continued upward trend and there are a lot of lessons out there that we are learning on what interventions we need to employ in order to achieve the downward trend. I think we will get there."

He says PNG's scarcity of infrastructure in the rural areas made it difficult for authorities to get their awareness programs into villages, where 85 percent of PNG's population live.

However, Dr. Temu is optimistic that the HIV/AIDS epidemic would be brought under control in the next two to three years, despite PNG lacking data from which to formulate effective strategies, and possessing 850 different languages which made awareness programs harder.

John Davidson, the head of Australian development agency AusAid in PNG, recently expressed concern that PNG was moving closer to a 1 percent HIV/AIDS infection rate.

He says all stakeholders, including the PNG government, needed to show they are serious about tackling the issue. AusAid's main contribution is the $AU60 million National HIV/AIDS Support Project, a six-year program that finishes in 2006, which aims to strengthen the response in provinces with high HIV prevalence and specifically targets vulnerable groups such as sex workers and youths.

A 2002 report commissioned by AusAid examined the potential economic impacts of HIV in PNG. It concluded that HIV/AIDS had the potential to exacerbate poverty in PNG, with measures of economic welfare falling between 12 and 48 percent by the year 2020. The report also projected that the labor force could be 13-38 percent lower by 2020 than that expected without HIV; and that the budget deficit is forecast to increase by between 9 and 21 percent within the same period.

"We all need to show leadership on getting this message out and on saying to people this is something we should be talking about. We should be talking seriously and something (that) frankly the PNG budget needs to reflect. This is an important issue for the future of PNG. If you look at the economic impact, it's huge," says Davidson.