PNG leaders must overcome HIV complacency

The business Coalition Against HIV/ AIDS group has begun its endeavour to partner private enterprise with government efforts to stop the HIV/AIDS epidemic that is burning through Papua New Guinea. The group is led by Qantas chairman Margaret Jackson, who flew into Port Moresby accompanied by Lachlan Murdoch and Ian Thorpe to attend a dinner hosted by the coalition. The PNG Health Minister and other Government officials were present and duly expressed their concern over the epidemic.

However, the PNG Government has presided over a health situation that has deteriorated rapidly in the past 30 years, to the point where the rapid spread of HIV/ AIDS in the country has created a health emergency. Little has been done to arrest the obvious decline and for any business/ government partnership to have a lasting effect, this complacency on the part of the government must change.

At least 120,000 Papua New Guineans are likely to have HIV/AIDS and infections are multiplying rapidly. Infection rates are now estimated to be 2-3 per cent of the population and if, today’s rising infection trends continue, 18 per cent of the population could be affected by 2010, and 25 per cent by 2020. PNG could lose a million people to the disease. The resulting decline in the labour force and in gross domestic product per capita would be catastrophic, not to mention the distress of the orphans and those left to look after the survivors.

Allocating blame for this situation is a waste of time that PNG’s people don’t have. A clear picture is needed of the dimensions of infection and the way it is spread. The biological, social and political drivers responsible for this speedy rise in HIV/AIDS infections have to be identified if practical steps that will stop the current trends are to be found.

In PNG, HIV/AIDS is spreading through heterosexual sex and social conventions of promiscuity. Old men sleeping with young girls, for example, keeps the virus circulating between generations; casual and commercial sex increases the chance that men will bring the virus home to their wives; the low status of women means they have little power to negotiate sexual relations, let alone condom use. Young women, often subject to rape, are the most vulnerable group in the country.

The HIV virus is also attacking a population already debilitated by malaria, tuberculosis and diarrhoeal diseases. These are endemic because of low standards of living (standards that have barely improved in the past 30 years) and a decaying health infrastructure. PNG’s maternal mortality rate, for example, is the second highest in the world: one in 18 rural women dies in pregnancy or childbirth; of the infants who live, one in 10 will die before their fifth birthday. Sexually transmitted diseases, which are closely linked to the spread of HIV/AIDS, are also widespread in PNG.

Unlike scourges such as bubonic plague or cholera, the long gestation period of HIV/ AIDS means that an epidemic won’t simply ”burn out”. The virus is most infectious when newly acquired, but it is often not diagnosed until years later, increasing the chances for the virus to spread. Again, unlike many other diseases, HIV/ AIDS attacks people in their prime, not the very old or the very young.

High crime levels in PNG and suspicion of police and government also aggravate the epidemic by decreasing trust, and fuelling rumours and misinformation. One of the results is sorcery and quack remedies that become part of the problem and often lead to more violence, mainly against women. The extent of the epidemic in our Pacific neighbour is probably underestimated because the health infrastructure is crumbling, particularly in rural communities. Most hospitals are poorly equipped and maintained and often run out of basic medical supplies. In many hospitals there is not even running water to wash your hands. Anti-retroviral therapy can only be offered to a tiny proportion of those infected.

Australia has a direct interest in PNG’s HIV/AIDS epidemic because increasing numbers of that country’s nationals are accessing the Queensland health system in the Torres Strait islands and on Cape York.

Large volumes of aid, notably from Australia, but also from other countries and multilateral agencies, are being devoted to the epidemic. In the past six years, Australia has allocated more than $60 million specifically to fight HIV/AIDS in PNG. Despite this, in the absence of a commitment by the PNG Government to fighting the epidemic, these sums are ineffectual. However, the future inherent in current trends cannot be allowed to come to pass. In South Africa, where HIV/AIDS was not dealt with aggressively by the government, citizens now spend more time attending funerals than they do getting their hair cut, shopping, or having barbecues. HIV/AIDS has altered the fabric of a nation. Nowhere in the world has a country made serious headway in stopping or slowing the spread of HIV/AIDS without serious and resolute commitment by those in power. There have been too many tragic precedents for PNG to ignore the HIV/AIDS epidemic. The world wants to help, but outside efforts alone cannot be effective without leadership from PNG itself.

Miranda Darling Tobias is a Research Fellow in the Foreign Policy Program at The Centre for Independent Studies.