Papua New Guinea is on the brink of a health catastrophe. COVID-19 is rapidly spreading across the entire country. What little testing is being done shows cases have been rising exponentially over the past two months. The hospitals are now overrun, with health workers being infected at an alarming rate. Beyond official statistics, the “Haus Krais” of mourning are being heard across the country’s capital, Port Moresby, as deaths spike. Authorities are poised to order burials in a “designated mass grave” as morgues grow full. Prime Minister James Marape has said PNG is on red alert as positive case numbers continue to accelerate, while PNG’s former prime minister Peter O’Neill is warning of a total health crisis and calling for more international support.
More support is coming. Australia is stepping up, with a small forward team of two AUSMAT medical professionals arriving this week shepherding 8000 doses of the AstraZeneca vaccine from our own stockpile, along with other logistical supplies, to begin vaccinating frontline health workers by the weekend. This is an extremely welcome move by the Australian government, and testament to the Morrison government’s commitment to Australia’s “Step Up” in the region when it is most sorely needed.
But this must be just the start of our rapid intervention to help PNG to get a hold on this rapidly escalating crisis.
Make no mistake, PNG matters for Australia. We are wedded by history, geography and a colonial legacy. PNG is one of our largest diplomatic missions. It’s our largest aid partner. Australian business has $17bn invested in the country — more than it has in Indonesia. At any given time as many as 20,000 Australians live or work in the country. A walk through Bomana war cemetery in Port Moresby is a sobering reminder of PNG’s strategic importance to Australia. With 4km separation between PNG and the nearest Torres Strait Island, looking through a lens of complete self-interest, we cannot afford for PNG’s health system to collapse.
If things continue as they are, collapse is where we are headed. PNG’s health system is already incredibly stretched. The country’s entire health budget — before corruption clips the ticket — is $850m. For comparison, the budget for the Canberra Hospital, which is one of two public hospitals servicing the ACT, is $1.37bn. In Australia we spend 77 times more per capita on healthcare than PNG. Already dealing with tuberculosis, malaria, dengue, HIV, diarrhea and other illnesses, the only thing holding the system together is the Herculean efforts of the 4000 nurses and 500 doctors servicing a nation of 10 million. These healthcare workers are being infected at an alarming rate.
So, what more can Australia do, immediately, to assist?
First, logistical support should be ramped up substantially. While our forward AUSMAT team is surveying the picture on the ground, we should be loading up the HMAS Adelaide or Canberra with all the logistical support in terms of people and supplies needed for a larger rollout. By the time the ship arrives, we’ll know where they are needed. These vessels have done fantastic humanitarian work in Fiji in the past, and it’s time to do the same in PNG. While the practical stage of vaccine delivery — where the needle goes into the arm — must absolutely be administered by PNG professionals, the rest of the logistical chain can be operated by Australia. PNG’s already stretched healthcare system needs to be insulated as much as possible from this burden to continue keeping the basic functions of service delivery operating.
Second, we need to be prepared to hand over more doses from our domestic stockpile. This is not life or death for those waiting in Australia, but days matter in PNG. While we wait for the 288,000 doses to be delivered by the WHO COVAX facility sometime in April, if more is needed in the interim, more must be immediately provided.
Third, Australia and PNG should work to create an immediate stock take of partners in every one of PNG’s 22 provinces, 19 of which have active COVID cases, that can assist with a rapid rollout of vaccines. Be it churches, mining companies, loggers, NGOs, provincial health authorities, you name it. Whoever can be co-opted to assist should be, and will likely do so gratefully. This will require a profound rethinking of how we work, and who we work with, in the health space in PNG.
Finally, Australia should provide any support needed for a comprehensive communications rollout. Through Facebook, the primary means of information sharing in the country, fake news and misinformation is spreading faster than the virus. An alarming number of PNG’s educated and elite are sceptical of the reality of COVID-19, let alone the efficacy of a vaccine. Every leader in the country must be quickly vaccinated, and do it publicly. NRL players — celebrities in PNG — should be speaking up. Facebook should be co-opted to coordinate a mass information campaign on its platform. A full-court press will be needed to win the information battle. Just next door in Solomon Islands, where Facebook is just as important, Prime Minister Manasseh Sogavare has been putting on a master class of how this can be done.
PNG’s health system is on the precipice. Through our successful effort at home in containing the virus we can afford to be bold. The Morrison government has made fantastic first steps in acting to aid our nearest neighbour. We need to keep going.
Jonathan Pryke is director of the Pacific Islands Program at the Lowy Institute.