BBC News - September 28, 2006
Penny Spiller

The Health Minister Peter Barter shocked a recent meeting of world health officials by saying that infection rates had reached double digits in some remote parts of the country.

With nearly 2% of the population now believed to be living with HIV and Aids, experts fear Papua New Guinea is heading for a crisis similar to that in sub-Saharan Africa.

The country's government was for a long time accused of lacking the political will to do anything about infection rates that were rising at an alarming 30% a year.

But now it is "taking the bull by the horns", Secretary for Health, Dr Nicholas Mann, told the BBC.

Prime Minister Sir Michael Somare has brought the issue under his remit and the government is working with agencies in the country on a coordinated approach to tackle the crisis, he said.

Witchcraft

But tackling the problem in a country such as PNG is "very difficult", he admitted.

"We have about 800 different cultures and languages, and trying to translate the message in a society that is only 34% literate is a monumental task."

HIV is spread largely through heterosexual sex in Papua New Guinea, one of Asia's poorest countries. Unprotected sex, both paid-for and casual, is reported to be widespread.

The problem is particularly prevalent around the capital Port Moresby and other towns, major transport routes as well as mines and plantations.

But aid agencies point to a high level of violence towards women in the country as fuelling the epidemic.

"Women at most risk - those whose partners have multiple wives or who travel a lot - often say they have no control over the use of condoms and cannot refuse sex," Amnesty International recently said.

Deep-seated traditional and cultural belief systems are another factor, Dr Mann says.

"Firstly, people blamed it on witchcraft and sorcery," he said, admitting: "It will take some time and, unfortunately, loss of life before the message catches on."

On a practical level, experts say the country's health care infrastructure and resources are not adequate to cope with such an epidemic.

'Ambitious targets'

Earlier this month, Peter Barter told the World Health Organisation's annual Asia-Pacific conference that HIV infection rates in some areas had reached double figures.

Hospital pathology reports from two areas of central Enga province suggested infection rates could even have reached 30% in isolated cases, he said.

One health ministry study found that of 700 workers - both Papua New Guineans and foreigners - who were tested at a gold mine in Enga, 70 had HIV.

Dr Nicholas Mann says those results are very much a one-off.

"This is an isolated town where there is economic activity and many males, who take prostitutes," he said.

But the World Health Organisation has warned that the number of infections in Papua New Guinea could reach one million by 2015, unless decisive action is taken.

Dr Bernard Fabre-Teste, WHO adviser for Asia-Pacific region, said he was seeing a real determination by the PNG government to tackle the crisis.

"Papua New Guinea is very committed now and is setting ambitious targets for universal access," he said.

These targets cover the development of testing and counselling services; the creation of different types of prevention programmes; strengthening the system of treatment and care; and developing more accurate and strategic information.

WHO staff are helping to train local doctors and nurses, support the implementation of care for sufferers and help implement the government's HIV/Aids programme.

Cambodia once faced a similar HIV/Aids epidemic, Dr Fabre-Teste says.

"Now the situation is much better. There was a very important political commitment and HIV/Aids rates there are now decreasing."

Dr Mann says that with the help of such partners, his government will be able to effect a similar turnaround.

"It's slow progress, but we believe we can avert the kind of trend we have seen in sub-Saharan African," he said.

PAPUA NEW GUINEA'S EPIDEMIC

*1987: First case detected

*From 1997: HIV diagnoses rise annually by 30%

*2005: Some 60,000 estimated to have HIV/Aids

*By May 2005, only 171 had received anti-retroviral drugs

*Infection rates are similar between men and women

Sources: WHO and UNAids

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