Our minds and screens have been full with what is happening at home and in countries like the United States and United Kingdom. In this and other ways, the current crisis on our doorstep highlights some perennial themes in the relationship between Australia and PNG.
Even for those who were paying attention, the apparently sudden spike in cases has come as a surprise. It had been difficult since the start of the pandemic to work out the real extent of COVID’s spread in PNG, given low testing rates and the inaccessibility of so much of the country.
But antibody analysis and testing of resource industry workforces employed by Australian and other international companies suggested that while the virus was present throughout the country, Papua New Guineans didn’t seem to be dying in the way that people in other countries were.
The apparently low rates of serious illness and death seemed to reflect the fact that three-quarters of the population is under the age of 35, and average life expectancy is only 64. Just a small proportion of the country’s inhabitants seemed to be in the main risk category — very elderly people.
But now it’s like a dam has been breached. Health facilities are close to being overwhelmed in Port Moresby, medical staff are being struck down and 50% of one batch of PNG swabs tested in Brisbane last week were positive.
Australians working in PNG
The crisis brings to mind a paradox in the Australia-PNG relationship. Despite our “blind spot” when it comes to our northern neighbour, there are thousands of Australians who have very strong PNG connections.
About 20,000 Australians call PNG home. They are heavily engaged in work there as teachers, miners, diplomats, aid workers and government advisers.
These people have known for some time how the pandemic has aggravated existing challenges in the country. It has strained the country’s fragile health system, put a squeeze on people’s incomes and encouraged a growing debt problem.
Many Australians, too, have been working on COVID’s front line there.
While the rest of us have been hunkered down safely behind closed borders, Australian women and men working in the resource industry have continued to come and go – doing quarantine at both ends, spending longer periods away from home and family.
They are managers and technical specialists, and they have been working with their PNG colleagues to implement world-class testing and treatment protocols in their mines and LNG production sites. This has helped keep thousands employed and some revenue flowing to the cash-strapped nation.
The better companies have also been working “outside the gate” to help local authorities manage the impact of the pandemic on their communities and combat widespread misinformation about the disease and vaccinations that will come.
The tough new restrictions on travel between Australia and PNG are undoubtedly a prudent move, but this has left many Australian resource industry workers and others feeling stranded.
Resource companies operating in PNG, from Newcrest to Oilsearch, need to brief the Australian health authorities on the stringent protocols they are enacting for their workers when they are in PNG. These arrangements, they argue, make their employees a safer bet to travel for work than Australian citizens coming home from many other parts of the world.
Helping PNG is in both our interests
In the past week, mainstream Australian media have finally found a reason to draw broader national attention to what is happening next door.
Self-interest is an important motivator of public attention, and there is now legitimate concern about the disease spreading across the Torres Strait into northern Australia.
We don’t know how bad the problem is in PNG’s western province, less than four kilometres from Queensland’s northernmost islands. But we do know that several positive cases had led the Ok Tedi mine there to cease charter flights to Cairns well before the Australian government suspended travel from PNG yesterday.
We’ve seen a range of official responses from the Australian authorities over the past few days.
Queensland Premier Annastacia Palaszczuk has announced the vulnerable Torres Strait communities are being prioritised for vaccinations. Canberra has moved to bring forward its vaccination support to PNG, contributing 8,000 doses immediately to protect frontline workers and asking the European Union to divert one million of its AstraZeneca order to PNG.
Some will criticise all this as a knee-jerk response. But to be fair, it builds on a substantial existing program of Australian COVID-related support to PNG.
And I know from my own time representing Australia as the high commissioner in PNG that the pace of assistance is often determined by the host government. PNG is a sovereign country, and they need to request help.
There are also those who will accuse Australia of acting purely in its own self-interest. Any such commentary reflects another basic and longstanding misunderstanding of how Australian and PNG interests intersect.
Our neighbour’s stability and prosperity is in our interests. Surely, there can be no better example of this than the current crisis: what is good for PNG is also good for Australia.
A better reflection of the self-interest at play is how most of us, in the general public, have only just realised there’s a problem.
Tony Heynen, The University of Queensland; Paul Lant, The University of Queensland, and Vigya Sharma, The University of QueenslandAustralia’s nearest neighbour, Papua New Guinea, is battling an unfolding COVID crisis. The Morrison government is urgently deploying 8,000 vaccine doses to the nation’s health workers – but poor electricity access means there are serious questions over PNG’s broader vaccine roll-out.
Vaccine supplies must be stored at cold or ultra-cold temperatures along the supply chain. Importantly, when the vaccines reach hospitals and medical centres in PNG, stable electricity will be needed to power refrigerators to store the doses before they’re administered to patients.
Currently only about 13% of Papua New Guinea’s eight million people have reliable access to electricity. This is not an isolated problem. In 2019, about 770 million people globally lived in “energy poverty”, without access to electricity – and the problem has grown worse due to COVID.
Australia is working to provide one million doses for wider distribution in PNG. But the pandemic only truly ends when the vaccines are rolled out globally. Countries and communities without electricity access present a major barrier to this goal.
Energy poverty matters
Australia enjoys a relatively reliable electricity network, even in remote parts of the country. There are also systems in place to keep vaccines cold in the event of a power outage, such as backup power.
But around the world, even in our Pacific neighbourhood, energy poverty is widespread and persistent. And COVID-19 has created a vicious circle for these nations. The pandemic has forced governments to shift priorities, leading to less funding for electricity infrastructure. In some countries, progress in electricity access has reversed for the first time in many years.
There, 580 million people lack access to electricity – three quarters of the world’s total. The IEA estimates this number grew by 6% in 2020.
It cites Uganda, where public subsidies for an electricity access program have been put on hold, and South Africa where funds to expand rural electrification were redirected to health and welfare programs.
PNG wants 70% of the country connected to electricity by 2030. This will require large scale investment in new generation capacity, and transmission and distribution lines to connect people to the grid. But the nation has long suffered economic instability, and the pandemic has only added to this.
Making matters worse, the true extent and trajectory of COVID-19 may be uncertain in nations suffering energy poverty. For example, there is growing evidence of under-testing in Africa and under-reporting of cases and deaths in PNG.
Vaccine refrigeration is key
As experts have noted, efforts to end the pandemic have largely focused on developing, testing and manufacturing an effective vaccine. Less attention has been paid to distributing it rapidly at scale.
There are exceptions. The Lancet has identified local deployment as one of four key dimensions for an effective global vaccination roll-out.
More than 390 million vaccine doses have already been administered, mostly in high- and middle-income countries with effective financial and planning resources.
But in countries where electricity access is poor, refrigeration of vaccines during transport and storage may prove very difficult. Some countries may not be able to vaccinate large parts of their population.
Ultra-cold supply chains were established for the deployment of the Ebola vaccine in Africa in 2013–14. However, the scale required for COVID is enormous, and would be prohibitively expensive.
As reported in the Lancet, as of 2018, 74 of 194 member states of the World Health Organisation had no adult vaccination program for any disease. Fewer than 11% of countries in Africa and South Asia reported having such a program. This was thought to be partly due to a lack of systems for storage and delivery.
Alarmingly, a recent study suggested more than 85 less-developed countries will not have widespread access to COVID vaccines until 2023.
Many are relying on the World Health Organisation’s COVAX initiative, which aims to secure six billion doses of vaccine for less developed countries. Similarly, the Quad regional grouping – Australia, the US, Japan, and India – recently pledged to boost vaccine production and distribution for Asian and Pacific island countries.
But without access to reliable electricity, the roll-out of these vaccines will be hampered. This is particularly an issue in countries with remote and dispersed populations. There, keeping the vaccine cold over the “last mile” of distribution and storage may prove impossible.
Energy access is key to ending the pandemic
Communities experiencing energy poverty, such as in PNG, face other setbacks when it comes to managing the pandemic. Those populations are more likely to use solid fuels, such as wood, for cooking. This leads to indoor air pollution which can cause severe respiratory illnesses and more severe COVID-19 symptoms.
Without electricity access, such communities are unlikely to provide appropriate COVID-19 health responses, leading to a higher burden of disease.
In PNG, an “Electrification Partnership”, of which Australia is a key partner, appears on track. For instance, at a virtual summit at the height of the pandemic last August, Australia committed to financing a large-scale solar plant in Morobe Province. It would be one of the largest solar plants in the Pacific.
But as immunisation emerges as the world’s primary weapon to combat COVID-19, much more work is needed to improve electricity access to those who desperately need it. Indeed, ending the global pandemic may demand it.
Tony Heynen, Program Coordinator, Sustainable Energy, The University of Queensland; Paul Lant, Professor of Chemical Engineering, The University of Queensland, and Vigya Sharma, Senior Research Fellow, Sustainable Minerals Institute, The University of Queensland
The Morrison government is gifting 8,000 doses of COVID-19 vaccines to Papua New Guinea, and demanding AstraZeneca and European authorities urgently provide one million doses of Australia’s contracted supplies to help the country deal with its escalating pandemic crisis.
In an effort to prevent transmission of the virus to Australia, the government is also suspending passenger flights from PNG into Cairns from midnight for at least a fortnight.
Prime Minister Scott Morrison announced a raft of measures at a news conference on Wednesday morning, aimed at both supporting PNG and protecting Australians.
Charter flights from PNG are also being suspended (with limited exemptions for medevac and the like) and the passenger caps on flights from Port Moresby to Brisbane are being cut by a quarter.
Outbound travel exemptions for Australians to go to PNG will be suspended – except for critical workers – including for fly-in-fly-out workers. “You FI or you FO,” Morrison said. “If you’re there, you stay. If you’re here, you stay. We cannot risk more people going into those areas and then coming back to Australia.”
The government will boost the medical support it is providing to PNG. It will gift one million surgical masks, 200,000 P295 respirator masks, 100,000 gowns, 100,000 goggles, 100,000 pairs of gloves, 100,000 bottles of sanitiser, 20,000 face shields, and 200 non-invasive ventilators.
The 8,000 vaccine doses will be used for frontline health workers from next week.
Morrison said the doses Australia was seeking to assist this “developing country in desperate need of these vaccines” had been contracted for by Australia.
“We’ve paid for them and we want to see these vaccines come here so we can support our nearest neighbour, PNG, to deal with their urgent needs. And we’ll be seeking the support of the European Union and AstraZeneca to achieve that as soon as possible.”
A critical planning AUSMAT team of health specialists will be sent to PNG next week. They will work with PNG authorities on infection control, triage and emergency management, and public health measures. They will also prepare for further Australian assistance and deployment of a clinical team.
Vaccinations are particularly important for those in the Torres Strait Protected Zone, where people on both sides of the strait form one community. The Queensland government has already begun this rollout, and the federal government will work with the PNG government, as well as with Queensland.
Chief Medical Officer Paul Kelly said the PNG situation had changed very rapidly in the last couple of weeks and there was now “a major pandemic in the community”. He said mass testing had been done at the Ok Tedi Mine and almost half the results were positive. Australia has already suspended flights from the mine.
“They are finding the same when people are being admitted into hospital in Port Moresby – half of the women who are coming in due to pregnancy are positive.”
According to the latest numbers on Tuesday, there were 82 new cases in the previous 24 hours. This brought the total official number of cases to 2,351, including 26 deaths.
Morrison said of PNG: “They’re our family. They’re our neighbours. They’re our partners. They have always stood with us and we will always stand with them.”
PNG Prime Minister James Marape said this week his country was now “in the critical red stage” of COVID-19.
“We are possibly having an infection rate about one to three or four in our country.”
He said “the status of our public health system is that what we have in our country is not adequate to sustain a full-blown outbreak, that is of pandemic nature”.
The COVID epidemic in Papua New Guinea has significantly accelerated, judging by the available reports of case numbers.
Since its first case was diagnosed 12 months ago, PNG has avoided a large number of reported cases and corresponding deaths. That situation has changed dramatically over the past fortnight. A crisis is now unfolding with alarming speed and the response must quickly match it.
Australia can be proud of its preparations to support PNG and the region in responding to COVID-19, especially its preparations to support vaccination in the region. These include contributing A$80m to COVAX, $523m to the Regional Vaccine Access and Health Security Initiative, and $100m towards a new one billion dose COVID-19 vaccine initiative together with the United States, India and Japan (the “Quad” group of nations).
As good as they are, these plans are unlikely to be fast enough to stop this current surge before enormous damage is done. There’s simply no time to waste in responding.
Why the urgency?
Reported COVID-19 testing rates remain critically low, with just 55,000 taken from an estimated population of nine million people. This means we don’t yet have a precise picture of the scale of the epidemic.
The reported numbers are highly concerning. In the first week of March, 17% of all people who were tested throughout the country were positive to COVID-19, with over 350 newly confirmed cases. This is the highest number of cases in a single week in PNG since the start of the pandemic. Over half of PNG’s 22 provinces reported new COVID-19 cases in that week.
There are other indicators of a potential large scale outbreak, such as reports of increased cases among health-care workers. What’s more, the total number of documented COVID-19 deaths in PNG has nearly doubled in the past fortnight alone.
Low testing rates, combined with reports of high daily case numbers, means there are likely many thousands of current cases in Port Moresby and widespread seeding and spreading of infections throughout the country.
PNG’s hospitals and front-line health-care workers remain particularly vulnerable. With limited public health controls in place and an effective vaccination program yet to be initiated, and with last week’s huge commemoration ceremonies for Grand Chief and former Prime Minister Michael Somare, there’s every chance the current outbreak will continue to grow exponentially for some time yet.
The people of PNG now face dual health emergencies: death and disease from COVID-19 itself, and a likely increase in existing major diseases barely held in check by the nation’s already stretched health system. These indirect effects, such as potential rises in malaria, tuberculosis, HIV, cervical cancer, vaccine-preventable diseases and poor maternal and newborn health, are likely to be even worse than the direct impact of COVID-19.
Australia and PNG’s vital partnership
This health crisis should be reason enough for Australia to respond urgently in support of PNG. But there’s another reason too. High levels of circulating SARS-CoV-2 in the Asia-Pacific region are a recipe for generating mutant coronavirus variants that might spread more readily, evade immunity more easily, and/or cause more serious disease. A regionally coordinated effort to combat COVID-19 will help ensure protection for everyone, including going a long way to help preserve Australia’s own vaccine program.
PNG already has a coordinated national and provincial COVID-19 response and a vaccine technical working group that has begun planning for deployment of the first allocation of vaccines to front-line health-care workers.
Meanwhile, Australia is also playing a crucial role in supporting this effort, contributing generously to the COVAX vaccine access facility and to a A$500 million fund to support COVID vaccination in PNG and the wider Pacific.
However, these plans were developed on the basis there was substantially more time for planning, deployment and phased rollout than the current case numbers would suggest.
What action is needed?
Two considerations are now paramount. First, the response needs to be requested by — and, more importantly, led by — PNG itself. Second, the response needs to reflect the urgency and scale of the unfolding emergency.
This “emergency package” could conceivably involve:
immediate provision of masks in the community, appropriate PPE for health-care workers and increased support for widespread testing
a campaign to counter COVID-19 misinformation, which is rampant, and
a significant ramp-up of vaccination across PNG, with an ambitious target — perhaps a million doses before the end of the year, aimed at the most at-risk groups.
Arguably the most important element of this would be immediate vaccination for health-care workers in the most heavily impacted areas of the country. Ideally, all of PNG’s crucial health-sector workforce should be vaccinated within the next fortnight. Australia could provide around 20,000 vaccine doses for health-care workers without putting a significant dent in its own vaccine supplies, potentially making a profoundly important intervention in the course of the epidemic in PNG.
This is the moment for dialogue to occur between the two nations, so PNG can ensure Australia’s help with such an immediate and ambitious response.
PNG is Australia’s closest geographical neighbour, and our countries have a deep shared history of mutual support. An out-of-control COVID-19 epidemic in PNG would be a humanitarian and economic disaster for the nation itself, and a grave threat to the health of the region, particularly with shared borders to Solomon Islands in the east and Indonesia to the west.
Given this pandemic expands at an exponential rate, and with new variants of concern arising regularly in regions of high transmission, it’s the speed of a strong response that matters the most. A rapid public health intervention, to be supported and facilitated at the highest levels of government, would go a long way to mitigating what may well become a public health catastrophe.
Brendan Crabb, Director and CEO, Burnet Institute and Leanne Robinson, Professor, Program Director of Health Security and Head of Vector-borne Diseases & Tropical Public Health, Burnet Institute; Laboratory Head, Walter & Eliza Hall Institute; Adjunct Principal Research Fellow, PNG Institute of Medical Research, Burnet Institute
In March 2020, Papua New Guinea went into a state of emergency to contain the spread of COVID-19. For Ahus Island — a small atoll community of around 600 people off the north coast of Manus Island — the state of emergency had far-reaching consequences.
In July and August, we interviewed Ahus islanders about their experience of COVID-19, and what they did to cope.
Their stories from the first six months of COVID-19 offer insight into the impacts of the pandemic on small-scale fishing communities and isolated islands.
As the new normal unfolds, the COVID-19 pandemic will continue to reverberate across fishing communities. The stories from Ahus island reflect the experiences of other fishing communities across the Pacific. Other Papua New Guinean coastal communities struggled with food shortages, and needed external support for basic foods and services. Getting cut-off from markets and food can affect people’s livelihoods and well being in unforeseen ways.
Globally, there is a need to coordinate short and long-term responses to support small-scale fisheries, especially across the Indo-Pacific, where food insecurity is already a concern.
Fishing pressure on island’s reefs decreased, but at the cost of people’s livelihoods
In Ahus, most people earn a livelihood selling fish — almost no food is grown on the island itself, and there are almost no other jobs.
During the state of emergency, fishers and fish sellers struggled to get to markets and to sell fish, which put stress on fishing families. Normally, fishers sell fish at the town market, a 40-minute boat ride from the island. During the state of emergency, the market was deserted and there was almost no demand for fish. With no customers, people stopped earning income and were unable to buy food:
We found it hard because you go to the market and there’s not one person who’ll buy fish from you.
If you have money, you get food, if you don’t have money you can’t get food. And the way we get money is from the sea alone.
Passenger restrictions meant fewer passengers could get to town. And trips took three times as long because boat owners switched to smaller motors to save petrol.
One man explained:
For us on this island, it is hard … We travel by sea. We go by boat. Now, if only limited people can get on a boat, then that affects us.
The island’s market also closed briefly at the beginning of the pandemic, and travel to the mainland was restricted, leaving some people with no way to access food. Some people secretly bartered fish with relatives on the mainland, but others had to wait for markets to reopen.
When they did reopen, there was limited cash in the community, and many returned to a traditional system of bartering fish for vegetables.
The combination of disruptions of markets and transport restrictions impacted fishing. People explained that it was hard to get fuel from town to troll for ocean fish. Others fished less because they were afraid to leave the house for too long.
The town hospital was only accepting emergency patients. One woman said:
So I told our family, you can’t go to the sea, because if you get sick then how can we go to the hospital? So during that time no one went fishing, and we didn’t have money or enough food.
Fishing pressure on island’s reefs decreased, but at the cost of people’s livelihoods.
‘Little, little for each child and each adult’
To cope with lack of income and difficulty getting food, most households started reducing what they ate. One woman said:
Before, we’d all eat rice often. Not now. I’ve cooked sago over and over, and everyone complains … but there’s nothing else.
Many families rationed food. As one person said:
There was limited food … we’d serve just a little, little for each child and each adult. It doesn’t matter if you’re full up or only just full, that was your share.
Restricting food comes with risk. Diets of fish, sago and rice alone don’t contain enough essential nutrients to maintain health. Children’s physical and mental development can be permanently impaired if they are undernourished.
As families struggled to support themselves, some stopped sharing and helping others in the community. Several people mentioned that they’d received government support during past emergencies in the form of food and basic services. Others had heard other provinces were receiving support and were frustrated that their community had been left out.
The road ahead
Since these interviews, we have spoken again with people in the community. Their situation has improved since the state of emergency lifted.
The sea cucumber season opened in September, bringing a quick cash injection to the community. Markets have returned to business as usual, food is accessible and people have started sharing again.
But the last year has shown many communities are ill-prepared for the economic disruption that comes with a pandemic. Pandemic responses that do not account for impacts on food and nutrition security may lead to non-compliance and foster distrust in the legitimacy of future directives.
Decision-makers, locally and globally, must balance management of pandemics with a recognition that fish and fishing communities are essential to local well being.
Our research report can be found here.
Wilda Hungito, a PNG-based private research consultant and co-author on the report, contributed to this article.
Papua New Guinea