Lebanon’s crisis has gone from bad to worse. But is anyone listening?

Tony Walker, La Trobe UniversityIn the midst of a pandemic that has wrenched the world off its axis, Lebanon’s precipitous decline has not received the attention it deserves given the country’s strategic importance.

Bordering Syria to its north and east, and Israel to its south, Lebanon occupies a critical space in the Eastern Mediterranean. Its collapse would risk spilling over into surrounding areas.

The country is sagging under the weight of a vast refugee population from neighbouring Syria and a permanent Palestinian refugee presence. It certainly qualifies as a “crisis state”, which the London School of Economics defines as one in “acute stress”.

The question is whether the “crisis state” becomes, to all intents and purposes, a “failed state” under the LSE definition of one that “can no longer perform its basic security and development functions”.

Lebanon, which has taken more than a year to form a new government after an ammonium nitrate explosion ripped through its port area and forced the resignation of the government of the day, is again teetering on the brink.

Fuel shortages, which this week shut down its main power stations, have drawn the world’s attention to Lebanon’s continuing slide towards outright ruin.

An ammonium nitrate explosion ripped through Beirut’s port in August 2020, killing at least 216 people.
Hassan Ammar/AP/AAP

The emergence last month of a new prime minister after months of wrangling over power sharing among the country’s confessional groups hardly engendered confidence in the new government’s ability to get on top of Lebanon’s problems.

Fuel shortages caused by a foreign exchange crisis in which the country is effectively bankrupt is merely one of a series of cascading problems that has prompted the World Bank to describe the situation as one the world’s top-10 “most severe crises since the mid-nineteenth century”.

The World Bank speculates that Lebanon’s crisis may well rank in the “top 3”. This includes the Great Depression of the 1930s.

In a report issued in June by its Beirut office before the formation of the new government, the bank said Lebanon faced

[…] colossal challenges [that] threaten already dire socio-economic conditions and a fragile social peace with no clear turning point on the horizon.

The installation of Najib Mikati, a billionaire telecommunications tycoon, as prime minister has coincided with a further step down in Lebanon’s fortunes to the point where its ability to arrest its slide now depends on outside help. But that’s the problem.

New Lebanese Prime Minister Najib Mikati faces several critical and cascading problems in his country.
Bilal Hussein/AP/AAP

Potential international donors, led by France with its traditional ties to the country, are fed up with Lebanon’s inability to get its house in order and its endemic corruption, and fear external assistance will merely strengthen the radical Shi’ite Hezbollah’s grip on the country.

With Iran’s backing, Hezbollah has been portraying itself as Lebanon’s saviour. Iranian-supplied fuel has been shipped into Lebanon by truck from the Syrian port of Baniyas to circumvent US-imposed sanctions.

Since its emergence at the height of Lebanon’s civil war, which lasted from 1975-1990, Hezbollah has gradually strengthened its position as the dominant player in the country’s complex political make-up.

Read more:
Beirut explosion yet another heartbreak for a country already on the brink

This divides power between Christian and Muslim confessional groups under a power-sharing arrangement brokered by France in 1943. A Saudi-mediated deal, known as the Ta’if agreement to end the civil war, acknowledged Hezbollah’s role.

Hezbollah is designated as a terrorist organisation by the United States and other countries.

In the three decades since Ta’if, Lebanon has got itself back on its feet under various administrations only to slide back again, and now disastrously.

The reasonable question in all of this, given its intense internal problems overlaid by a governance structure that is clearly outmoded, is whether Lebanon is ungovernable in its present form and risks breaking apart.

In an assessment of Lebanon’s status as a potential failed state the Council on Foreign Relations nominated the following criteria. These included the 75% (at least) of Lebanese living below the poverty line, the 1.7 million refugees whose plight is even worse than that of Lebanese nationals, the duration of power blackouts of 22 hours a day, and public debt of 175% of GDP.

Since that assessment in September last year the situation has got much worse, if that’s possible. The Lebanese pound is virtually valueless, having lost 90% of its value against the dollar in the past several years. The country is beset by hyperinflation with price rises of more than 400% putting basic foodstuffs beyond the reach of many. Lebanon’s economy contracted by more than 20% in 2020.

One-third of Lebanese people are now living in ‘extreme poverty’.
Hassan Ammar/AP/AAP

One-third of Lebanese are living in “extreme poverty”, according to the United Nations.

Not least of Lebanon’s problems is its huge refugee burden. The United Nations High Commissioner for Refugees (UNHCR) reports the country has 865,530 registered Syrian refugees among an estimated 1.5 million Syrians in Lebanon.

On top of the Syrian presence, there are some 190,000 Palestinians in Lebanon, many in refugee camps. The Palestinians are effectively stateless and even more vulnerable to a deteriorating economy than the impoverished Lebanese.

Lebanon’s population, including refugees, stands at around 6.8 million.

Compounding Lebanon’s problems is an acute foreign exchange crisis. It is to all intents and purposes broke, and therefore unable to continue to subsidise imports of vital commodities, including food and medicine.

This has pushed prices through the roof.

Embattled Mikati put it bluntly after his swearing in.

Where are we going to get dollars to subsidise? We are dry. We don’t have any reserves or money that allows us to help.

Meanwhile, billions of dollars have flowed out of the country as wealthy Lebanese and corrupt officials have sought to shelter their assets given the collapse of the country ‘s banking system.

Banks have become insolvent. Thousands of Lebanese have lost their life savings. In the midst of this, they would have reason to be dismayed by revelations in the leaked Pandora Papers that prominent figures in government and the bureaucracy had been siphoning funds out of the country for years.

Read more:
Pandora papers: as ordinary Lebanese suffer, elite secretly drain off billions

Among those identified as having shifted funds abroad is Riad Salameh, Lebanon’s long-standing central bank governor. He is the sole director of a British Virgin Islands company established in 2007.

Salameh is under investigation in Switzerland and France for potential money laundering and embezzlement. He has been accused in local Lebanese media of shifting funds abroad in violation of regulations. He denies having made any such transfers.

However, what is not in doubt is that Lebanon is one of the world’s most corrupt jurisdictions. This is contributing to its inability to put its house in order.

In the global Corruption Perception Index, recognised as the most credible assessment of global corrupt practices, Lebanon rates 137 on a list of 180 countries along with Russia, Papua New Guinea and the Democratic Republic of Congo.

On the Fragile States Index compiled by the Fund for Peace in collaboration with Foreign Policy magazine, Lebanon ranked 34 in 2020, down from 40 in 2019. Given its accelerating decline over the past 12 months, its 2021 rating may well rival that of failing states like Yemen, Somalia and Syria.

If Lebanon is not a failed state now it is certainly one in the making. This is barring a substantial intervention by reluctant international lending institutions and western governments concerned about its further slide towards an Iran-led “axis of resistance”.The Conversation

Tony Walker, Vice-chancellor’s fellow, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The COVID-19 crisis in western NSW Aboriginal communities is a nightmare realised

Bhiamie Williamson, Australian National UniversityThe afternoon of August 11 was rather exciting in my community – the tiny, remote Aboriginal township of Goodooga in north-western NSW. After months of waiting, our COVID-19 vaccination clinic was planned for the next day.

Then the news came through of a positive case in Walgett, and the vaccine clinic was cancelled. In the midst of an unrelenting COVID-19 outbreak in NSW, other Aboriginal communities like Goodooga are facing uncertain times ahead.

A clearly defined vulnerable community

From the start of the pandemic, Aboriginal people were identified as “a clearly defined vulnerable community”.

These vulnerabilities stem from both chronic health conditions suffered by Aboriginal people and under-resourced health services in regional and remote areas.

In response, the Commonwealth Department of Health listed Aboriginal and Torres Strait Islander people in Category 1B:

Aboriginal and Torres Strait Islander adults have been identified as a priority group for the COVID-19 vaccination rollout program.

Yet as far back as June, concerns were raised over low COVID-19 vaccinations.

Western NSW – a Pfizer desert?

Total Aboriginal and Torres Strait Islander vaccination rates are low, but there are also concerns about pockets of poor vaccination coverage in individual communities. As Dr Jason Agostino from the National Aboriginal Community Controlled Health Organisation shared with the Guardian:

Unless we’re paying attention to those small levels of geography and those individual communities, we might find islands of poor vaccination coverage that leave those communities vulnerable.

Low vaccination rates have been exacerabated by an absence of Pfizer supply to a youthful population. Aboriginal vaccine hesitancy in Western NSW is largely attributable to anxieties around AstraZeneca, something which isn’t specific to Aboriginal communities.

AstraZeneca hesitancy has been heightened by ATAGI’s recommendation that Pfizer is the preferred vaccine for those aged 12–59.

But in Brewarrina, a recent vaccination hub was organised, only for community members to find out it was only administering AstraZeneca. Instances such as this hardly alleviate anxieties, especially when the Aboriginal population is overwhelmingly young — 86% of Aboriginal people in the Brewarrina area are less than 60 years old.

Although Aboriginal people are in priority categories for access to the vaccination, in Western NSW we haven’t been given access to supplies of the Pfizer vaccine ahead of lower priority groups in Sydney. The cancellation of vaccine clinics such as Goodooga and others (Bourke also had their vaccine clinic cancelled), add to these issues.

Indigenous organisations have long identified the need to deliver culturally appropriate public health messaging, especially around vaccinations, with some developing their own communications, such as NITV’s “Keep the Mob safe from COVID-19” campaign. But this messaging has made limited headway given the mixed messaging about AstraZeneca and lack of access to Pfizer.

Lax COVID testing results in community infections

The state government was put on notice by Aboriginal justice advocates who had highlighted the vulnerabilities of Aboriginal people in custody and in prison. Factors such as over-crowded conditions which make physical distancing impossible, and incarcerated people have much higher rates of chronic health conditions.

Research from the USA has highlighted that the rates of COVID-19 infection in custodial settings are far higher than in the general population (about five times higher). Those prisoners are also more likely than the general population to die from COVID-19.

Justice advocates continue to call for more urgent and rapid testing in NSW prisons.

Brett Collins, coordinator for Justice Action stated:

The moment that the infection gets inside any of the prisons it’s really a bomb going off.

Read more:
First Nations people urgently need to get vaccinated, but are not being consulted on the rollout strategy

A nightmare realised

Then, in the first week of August, a young man in Western NSW was taken into custody over a weekend, tested for COVID-19 upon entering the prison, and then released on bail a few days later. This young man’s test was not considered urgent because he had not been to a location of concern nor a close contact of a known case.

By the time the young man’s positive test was returned, he was in his hometown of Walgett. The town was plunged into a snap lockdown, with emergency testing facilities established and urgent pleas for vaccines.

While this was happening, an outbreak was spreading in Dubbo, a large regional centre that services much of the north-west. The adjacent local government areas of Bogan, Brewarrina, Bourke, Warren, Coonamble, Gilgandra and Narromine were also placed in a snap seven-day lockdown.

According to our estimates, Aboriginal people make up 25% of the general population in the nine areas of most concern in western NSW. Of this population, 26.5% are under the age of 11, meaning they are currently unable to be vaccinated.

A further 62.4% are aged 12–59, the age group for which Pfizer is ATAGI’s preferred vaccine. Until adequate supplies of Pfizer are provided, our community is unlikely to be protected against the virus.

Fears in western-NSW continue to rise with the increased rate of positive tests in Aboriginal families with particular concern over the rate of COVID-19 infections in children.

It is also important to understand these remote townships rarely have the services and goods to sustain themselves. For example, my hometown of Goodooga is located in the Brewarrina Shire, and yet our closest store is Lightning Ridge, located in the Walgett local government area. According to the restrictions first announced by the state government, our community were initially not permitted to travel there for basic supplies.

Read more:
COVID-19 restrictions have left many Stolen Generations survivors more isolated without adequate support

Communities being left behind

As COVID-19 has spread, so has fear and anxiety. Uncle Victor Beale, a Walgett Elder speaking to ABCs Nakari Thorpe, said, “I thought Walgett was one of the safest places on earth [but now] there’s a lot of anxious people”. Another Elder, Aunty Marie Denis Kennedy, meanwhile shared her concern and anger, “There’s no sort of protection for us”.

Scott McLachlan, the chief executive of the Western NSW Local Health District, shared his concerns around these recent outbreaks:

The large proportion of the new cases, and our total cases, are Aboriginal people both in Dubbo and Walgett and many of those are children.

Meanwhile, the NSW Health Minister admitted the medical services in Walgett were not prepared for an outbreak.

There has also been anger at the confusion caused by uncoordinated and confusing messaging from the NSW government about infections and exposure sites.

Multiple, successive, and cascading policy failures

The COVID-19 response in Sydney, where the Delta outbreak originated, was late, inadequate and ineffective.

Now what we see unfolding is the result of multiple, successive and cascading policy failures:

  • failure to vaccinate Aboriginal communities, one of the highest priority groups
  • failure to safely transition inmates and detainees from correctional facilities to their home communities
  • failure to plan for and create a surge capacity within local medical services
  • failure to plan for a COVID outbreak in regional and remote areas, where Sydney’s rules (such as not leaving your local government area) are ineffective in a vast landscape with interwoven communities that depend on one another.

Sensible strategies with achievable milestones that have long been advocated for – such as securing temporary accommodation for inmates and detainees transitioning from correctional facilities – could have protected our communities.

Now, the responsibility to make our communities safe is falling on our own organisations. Often under-resourced and under-staffed despite calls for extra support from the government, these community organisations work tirelessly, often without due recognition or appropriate pay.

Though this work may seem invisible to outsiders and government alike, we see it and we thank you.

Back in Goodooga, families hide in their homes, hoping to ride out this outbreak. But there is a feeling also of being forgotten. In this extraordinary and scary time, all we seem to have is each other, and our families in the city who worry for us.The Conversation

Bhiamie Williamson, Research Associate & PhD Candidate, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

India is facing a terrible crisis. How can Australia respond ethically?

Paul Komesaroff, Monash University; Ian Kerridge, University of Sydney, and Wendy Lipworth, University of SydneyIndia’s COVID-19 crisis has revived a longstanding debate about whether foreign governments should come to the aid of countries facing major economic or humanitarian challenges and, if so, what kind of help they should provide.

There’s a common assumption foreign aid produces undoubted benefits. But there’s actually limited evidence that it does. Increasing data suggests it may perpetuate existing inequities and inefficiencies, enable corruption, and generate adverse cultural and economic effects.

There are serious questions about the underlying causes of India’s crisis. There’s evidence the Modi government repeatedly ignored warnings from public health experts and refused to plan for the predicted increases in need. Instead, it pursued a public discourse of misinformation, promoted fake cures, withheld health data, intimidated journalists, and encouraged super-spreading events.

Government officials also continue to deny the existence of shortages of vaccines and other medicines. These facts suggest there are underlying structural obstacles, which aid contributions would be unlikely to reverse.

Read more:
COVID in India: how the Modi government prioritised politics over public health

But the moral arguments about the obligations humans have to each other are well established. So is the principle that we should come to someone’s aid if they’re in need. We are also bound by mutually beneficial values such as equity, justice, solidarity and altruism. Consequentialist philosophers, who argue the only things that matter are outcomes (rather than principles, obligations or intentions), claim foreign aid generally provides more benefit than harm overall.

Unfortunately, the fact we have a moral obligation to rescue someone from harm provides little or no guidance about what kind of help or assistance is thereby required.

We should enter into discussions, led by the Indian people, about what kinds of support are likely to make a difference.

As imperfect as the outcome may be, Australia might genuinely be able to help in areas such as assisting the development of expertise and infrastructure, and advocating for the relaxation of vaccine patent restrictions.

Here’s how Australia can help

Last week, Australia committed to sending an initial support package of ventilators, oxygen, and personal protective equipment to India.

If we choose to act further, we should do so in a generous and compassionate manner, but also with prudence and circumspection. We should be realistic about the limited options available to us. Aid cannot be given with conditions attached — for example, that it be directed preferentially to those in greatest need.

What’s more, it cannot be contingent on the enforcement of a value system that’s contrary to those presently in authority. Foreign donors have no straightforward right to insist on the abolition of corrupt or counterproductive policies and practices in the countries they’re supporting.

However, there are options available to us that can ensure we actually make a difference — and some of these may appear to undermine our own interests.

Top health officials have suggested wealthy countries, which have contracted to purchase many more vaccine doses than they need, should urgently donate excess vaccines to middle- and lower-income countries such as India. Some people may argue that, because of our present lesser need, Australia could donate its entire stock of available vaccines. However, this wouldn’t likely be of much benefit given the logistical, political and structural impediments described above.

Instead, we should draw on our experience over the past year in developing effective processes for responding to the pandemic. We should offer to provide India with expertise about quarantine measures, hygiene, masks, and vaccine education campaigns. Our experts and policymakers could respectfully advise on appropriate economic and social policies.

What’s more, we could call for the relaxation of patent and other intellectual property restrictions. These have, since the late 1980s, imposed severe limits on the ability of poorer countries to produce vaccines and pharmaceuticals developed in the United States and Europe. Although India is the world’s largest vaccine producer, the current demand obviously exceeds supply.

What vaccines are available are much less likely to find their way to poorer sections of India’s population than wealthier ones. This is partly because of insufficient government support, but is also exacerbated by the refusal of rich countries (including Australia) to allow the relaxation of the strict patent laws that prevent state-of-the-art vaccines being manufactured cheaply and efficiently in developing countries.

Read more:
Over 700 health experts are calling for urgent action to expand global production of COVID vaccines

There’s already a well-tested mechanism for suspending patent restrictions in an emergency, known as the “Doha Declaration”. This was negotiated in 2001 in response to the urgent need for increased access to newly developed HIV medications. This instrument is ready to use and could be implemented rapidly. Australia should announce its unqualified support for the immediate application of the Doha Declaration to COVID vaccine production.

But that’s not all

India’s huge pharmaceutical industry has previously provided vaccines and medicines to developing countries — many of them in Africa — largely funded by the World Health Organization. The Indian crisis has left these countries vulnerable, through no fault of their own.

Rather than merely responding to the crisis in India, largely self-inflicted by its own government, we should also turn our attention to the increasingly urgent needs of those countries that now face their own major emergencies as a consequence.

Regardless of what anyone does, many people will still die. All that’s open to us is to act ethically in accordance with our own values, informed by knowledge about the complexity of the multiple forces at work.The Conversation

Paul Komesaroff, Professor of Medicine, Monash University; Ian Kerridge, Professor of Bioethics & Medicine, Sydney Health Ethics, Haematologist/BMT Physician, Royal North Shore Hospital and Director, Praxis Australia, University of Sydney, and Wendy Lipworth, Senior Research Fellow, Bioethics, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

India’s staggering COVID crisis could have been avoided. But the government dropped its guard too soon


Pradeep Taneja, The University of Melbourne and Azad Singh Bali, Australian National UniversityIndia reported 314,000 new cases of COVID-19 on April 22, the highest-ever infection tally recorded by any country on a single day.

Many hospitals across the country are unable to cope with the unprecedented demand for life-saving necessities. Family members are scrambling to buy oxygen cylinders and medication for their loved ones in hospitals, often paying exorbitant prices in the black market.

Around the world, several countries such as the UK, Australia, New Zealand, Canada and Pakistan, have imposed new restrictions on travellers from India, including flight bans.

While many countries around the world have faced multiple waves of infections, what has led to this massive — and sudden — spike in India?

Read more:
As India’s COVID crisis worsens, leaders play the blame game while the poor suffer once again

Complacency is certainly to blame. But so, too, is the government’s feckless handling of the crisis, particularly Prime Minister Narendra Modi’s ineffective leadership in recent weeks.

Perhaps nothing illustrates this more clearly than Modi’s televised address this week in response to the growing crisis, when he sought to use his personal appeal to encourage Indians to practice COVID-safe behaviour.

He offered little in the form of concrete measures to contain the surge in infections, and counselled the state governments against using lockdowns. Unlike Modi’s public addresses during last year’s first wave, there was little that appeared to resonate across society.

Pandemic fatigue sets in

India was one of the first countries to enforce a nationwide lockdown when infection rates started to rise in March 2020, and this response, along with public vigilance, appeared to be successful in bringing cases under control. New cases peaked at nearly 100,000 in mid-September to under 10,000 in early February.

As case numbers declined, Modi’s popularity soared. And since late last year, businesses, government offices and ordinary people have returned to their pre-COVID routines, with many defying guidelines on wearing masks or practising social distancing. Some did so out of necessity to enable them to work, while others simply flouted norms out of arrogance or sheer ignorance. It was as if COVID-19 was no longer a major concern.

Read more:
After early success, India’s daily COVID infections have surpassed the US and Brazil. Why?

The complacency and pandemic fatigue evident in society was echoed in the actions of the Modi government. The government dropped its guard and started to boast about its success at controlling infections and India’s low mortality rate compared to many other countries.

Following a win for his party in the elections in the populous state of Bihar in November, Modi claimed the

results have endorsed the way we have tackled the coronavirus crisis situation in the country.

However, the situation in the country now is looking increasingly grim. So, what did the government get wrong?

Conflicting messaging and a botched vaccine roll-out

First, the government did not prepare the country for the possibility of COVID-19 returning with a vengeance, as had happened in other parts of the world.

Despite rolling out a national vaccination drive, it did very little to shore up capacity in hospitals to handle a sudden surge of infections and hospitalisations. This has led many hospitals across the country to panic, struggling to meet the growing demand for oxygen.

Second, even as the virus spread like a wildfire, Modi and his cabinet ministers kept campaigning in state elections in five states, addressing massive rallies and praising the crowds for turning out in large numbers.

A maskless Modi addressing his party's supporters
A maskless Modi addressing his party’s supporters during an election rally in Assam in early April.

This resulted in conflicting messaging. It mattered little to the government that pandemic protocols were being flagrantly violated by those organising and attending the rallies. As cases continued to soar, Modi was forced finally to call off election rallies in the state of West Bengal.

Third, the second wave of infections has been fuelled by one of the world’s largest religious festivals, the Kumbh Mela, held in the holy city of Haridwar every 12 years. It became a super-spreader event.

Taking a dip in the Ganges during Kumbh Mela
Kumbh Mela is one of the most sacred pilgrimages in Hinduism.
Karma Sonam/AP

From April 10–14, over 2,000 people who attended the festival tested positive for the virus. By the time Modi appealed to the religious leaders in a tweet on April 17 to keep the Kumbh Mela “symbolic” — meaning not to attend in person — the festival had already been going for more than two weeks. Two prominent Hindu seers had also died of COVID.

Finally, this week, religious leaders decided to wind down the festivities.

And the fourth misstep of the government has been in its handling of the vaccine rollout. While nearly 10% of India’s population has received the first dose, many vaccine distribution centres have in recent weeks run short on supplies.

Vaccine shortage notice in Mumbai
Vaccine shortage notices have been a common sight in India’s major cities.
Rafiq Maqbool/AP

This is partly a result of the Modi government prioritising its vaccine diplomacy initiatives rather than vaccinating its own people. According to the Indian Express, India had exported more vaccines (60 million doses to 76 countries) by late March than it had administered to its own citizens (52 million doses).

As India is one of the world’s largest manufacturers of vaccines, it could have used this as an opportunity to vaccinate a greater share of its population while simultaneously addressing the fault lines within the health system that have been exposed by the second wave of infections.

But the government didn’t take this approach — and now India is paying the consequences. Perhaps the Modi magic is finally beginning to wear off.The Conversation

Pradeep Taneja, Senior Lecturer in Asian Politics, School of Social and Political Sciences, The University of Melbourne and Azad Singh Bali, Senior Lecturer in Public Policy, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A catastrophe looms with PNG’s COVID crisis. Australia needs to respond urgently

from www.shutterstock.com

Brendan Crabb, Burnet Institute and Leanne Robinson, Burnet Institute

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.

Read more:
‘We didn’t have money or enough food’: how COVID-19 affected Papua New Guinean fishing families

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.

COVID-19 posters in PNG
These posters in PNG’s East New Britain Province help spread COVID-19 public health advice.
Parrotfish Journey / Shutterstock.com

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:

  1. immediate provision of masks in the community, appropriate PPE for health-care workers and increased support for widespread testing

  2. a campaign to counter COVID-19 misinformation, which is rampant, and

  3. 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.

Read more:
3 ways to vaccinate the world and make sure everyone benefits, rich and poor

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.

Read more:
After a year of pain, here’s how the COVID-19 pandemic could play out in 2021 and beyond

The Conversation

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

This article is republished from The Conversation under a Creative Commons license. Read the original article.