|An AIDS public awareness campaign dominates the roof of Goroka's central market.|
Here is a good news story from Papua New Guinea: Australia's nearest neighbour has dodged the bullet of what the World Health Organisation feared could become an AIDS pandemic as deadly as those which have devastated parts of Africa.
Several years ago there were predictions that as many as one in 20 of PNG's population of 7 million could become infected with HIV, amid signs that the disease was spreading unchecked across parts of the highlands region. Now the epidemic is being contained, most of those infected are receiving lifesaving treatment and health workers are optimistic that this can be reduced to another manageable public health challenge.
''It is good news. We now know that this is a concentrated epidemic, not a generalised epidemic. The disaster that was predicted hasn't happened,'' says Dr Geoff Clark, a former WHO official who is now the Australian Agency for International Development's program director for health and HIV in PNG. ''The surveillance data now is much better than we were working with a few years ago when there were fears this could spread to 5 per cent of the population or more.''
While the spread of the virus is being checked, its management still poses a formidable public health challenge. Almost 12,000 adults and children were undergoing treatment last year, compared with about 9500 in 2011. The national infection rate is estimated to have stabilised at about 0.83 per cent of the population, with higher rates in some highlands provinces and in Port Moresby's National Capital District. About 1.4 per cent of the ''sexually active'' population (aged 15-49) in the Western Highlands is HIV-positive. ''This is being driven by poverty and people engaging in transactional sex,'' Dr Clark says.
Among the highly vulnerable are growing numbers of people driven to sell sex casually to survive, particularly single women with no support, or abandoned married women.
Great success is being achieved in the management of HIV among mothers and children. With better treatment and better education programs, the incidence of mother-child transmission has been greatly reduced in PNG, with about 400 children receiving treatment for HIV.
''It's working. People understand that HIV is here to stay but mothers are taking responsibility,'' says Lillian Bejigi, a nurse mentor with Susu Mamas, the national breastfeeding organisation that is taking a lead role in fighting AIDS.
Part of Australia's annual aid budget of $500 million to PNG is supporting local government efforts to provide antiretroviral treatment, with 80 per cent of eligible adults expected to be receiving the drugs by 2015.
Three Australian-funded non-government organisations are providing treatment directly or in tandem with government agencies to about half of those infected across the country. ''One of the reasons we are having success in reducing the spread of HIV-AIDS is because of the number of people who are now on treatment,'' says Dr Clark.
If the news on HIV/AIDS in PNG is good, then the sobering counterpoint is the rapid spread of tuberculosis. The official estimate is that the TB infection rate is 331 per 100,000 people, but Dr Clark believes it could be as high as 1000 per 100,000.
Mark Baker visited PNG as a guest of the Australian Department of Foreign Affairs and Trade.
Source: The Age