HIV-TB epidemic

PNG at mercy of HIV-TB epidemic

PAPUA New Guinea is on the verge of a combined HIV-tuberculosis epidemic “of African proportions” and Australia is its only hope of miti gating the disaster, regional tubercu losis expert says. However, Michael Levy, director of the Community Health and Anti-Tuberculosis Association, said yesterday Australia was reluctant to fund anti-tuberculosis programs because of the PNG Government’s corruption and instabil ity. The World Health Organisation yester day identified PNG as one of seven Asia- Pacific hot spots where co-epidemics of HIV/AIDS and tuberculosis had reached crisis levels. But the Sydney-based Dr Levy said that even in a region the WHO now described as the epicentre of a global tuberculosis emergency, “PNG stands alone” in the severity of its health crisis.

“PNG is facing a combined HIV-tuber culosis epidemic that I would estimate is of African proportions,” said Dr Levy, who led a WHO tuberculosis study team to PNG in late 1997 and has been associated with two other recent investigations. “That means it is at the level where population and economic estimates will have to be phased down in the medium to long term because of the impact of these diseases”.

The wildfire spread of HIV/AIDS through Africa and Asia has been the sin gle greatest factor in the resurgence of tuberculosis. Although the tuberculosis bacillus is estimated to infect one in every three people, healthy immune systems pre vent the disease developing in most peo

ple.

Weakened immune systems allow tuberculosis to flare among late-stage AIDS sufferers, who then infect healthy people. New estimates presented yesterday show HIV incidence in PNG last year as two per 1000 adults and seven per 1000 for tuberculosis. These proportions are still

well below those in Cambodia, which is now recording worse incidence rates than in East Africa.

However, Dr Levy said Port Moresby authorities had been the slowest and least effective in the region to deal with the co epidemic and the available statistics “are

so shaky they are almost not worth quoting in terms of any precision”. "But, even so, they are already at the high end of the range for both diseases.” The inadequacy of the PNG response - only a single anti tuberculosis pilot project exists in the country - meant Australian aid and exper tise were the country’s only hope.

However, Dr Levy believes the Australian Government aid agency, AusAID, is reluc tant to commit to any new medical projects because of the Skate Government’s corrup tion and unreliability, and the overall polit ical and social instability”.

Nobody cares about PNG except Australia, that’s a fact,” he said. “PNG looks to us for support and it isn’t going to come from any other direction”. * The Australian ■