by BRIAN GOMEZ
Authorities should welcome HIV debate

Some time last month, a new report from the Centre for Independent Studies in Sydney came out with a report that took a look at the HIV/AIDS crisis in PNG.
Shortly afterwards, the report came in for some scathing attack from a number of sources, most notably a group of researchers and academics involved with the highly regarded PNG Institute of Medical Research.
At the time it appeared
pleasing that so many PNG academics and researchers, who are usually silent on controversial policy issues, had taken
up the cudgel to defend the country from another foreign onslaught.
However, as a journalist who occasionally falls into the trap of jumping into controversial subjects without a proper understanding of the issues – it is not a good excuse that deadlines have to be met – I am glad Bottom Line held back from joining the fray.
Having read the full CIS article by Miranda Darling Tobias, it is possible to suggest the author may not have been fully up-to-date with recent developments such as the establishment of provincial and even district level groupings to tackle the AIDS issue.
But Tobias has done an excellent piece of academic research anyway and the 18-page article, and its references, should certainly be read by anyone with a serious interest in the AIDS issue and its possible ramifications for PNG.
From memory, it appears that the theme of the PNGIMR experts rebuttal was mainly on purely technical grounds, more or less on the basis that if research methods are no good, the results are valueless.
Their criticisms seem misplaced when one looks at the CIS paper.
Tobias makes no pretence of trying to assess the actual numbers of people in PNG who are afflicted with HIV/AIDS even though she does put an extremely high figure of 120,000 Papua New Guineans as being likely to be infected.
She suggests infection rates could be as high as 2% to 3% of the population.
Official figures on the numbers infected are probably around an eighth of her estimate, but the reality is that there are no reliable statistics on infection rates for a variety of reasons that most people are aware of.
So in that sense the executive summary of the Tobias article does provide a scary scenario and a warning that 25% of the population could be affected by 2020.
The criticisms of these ‘high’ numbers is somewhat misplaced anyway since Tobias does quote a World Health Organisation source as saying HIV infection rates of 1% to 2% “are far too low”.
WHO, as far as Bottom Line is concerned, is as authoritative as you can get.
Arguably it was insulting and denigrating to suggest that there was an “absence of a commitment” by the PNG Government to fight HIV/AIDS.
Maybe Tobias was unaware that Prime Minister Sir Michael Somare has specifically appointed a minister to report directly to him on the HIV/AIDS issue.
It is possible that this kind of high level commitment is what has attracted groups such as the Global Fund and Bill Clinton to PNG.
It has not been easy to see the fruits of such high level policy commitment in practical ways, although the National AIDS Council is certainly doing its utmost to prevent the spread of the infection.
But leaving these niggling issues aside, Tobias provides some good analysis about why HIV/AIDS may be spreading more rapidly than many people believe.
The CIS paper provides interesting commentary and analysis on how the Papua New Guinea situation compares with what has happened in Africa and in Asia and why transmission patterns are similar to Africa.
There is also some good analysis of PNG’s very inadequate health system and its failings – what a depressing thought that PNG’s maternal mortality rates is the second worst in the world with one in 18 women dying in pregnancy or childbirth in rural areas.
Then there is the impact of malaria and tuberculosis, both of which are highly debilitating and with severe socio-economic impacts.
Tobias also points out that in many hospitals there is no running water to wash your hands.
There is no point in getting upset about discussion about the deterioration of the country’s health services because this is the reality for most Papua New Guineans.
We would like to believe that there has been significant improvements in hospitals in the past five years but facilities and services can vary widely whether one is in Port Moresby or in Mendi.
As Tobias points out, budgets may sound great but much of the allotted funds don’t reach hospitals and clinics.
The CIS paper is very useful because it assesses a range of issues that contribute to the difficult health situation facing PNG, from sexual behaviour to questions of law and order and
the problems involved in promoting preventive policies.
Miranda Tobias is a messenger who has delivered a very clear and timely analysis of the HIV/AIDS crisis.
What is needed is a better delivery of medical services, along with more analysis, discussion and more reliable statistical information.