Real issue with tuberculosis in PNG

WORLD TB Day was commemorated last Saturday with some fanfare and more or less a morbid fascination about this dreaded disease.
Most of the facts and figures about tuberculosis in Papua New Guinea are negative and point to the huge challenge faced by the government and relevant authorities in addressing the situation.
The list of negative statistics includes:
lPNG has the highest number of TB cases in the Pacific region with more than 20,000 new cases diagnosed every year;
lTB is one of the biggest killer diseases among children;
lHigh infection rates among children and elderly people; and
lEmergence of multi-drug resistant tuberculosis (MDR-TB) due to an increase in the number of patients who have dropped out of first-line treatment.
MDR-TB is of greater concern to health authorities, according to medical specialist Dr Philip Golpak of the Port Moresby General Hospital, who also revealed that one in 13 children in PNG will die from tuberculosis before the age of five.
Australia’s ambassador for TB, HIV/AIDS and malaria, James Gilling, who revealed that PNG had the highest number of TB cases in the Pacific, also provided another startling statistic – PNG’s estimated rate of new infections was 346 cases per 100,000 people.
The only good news from last Saturday’s event came from Health and HIV/AIDS Minister Michael Malabag, who revealed that PNG now recorded a case detection of 61% and a treatment success rate of 69% for TB.
Amid the doom and gloom, the minister reckons this is a giant step from the situation before 2005, which means some of strategies in addressing TB are actually working, including the directly observed therapy short-course (DOTS) strategy.
While it may be too early for our health authorities to pat themselves on the back, they and their stakeholders, namely the Australian government, World Health Organisation (WHO) and the Global Fund, should nonetheless be commended for their worthwhile efforts and continued financial support in helping to stop the spread of TB in this country.
In particular, the Australian government has been working behind the scenes to help rid the country of this disease.
According to special envoy Gilling, Australia provides funding to the Global Fund to support PNG’s TB, HIV and malaria plans.
In addition, Australia provides support to PNG in areas of research to detect drug resistance, financial support to WHO to provide technical assistance to the Health Department and targeted assistance of K62 million to help the government address the disease in Western.
Without that kind of assistance and commitment from our former colonial ruler, PNG would indeed be in a precarious position. It is therefore imperative that the health minister and his department ensure TB plans and programmes are effectively implemented throughout the country to achieve the desired results.
As Gilling stated, TB contributes to economic and social distress and is one of PNG’s biggest development obstacles. We couldn’t agree more.
It would be wise of Malabag to also take heed of the concern expressed by NCD Governor Powes Parkop about betel nut chewing and spitting in public places.
In his message on World TB Day, the governor urged betel nut chewers to be mindful of the health risks associated with spitting in the spread of communicable diseases such as tuberculosis.
Parkop says his intention to ban buai in Port Moresby is not only to keep the city clean but also for health reasons. Concerned city residents are eagerly waiting to see the imposition of the ban.
The governor’s proposal is highly commendable and needs the support of the health minister and his department, which has been somewhat lacking.
While there may be little or no evidence to suggest that betel nut spitting is directly linked to the spread of TB, it is nonetheless a health risk that should not be ignored.
Residents in the nation’s capital should also support their governor and help to educate their careless relatives and wantoks about keeping the city clean and also about the health risks associated with buai spitting, especially in public places such as shopping centres and markets and in public motor vehicles.
PNG would indeed be paradise if not for the filthy and unhygienic habits of many of its betel nut chewers.