Medicine – Asia Pacific Report

Nick Rockel: ‘Over and out from me’ – Dr Ashley Bloomfield

APR editor — Sun, 31 Jul 2022 19:15:07 +0000

COMMENTARY: By Nick Rockel

On Friday I watched Ashley Bloomfield’s last afternoon health update. After all we’ve been through over the past couple of years, and the major role he had in communicating to us and keeping us safe, I’ve got to say I felt a bit emotional.

The end not of an era, sadly the virus is still very much with us, but in a way a part of what has been one of the major events in all of our lives.

His humble, calm, well informed voice was a great antidote to some of the stupidity that we saw overseas in the early days of the pandemic, I’m looking at you America, but sadly we see more and more of that here in Aotearoa.

READ MORE: Other Nick Rockel articles at Asia Pacific Report

Maybe it was always there; I guess you’d have looked pretty stupid slagging the guy off in the comments section two years ago.

Not anymore apparently.

I was going to include some of the negative comments here from during his last briefing to demonstrate how full of hatred, conspiracy theories, and misinformation these people are. But when I went back and looked at them they just made me feel sad and I decided I didn’t want to repeat any of them even to mock them.

Of course the poisonous hatred and stupid fuelled negativity aimed at Dr Bloomfield on social media is minor compared to the Tsunami of Bile frothed by those attacking Jacinda for things like — it being her Birthday the other day.

Rewinding back
Isn’t it reassuring to know we live among people who see red fury at people wishing the Prime Minister a Happy Birthday, or a Doctor giving medical advice?

What must celebrations be like at their place?

“Don’t say Happy Birthday to that little bastard he hasn’t even finished putting 100 pins in his Jacinda and Ashley dolls yet”

“C’mon Kev he is only four!”

But let’s rewind back to the beginning, the early days of the daily update…

We were listening to scientists not business people. The messages were clear about putting our lives, our family’s lives, and the lives of those around us in the community first; the message wasn’t filtered through what CEOs or corporate sponsors wanted.

We were told saving lives mattered, washing hands mattered, and commerce would just have to wait for once as much of it was put into an induced coma until it was safe to listen to business people, or certain politicians, again.

The cryogenic switch
And who was flicking that great cryogenic switch, who was saying “don’t go to work stay at home and chill, if you’re able work online in your underpants” as if some deadbeat mate you knew in high school had turned up to stay indefinitely.

It was Dr Bloomfield.

Who told us of each new outbreak, scientific break through, the vaccine rollout, or sadly life lost?

It was Ashley. I’m sure we can all remember certain updates, I particularly remember the spread in a West Auckland old peoples home, which wasn’t far from us and brought it very close to home.

The youngest member of our household would listen to the updates hoping there would be an increase in numbers, not too many he didn’t want people to be ill, but just enough to keep schools closed a bit longer. Funnily enough he was less enthusiastic about the restrictions applying to football and dance classes.

Dr Bloomfield called those making racist comments about people infected with covid “gutless” — could he have been any more awesome?

And who could forget the day we went to zero community cases – what a day! It was like we had won the World Cup except it was something that actually mattered.

The Vaxathon spirit
A little later there was the Vaxathon that made those of us of a certain age fondly remember Telethons of old. It even remarkably captured some of that same spirit in the age of everything on demand — or maybe it was just us oldies that thought so.

We had this guy telling it like it is, the Doc was giving it to us straight. Of interest especially to we middle aged white guys was the fact here was a guy capturing the nation who if push came to shove and he had to take to the dance floor he’d probably dance a lot like us.

So what turned people?

Was it the positivity, the being well informed and not putting up with any nonsense? He didn’t outright mock “alternative theories” but it was pretty clear what he thought of them.

Was it standing alongside The Prime Minister the two singing in unison how we could all be kind in our socialist utopia that put people first?

Was it having certain media people and opposition politicians finding any angle to criticize the approach we were taking and attacking Dr Bloomfield for his performance? I remember one of the reporters at a press conference even asked him if he should offer his resignation.

Or was it having a nerd tell them whether they could go out and play with their friends and their toys or not?

The silent majority
It struck me, as it often has looking at comments; surely the silent majority are decent people grateful for how well we have been served by Dr Bloomfield. Is it really possible that this many people are filled with anger and disinformation, or are they just the loudest and actually mainly fake?

We saw people opposing health measures increasingly of course. First they were anti the vaccinations, then anti the mandates that were there to keep people safe and could so easily be avoided with a little prick.

Now that life is by and large back to normal, albeit with a disturbing number of daily cases and deaths, they are anti any ongoing measures — anti the wearing of masks!

People who genuinely believe, or at least claim, that masks not only don’t inhibit the spread of disease but will actually say until they are blue in the face that masks make the spread worse!

The mind goggles. Imagine if the anti-mask crowd took that approach to other areas of life?

“Don’t you throw that water on me everyone knows it only makes being on fire worse!”

What else do people decide — meh I’ve been doing this a couple of years I can’t be bothered any more?

Seat-belt lessons
We didn’t decide a couple of years after seat-belts were introduced that, you know what, people are still dying in car accidents so I’m not wearing one any more — in fact if you do your research you’ll find seat-belts make car crashes more dangerous!

People don’t say you know when I’m driving home tonight in the dark I’m going to go with Natural illumination – the light from the moon. No more artificial illumination for me, everyone knows this has worked for thousands of years.

Walking on the footpath instead of the road or wearing a parachute jumping from a plane? Not for them, you can only hope they’re wearing condoms.

Have these people always been around? Will they always be like this? Is this Darwin at work?

Evolution is painful to watch.

For the rest of us Covid hasn’t actually gone away but could it be that some us are already looking back to the height of the pandemic, the lockdowns as inconvenient as they were on occasion, as a better simpler time?

Getting our priorities right
A time when we got our priorities right of family and caring for each that doesn’t always occur?

A time of people over profits – it was a bit of an adventure – it didn’t feel much like it queuing in the rain for groceries, but in hindsight….

Didn’t he do well – Ashley, there he was yesterday getting a standing ovation, still smiling, still calm – he really did us proud!

Thank you Dr Bloomfield, we will remember what you did.

Nick Rockel is a “Westie Leftie with five children, two dogs, and a wonderful wife”. He is the publisher of The Daily Read where this article was first published. It is republished here with the author’s permission.

Papua New Guinea’s first woman neurosurgeon graduates at UPNG

APR editor — Thu, 28 Apr 2022 22:44:33 +0000

By Phoebe Gwangilo in Port Moresby

Papua New Guinea’s first woman neurosurgeon has graduated from the national university.

Dr Esther Apuahe graduated with a higher post-diploma in neurosurgery during the University of Papua New Guinea’s 67th graduation ceremony yesterday.

“She is the first female neurosurgeon in Papua New Guinea,” said the dean of UPNG’s Medical Faculty, Professor Nakapi Tefuarani.

READ MORE: Other PNG medicine sector reports

Dr Apuahe, 43, originally from Morobe and married with three children, was also the first Papua New Guinean woman surgeon to finish in 2012.

“Surgery for almost 30 years had no female graduate since 1979 when the first male graduated. And, it has been a male-dominated field,” she said.

“In 2008 I started doing my masters in surgery at UPNG. I became the first female to finish in surgery.

“I finished in 2012 and I went out as a general surgeon at Vanimo General Hospital and I was called back here to take up neurosurgery.

New field for PNG
“It is a new field, basically to do with surgery of any brain pathology, head injuries and any brain tumour.

“Surgery, in the field of medicine, has been a male-dominated field.”

Dr Apuahe wanted to do something more than general surgery and, therefore, took up study in neurosurgery.

“After that, working outside, I felt that I needed to do more, maybe going further into surgery in some specialising,” she said.

Her study, which started in 2015, took a little longer than expected due to the pandemic as well as the unavailability of mentors.

“Neurosurgery is such a hard field. At that time, there were only two male neurosurgeons,” Dr Apuahe said.

“Because there was no one to cover in Port Moresby, I was called to come back here, so I’ve been here since 2015.

Not an easy journey
“The journey is not easy, it has been hard trying to manage patients and training with no medical supervision, just supervision externally, from Australia.

“It probably took a long time from 2015. I started, not officially, on training just getting some hands-on experience and I started towards the end of 2016, commencing neurosurgery.

“I had an attachment in Townsville (Australia) in 2019, but just as I was completing that, covid-19 came and so I was unfortunate enough to go before the pandemic and I came back and I sat for my exam last July.

“I thank the Royal Australian College for being there, supporting the training of neurosurgery and also to the academics at UPNG such as Professor Isi Kevau who pushed us through to make sure that I succeeded.

“After I graduated, there are now about eight female surgeons.”

Phoebe Gwangilo is a PNG Post-Courier reporter. Republished with permission.

Covid diagnosis: Could I have had the virus and not realised?

APR editor — Sun, 20 Mar 2022 19:36:17 +0000

ANALYSIS: By Ashwin Swaminathan, Australian National University

It seems not a day goes by without learning someone in our inner circle of family, friends and colleagues has covid. When we ask how unwell our acquaintance is, the responses vary from “they’re really crook” to “you wouldn’t even know they had it”.

This is in line with studies that report moderate to severe illness in a minority of people (usually older with other risk factors) and that up to one in three positive people exhibit no symptoms.

Given the ubiquitous presence of this highly infectious coronavirus in our community and the high rate of asymptomatic illness, those who have not been diagnosed with covid might wonder, “how would I know if I had been infected?”

And, “does it matter if I have?”.

How covid is diagnosed
Most people know they’ve had covid because they had a fever or upper respiratory tract symptoms and/or were exposed to an infected person AND had a swab test (PCR or rapid antigen) that detected the covid virus (SARS-CoV-2) in the upper airway.

At the beginning of 2022, many people with consistent symptoms or high-risk exposures were not able to access PCRs or RATs to confirm their diagnosis, but instead presumed themselves positive and quarantined.

It is possible to diagnose past infection in those who never tested positive. A blood test can look for SARS-CoV-2 antibodies (also known as immunoglobulins). When we are infected with SARS-CoV-2, our immune system launches a precision counter strike by producing antibodies against viral targets, specifically the Spike (S) and Nucleocapsid (N) proteins.

Covid vaccination induces a similar immune response against the S protein only. The S antibody “neutralises” the invader by preventing the virus from attaching to human cells.

These antibodies can be detected within one to three weeks after infection and persist for at least six months — potentially much longer. A blood test that shows antibodies to S and N proteins indicates someone has been previously infected. Detection of antibodies to the S protein only indicates vaccination (but not infection).

The problem with antibody tests
Before you rush off to get a covid antibody test, there are a few notes of caution. There is still much to learn about the characteristics of the immune response to covid infection.

Not everyone mounts a detectable antibody response following infection and levels can decline to undetectable levels after several months in some people.

Because there are other circulating seasonal coronaviruses (such as those that cause the common cold), tests may also pick up antibodies to non-SARS-CoV-2 strains, leading to “false positive” results.

Commercial and public hospital pathology labs can perform SARS-CoV-2 antibody testing, but the interpretation of results should be undertaken carefully.

So, antibody testing should really only be done when there’s a good reason to: say, when confirming past infection or effectiveness of vaccination is important for the current care of an individual.

Diagnosing a post-infectious complication or eligibility for a specific treatment, for example. It could also be useful for contact tracing or for assessing the background population rate of infection.

Antibody testing a population
“Seroprevalence studies” test for the presence of SARS-CoV-2 antibodies in repositories of stored blood that are representative of the general population, such as from a blood bank. This data helps to understand the true extent of covid infection and vaccination status in the community (and informs our assessment of population susceptibility to future infection and reinfection). It’s more useful than daily reported case numbers, which are skewed towards symptomatic individuals and those with access to swab testing.

New research from the World Health Organisation, which is yet to be reviewed by other scientists, reported the results of a meta-analysis of over 800 seroprevalence studies performed around the world since 2020. They estimated that by July 2021, 45.2 percent of the global population had SARS-CoV-2 antibodies due to past infection or vaccination, eight times the estimate (5.5 percent) from a year earlier.

There are plans to conduct fresh seroprevalence studies in Australia in the coming year, which will update local data and help us understand to what extent the omicron wave has washed through the population.

Even after ‘mild’ cases, a new study by this @CurtinUni expert finds “long COVID” symptoms may persist. This includes “brain fog”, fatigue, and problems with concentration and memory. https://t.co/4lckYrks0Y

— The Conversation (@ConversationEDU) March 7, 2022

Does it matter if I have had covid and didn’t know?
For most people, knowing your covid infection status is unlikely to be more than a topic of dinnertime conversation.

While some studies have pointed to a less robust and durable antibody response following mild or asymptomatic infection compared with severe illness, it is not known how this influences protection from reinfection. Certainly, the knowledge we have antibodies from past infection should not deter us from being fully up-to-date with covid vaccination, which remains the best protection against severe illness.

There are reports of people with mild or asymptomatic covid infection developing ‘long covid’ — persistent or relapsing symptoms that last several months after initial infection. Symptoms can include shortness of breath, physical and mental fatigue, exercise intolerance, headaches, and muscle and joint pain.

However, the likelihood of developing this condition appears higher in those who suffer a heavier initial bout of covid illness. This might be linked with higher viral load at that time.

Bottom line
As we enter the third year of the covid pandemic and given that up to one in three infections may be asymptomatic, it is likely many of us have been infected without knowing it.

If you are experiencing lingering fatigue, brain fog or other symptoms that could be long covid, you should talk to your GP. Otherwise, knowing our covid infection status is unlikely to be of much practical benefit. Antibody testing should be reserved for specific medical or public health indications.

Being up-to-date with covid vaccination is still our best defence against severe illness moving forward.

Dr Ashwin Swaminathan is a senior lecturer at the Australian National University in Canberra. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Table ‘transparent’ PNG medicine procurement proposal, says Juffa

APR editor — Tue, 21 Dec 2021 19:10:07 +0000

By Rebecca Kuku in Port Moresby

Oro Governor Gary Juffa has called on Papua New Guinea’s Health and HIV/AIDS Minister Jelta Wong to present a paper recommending a “proper and transparent” procurement system for the Department of Health (DOH) to procure medicine and pharmaceutical drugs.

Juffa, who was a member of the Public Accounts Committee of 2019 that held an inquiry into the DOH procurement, supply and distribution process, said the recommendations were endorsed and approved by stakeholders and donor partners that supported PNG in the health sector.

“The recommendations for the procurement system were put together by the Special Parliamentary Committee for Public Sector Reform.

“After the inquiry the DOH did not take action in implementing the recommendations made by the committee,” Governor Juffa said.

He said that recommendations proposed a more transparent system to procure, distribute and supply medicines and pharmaceutical drugs.

“I urge Minister Wong to present this paper to the National Executive Council for consideration.

“It is in the best interest of the country and the people,” Governor Juffa said.

Attempts to get a response from Wong yesterday were unsuccessful.

Meanwhile, Borneo Pacific Pharmaceutical has been awarded a one-year contract worth K65 million to supply medical kits throughout the country.

Rebecca Kuku is a PNG Post-Courier reporter. Republished with permission.

Port Moresby hospital under strain with overcrowding, says doctor

APR editor — Wed, 27 Jan 2021 11:33:57 +0000

By Lulu Mark in Port Moresby

Papua New Guinea’s biggest hospital is straining to provide medical services to the growing population of the capital Port Moresby – with an estimated growth rate of 3 percent annually, a medical executive says.

Port Moresby General Hospital chief executive officer Dr Paki Molumi said overcrowding, especially in the emergency department, was a big concern.

“The population increases at 3 percent a year yet services remain the same,” Dr Molumi said.

READ MORE: PNG’s health system unprepared for covid-19

“There is a discrepancy between demand and supply which is reflected by the overcrowding.”

He said sometimes patients died while waiting to be attended to because of the long queue.

“The hospital serves over a million people in Port Moresby, Central and Gulf,” he said.

“Limited staff are struggling to meet the demand which reduces the quality of care given to a sick person.

Specialised care needed
“As a specialist hospital, it should be concentrating on delivering specialised care so that our people do not need to go overseas for that.

“Instead, we are taking on primary and secondary care as we do not have a separate hospital for the growing population in the city.”

The city has an estimated population of 385,000.

Dr Molumi was responding to a complaint on social media about a woman being admitted at the emergency ward on Saturday but was not attended to until Monday night.

“There is no hospital for Central and the Gulf Hospital cannot offer adequate services,” he said.

“Hence, all come to the Port Moresby General Hospital.

“The overcrowding at the emergency department and outpatients is a reflection of a defective health service we are offering to our people.”

Dr Molumi sees a separate hospital for the National Capital District Health Authority and Central to look after primary and secondary healthcare, leaving Port Moresby General Hospital to concentrate on referrals as the best solution to the overcrowding.

Right now, he said, the hospital was dealing with “everything” which was putting a strain on existing resources.

Lulu Mark is a reporter for The National. Asia Pacific Report republishes The National articles with permission.

Covid-19 vaccine – hard ethical and practical choices over distribution

APR editor — Tue, 17 Nov 2020 20:43:31 +0000

ANALYSIS: By Barbara Allen, Te Herenga Waka — Victoria University of Wellington and Michael Macaulay, Te Herenga Waka — Victoria University of Wellington

The world was ablaze with hope following the announcement last week that a vaccine developed by Pfizer and BioNTech may be more than 90% effective in preventing COVID-19.

New Zealand politicians were quick to point out 1.5 million doses had already been pre-purchased through a legally binding agreement signed in late September to buy any vaccine to emerge from the multilateral COVAX facility.

Within the week, a second potentially effective vaccine emerged from US biotech firm Moderna. Health Minister Chris Hipkins would not say if New Zealand had negotiated for this option.

But assuming an approved vaccine is coming, attention then turns to logistics. Funding, procurement, storage and distribution all raise significant questions about values, decision-making and ethics.

We know there are multiple candidates for a covid-19 vaccine, but there will be few “winners”, as many countries have already pre-contracted substantial amounts based on calculated risk assessments of which will emerge first. Even then, the challenges will be immense.

For example, assuming the Pfizer vaccine does become available as a safe option, it must be held in “ultra-cold storage” at -70 degrees Celsius. As has been observed already, “Distributing an effective COVID-19 vaccine to the global population will likely be the greatest logistical challenge since World War II.”

UPDATE: We are proud to announce, along with @BioNTech_Group, that our mRNA-based #vaccine candidate has, at an interim analysis, demonstrated initial evidence of efficacy against #COVID19 in participants without prior evidence of SARS-CoV-2 infection.

— Pfizer Inc. (@pfizer) November 9, 2020

Who gets a vaccine first?
For New Zealand, as with all countries, the questions raised are complex: do we now spend a large amount of money to scale up a logistics, distribution and storage system for the Pfizer drug? Or should we wait for an alternative that is more effective, easier to transport and store, and possibly cheaper?

After all, the first available vaccine might not achieve the outcomes we want. But would it be fair (or feasible) to make the country wait?

Furthermore, because enough doses to treat everyone will not be available immediately, it will be necessary to prioritise recipients. What are the country’s obligations here? Do we offer the vaccination first to the oldest, or the youngest, or the most vulnerable?

National health systems will have some idea about how to go about this, but wealthy countries have never faced an immediate requirement on this scale.
An ethical framework
Answering these questions means calling simultaneously on a number of different ethical perspectives:

an ethic of justice to assess the fairness of a decision
an ethic of consequentialism to look at outcomes
the ethics of obligations to see who we may have made commitments to
an ethic of care to look at individual cases, rather than relying on abstract logic.

Only when we combine these perspectives can we begin to make sense of priorities.

The vaccine marketplace is a kind of oligopoly, with a few extremely large firms deciding which vaccines get made, when and at what price. Pharmaceutical companies are reluctant to invest in producing new vaccines for the developing world because they have little prospect of earning an attractive return.

While global organisations such as vaccine alliance GAVI have been instrumental in getting vaccines to developing countries, given the geopolitics of procurement it could be a long time before an effective COVID-19 option reaches the poorest populations.

We just announced that mRNA-1273, our COVID-19 vaccine candidate, has met its primary efficacy endpoint in the first interim analysis of the Phase 3 COVE study.
Read more: https://t.co/vYWEy8CKCv pic.twitter.com/YuLubU1tlx

— Moderna (@moderna_tx) November 16, 2020

The moral dimension
All this points to the deeper ethical issue of inequality. Many agencies, including the World Health Organisation (WHO), have demonstrated that health outcomes are related to socio-economic, ethnic and gender inequalities. COVID-19 has only made these inequalities worse.

Only last week, for example, a UK study showed 57.7 more people per 100,000 have died in the poorest areas of northern England than in the rest of the country.

This matches other research showing how the pandemic has disproportionately affected poorer families, including their being less likely to be able to work from home or adapt to home-schooling.

Limited or selective availability of a vaccine could exacerbate these problems. And while New Zealand may be in a relatively privileged position, this doesn’t mean there won’t be negative consequences for other countries.

This adds an international dimension to our national dilemma: we have a duty to protect our own citizens, but is there a way we can minimise harm to others at the same time?

Dr Barbara Allen is senior lecturer in public management, Te Herenga Waka — Victoria University of Wellington, and Dr Michael Macaulay is professor of public administration, Te Herenga Waka — Victoria University of Wellington. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Challenging covid-19 – two critics of PNG’s K10m drug development plan

APR editor — Sun, 01 Nov 2020 06:10:48 +0000

COMMENTARY: By My Land, My Country

The Post-Courier newspaper says a company, Niugini BioMed Ltd, set up just a month ago, will be be commissioned to create a new “miracle drug” that will save people in Papua New Guinea and around the world from coronavirus.

The newspaper said several ministers were not happy with the K10.2 million (US2.8 million) grant because they did not believe proper processes were followed, reports RNZ News.

But Prime Minister James Marape said the report was based on leaked national executive committee (NEC) documents and was a deliberate attempt to discredit his government.

He said the government had yet to make a decision on the grant.

Two commentaries about the controversy have been published this weekend on journalist Scott Waide’s independent blog My Land, My Country.

View 1: Explaining the process of drug development
By Barbara Angoro, a PNG doctoral student in Auckland

Reading the news on covid-19 drug production in Papua New Guinea has prompted me to do my take on it. Those who are familiar with drug research and development will agree with that screening for possible drug leads is just the start to call it a drug, there has to be research done and data available on the pharmacokinetic and pharmacodynamic profile of the drug.

Drug screening is the most basic step
Based on what I read in the Post-Courier, I get the impression that the academics have done simulations using existing drug molecules that are likely to have some drug activity against covid-19.

In a drug development timeline, this is the most basic step – you screen a whole heap of possible molecules and come up with a few potential candidates. After this step, the real drug development research happens in the lab:

Is it safe? What’s the mechanism of its actions? How is it absorbed, broken down, distributed in the body, excreted ? What is the best dosage to give? What are the side effects?

How does it work in different groups of people? If there are existing treatment, does this one do better? How do you dispense this drug – through the mouth, injection etc?

Drug development is a lengthy process
After these parameters are determined, it leads to next stages that involve clinical research and finally a review done by regulatory authorities to get approval to be used as a “drug”.

These steps can take up to 10 years, and one must have an equipped and accredited laboratory in order for the developed drug to be recognised. Because of the pandemic situation, teams around the world are fast tracking processes to find a possible vaccine for covid-19.

Covid-19, being a virus, makes it hard to find a drug cure – it is always several steps ahead, mutating and changing.

Not only that, but unlike bacteria which have their own machinery to survive, viruses tend to use the host machinery (body) to replicate.

Scientists around the world stick to vaccine development
Development of a drug that will target only the virus without causing toxicity to the human host has proved difficult. Hence, many scientists worldwide are sticking to vaccine and not drug development.

While I believe in PNG taking lead in drug research and development, I strongly feel that taking an approach that involves building the necessary infrastructure first, getting accreditation and looking at developing drugs that will target common illnesses seen in our country would be the way to go.

A well thought out plan with solid financial backing would do – not a novelty concept for covid-19 which quite frankly, based on past virus outbreaks, could quickly resolve just like it appeared, making this endeavor come to nothing.

This is my personal view as a PNG citizen (with a pharmaceutical science and pharmacology background) and does not represent that of any organisation that I am associated with.

View 2: Other priorities outweigh giving K10 million to a start-up
By Deborah Ruth Telek

The Niugini Biomed Ltd papers … seeking to “leap frog” over all the other things Papua New Guinea needs and do drug research. Image: Scott Waide blog

We cannot even get National Agriculture and Quarantine Inspection Authority (NAQIA) accredited laboratories up and running around Papua New Guinea for various lab testing our requirements.

These labs are used for testing water supply samples and processed food samples for public safety. But we want to leap frog over all the other things this country needs and do drug research.

Wow!

The National Institute of Standards and Industrial Technology (NISIT) is failing and cannot handle the local calibration of weights, thermometers and other standard measurement equipment so it needs to be outsourced or referred to the private sector.

It seems we have forgotten about the necessity of this associated enabling environment and are considering paying a start up entity for drug research.

Shocking!

Let’s say goodbye to our tax money! I mean, the government has just restructured an existing loan with the Bank of the South Pacific (BSP) and given us some breathing space so that K10.2 million is possibly just loose change that fell out of the Prfime Minister’s pocket while he was listening to their spiel.

I wonder if the EMTV news item, about Niugini Biomed justifying themselves, is reminiscent of how they presented to Prime Minister Marape?

Imagine if they were rambling like that in front of the PM too? Would he still buy it, hook line and sinker, with that poor presentation?

Right thinking Papua New Guineans would say NO to the Biomed proposal in its current form and at this time.

We have other pressing priorities!

Articles from Papua New Guinea journalist Scott Waide’s blog My Land, My Country are republished by the Pacific Media Centre with permission.

PNG auditor calls for ‘sanctions’ in private probe over medicines row

APR editor — Wed, 21 Oct 2020 21:40:28 +0000

By Clifford Faiparik in Port Moresby

Papua New Guinea’s Auditor-General has questioned who approved a US-based international auditing firm to audit the awarding of contracts by the Health Department to pharmaceutical companies.

Acting Auditor-General Gordon Kega said his office should “sanction” the involvement of any private firm in the auditing of public funds.

“Under the Audit Act, we are supposed to sanction private auditors to audit public funds,” he said.

READ MORE: Health, medical supplies protected issues affecting PNG

Kega said his office was not consulted when the Forensic Technologies International (FTI), a business advisory firm from the United States, was called in to carry out the audit after concerns were raised about the way AusAid funding was being used by the department to procure pharmaceutical supplies.

The Public Accounts Committee (PAC) of Parliament also conducted a commission of inquiry into the AusAid funding complaint.

Kega said the FTI audited the Health Department “without our authorisation”.

“And that report has been given to the police to carry out investigations,” Kega said.

Police have own jurisduction
“But then the police have their own jurisdiction to investigate any information they [receive] from complainants.

“We are available to clarify our position [with police] on the sanctioning of private auditors such as the FTI.”

He distanced the office of the Auditor-General from the auditing of Ausaid funding to procure pharmaceutical supplies.

The police said the work of the FTI had been approved by the government and funded by AusAid.

Chief Inspector Joel Simatab said the police had already received the FTI report and were awaiting the one from PAC chairman Sir John Pundari.

“The FTI report was sanctioned by the Department of Prime Minister and National Executive Council while the PAC report was sanctioned by Parliament,” he said.

The FTI and PAC conducted their enquiries in August last year.

“We received the FTI report first.

Both inquiries ‘similar’
“Both enquires are similar but PAC has statutory powers to summon people, seize confidential documents from the banks, companies, service providers and government departments,” he said.

He said the FTI “has no statutory power and so their report is not really in detail”.

“What they did was look into the tender of contracts, procurement, delivery of medical drugs and the lack of consultation between service providers and the provincial health authorities,” he said.

“PAC has the authority to go into detail.”

He said they had the same aim of finding out the processes of procuring medicines for the people of PNG.

“So while we are investigating the FTI report, we are mindful of the PAC report.

“Once we receive it from PAC, we will cross-check both recommendations [before we] conduct criminal investigations.”

The Pacific Media Centre publishes The National news reports with permission.

Audit report slams ‘flawed’ PNG health management, ‘extravagant lifestyles’

APR editor — Thu, 10 Sep 2020 05:02:53 +0000

By Rebecca Kuku in Port Moresby

Flaws in Papua New Guinea’s public health system and the medicine supply chain are because of poor management in the Health Department, with some officers “living extravagant lifestyles far beyond their salary”, according to a new report.

Public Accounts Committee chairman Sir John Pundari yesterday tabled in Parliament the report of an inquiry which began in August last year into the supply, procurement and distribution of medicines but is timely with a rising rate of covid-19 infections.

Sir John said the responsibility “rests primarily on the management” of the department “who are custodians of our medicine supply chain and our people’s health”.

READ MORE: Six new PNG covid cases take total to 503

“Our medical supply and distribution systems have been compromised because the (Health Department) allowed this to happen by either complacency, incompetence, design and or greed,” Sir John said.

He said “numerous reports had been received of senior officers of the department directly involved in the procurement of medicines, affording to living extravagant lifestyles, far beyond that which is expected from a normal public servant salary”.

Sir John said the inquiry was about establishing the truth.

“It was about understanding the reasons for the failing procurement, supply and distribution of medicines and medical kits throughout the country,” he said.

‘Deeply saddened by betrayal’
“The committee was deeply saddened that our very own politicians, bureaucrats and senior civil servants in positions of trust and authority have betrayed our own people in allowing greed and corruption to flourish in the procurement, supply and distribution of drugs and medical kits in our country that have resulted in avoidable deaths from curable diseases.

“If ever there was a sector which should be safeguarded by political leaders to ensure that services are provided in an effective and efficient manner, free from exploitation, it is public health.”

He related an “unforgettable and heart-wrenching” picture the committee came across of a rural aid post with a grave next to it.

“[Locals] told us that they carried [the sick man] for miles to the aid post,” he said.

“There was no hope to begin with. But he was their brother. Their father. Their husband. So they carried him anyway.

“Finally at the doors of the aid post, they were told that there was no health worker there anymore.

“Medicines [had] stopped arriving a few months back, so the aid post had been abandoned. [The sick man] looked at their tired and troubled faces and as he lay [dying] he asked them to bury him there so they would not have to carry his body back home.

‘They buried him alone’
“They buried him there alone, away from his land, his village and his family.”

He said the story depicted the truth about the failing health system.

“It needed to come from patients and health workers who regularly see men, women and children dying in front of them while they are helpless to save their lives.

“They tell us the truth.”

The Pacific Media Centre republishes The National articles with permission.

Off-label drugs may now be used in Philippines coronavirus trials

APR editor — Mon, 27 Apr 2020 00:04:39 +0000

Pacific Media Centre

Off-label drugs may now be used in clinical trials in the Philippines to test possible cures for the coronavirus, pandemic, the Department of Health (DOH) has announced.

During the department’s regular afternoon briefing yesterday, Health Undersecretary Maria Rosario Vergeire said the DOH is coordinating with the World Health Organisation (WHO) for the arrival and storage of medication that are part of the global solidarity trial which aims to find a treatment for covid-19, reports Rappler.

These off-label drugs, explained Vergeire, are used to treat other diseases, but will be tested by hospitals and doctors on patients in the solidarity trial to see if they can help against the coronavirus.

Vergeire noted, however, that these clinical trials should be conducted with the proper guidance of a licensed doctor.

“Habang hinihintay po ang pagdating ng shipment, maaari po nating gamitin ang mga gamot na available na mula sa HIV at malaria control programs ng DOH…ayon sa tamang gabay ng lisensyadong doktor,” said Vergeire.

(While waiting for the arrival of the shipment [of these drugs], we may now use the drugs that are available from the HIV and malaria control programmes of the DOH…with the proper guidance of a licensed doctor.)

Vergeire mentioned litonavir, ritonavir, chloroquine, and hydroxychloroquine as among the drugs that will be used in the solidarity trial. In an interview with DZMM on Sunday, Vergeire also listed remdesivir, lopinavir combined with ritonavir, and the last two drugs plus interferon beta.

21 hospitals in ‘solidarity’ trial
In a Facebook post on Sunday, the DOH said 21 hospitals would take part in the solidarity trial. Participating patients will also be made to sign consent forms.

The Health Undersecretary was also asked in Sunday’s DOH briefing about the United States Food and Drug Administration’s warning on hydroxychloroquine and its adverse effects on the heart and other body parts.

In response, Vergeire said patients will first go through screening procedures, and qualified patients will then be monitored by investigators and doctors to make sure that the treatments like hydroxychloroquine would not be harmful.

As of Sunday, at least 7579 coronavirus cases have been confirmed in the Philippines. Among them, 501 have died and 862 have recovered.

Dr Maria Rosario of the Philippines Department of Health speaking at a virtual media conference in Manila yesterday. Image: Rappler freeze frame PMC

Scott Waide: Let’s be honest! Nearly every PNG public health facility is facing medicine shortages

Scott Waide — Mon, 29 Oct 2018 07:46:32 +0000

COMMENTARY: By Scott Waide

In Lae City, Papua New Guinea’s second-largest city, there are seven urban clinics, each serving between 100 and 150 patients a day. They get their medical supplies form the Government Area Medical Store (AMS) in Lae.

The AMS in Lae also supplies the Highlands and the rest of Momase.

For the last six years, staff at the clinics have been battling medicine shortages. You can see, first hand, how the medicine shortage affects people in Lae.

At Buimo Clinic on Friday, a mother and baby came in for treatment. She was told that the last bottles of Amoxicillin suspensions would be given for her child and that she would have to go to a pharmacy to complete the treatment course.

The woman’s name is Merut Kilamu. She lives with her family at Bundi Camp in Lae. She is not just a statistic. She is a real person who is bearing the brunt of the ongoing medicine shortages.

“Sometimes, we are able to buy the medicine,” she says. “Other times, when we don’t have the money, we can’t buy what we need.”

Patients go from the clinics to Angau Hospital in the hope that they will get the medicines they need. But Angau can’t handle the numbers. Hospital staff have even posted on Facebook saying they too need the basic supplies of antibiotics, antimalarial drugs and consumables like gauze, gloves and syringes.

Hospitals and clinics have become little more than prescription factories channeling their patients to pharmacies who charge the patients upwards of K40 (about NZ$18) for medicines. Pharmacies are profiting from the desperation and ill health of the Papua New Guineans.

Prices increased
In 2017, when clinics ran out of antimalarial drugs, pharmacies increased the prices.

In some instances, officers in charge of clinics felt the need to negotiate with pharmacies to keep their prices within an affordable range. It is difficult for staff in smaller clinics to send away patients knowing they can’t afford to pay for medicines.

“Sometimes, we can’t send them away. Staff have to fork out the money to help them pay,” says Miriam Key, nurse manager at Buimo clinic.

This is a nationwide medicine shortage!

As much as the politicians dislike it, social media gives a pretty accurate dashboard view of the health system from the end user. Charles Lee posted on Facebook about how the medicine shortage was affecting his family in Mt Hagen.

“Relatives in Hagen have flown to POM to seek medical treatment because of a shortage of drugs in Hagen.”

His post drew more than 20 comments.

Gloria Willie said from Mt Hagen:

“They just discharged a relative from ICU and we are taking her to Kundjip (Jiwaka Province) today and if they are not allowed to receive medical attention then, we are also planning to bring her to port Moresby. It is really frustrating. But because of our loved ones, we are trying any possible way to have them treated.”

‘Stay at home’
Melissa Pela responded saying:

“Same here in Kavieng. Patients told to buy Panadol and keep at home. If you feel something like fever/running nose etc.. just take it. They say treat it before it becomes serious because there is simply no medicine.”

The officer in charge of Barevaturu clinic in Oro Province, Nigel Tahima, said by phone, the they are seeing an increase in the number of patients because other clinics just don’t have medicine.

The reports are flooding in from all over the country. There are too many to mention in one blog post.

If urban clinics are a gauge to measure the flow of medicines from the AMS to the patient, you can imagine what rural clinics are going through.

They are too far from the AMSs and too far to adequately monitor. The only way to get an understanding of their problems is when staff make contact or when you go there.

Scott Waide’s blog columns are frequently published by Asia Pacific Report with permission. He is also EMTV deputy news editor based in Lae.

More PNG health stories

Nepal’s new legal codes spark medical, media protests and divide nation

Pacific Media Centre — Sat, 22 Sep 2018 00:14:27 +0000

Nepal has recently updated its legal system with new civil and criminal codes. However, writes Rahul Bhattarai of Asia Pacific Report, failure to consult properly with stakeholders has led to protests and a strike by doctors.

Two new legal codes – civil and criminal – have been introduced in Nepal, threatening the medical profession and media industry, and dividing the country over the consequences.

Global and local media freedom groups have condemned the penal code because of limitations imposed on the freedom to provide news and information in the public interest.

Doctors went on strike over the new penal code earlier this month in protest against the criminalising of medical negligence and lodged a petition with more than 6000 signatures to the Nepal Medical Council.

The government has agreed to address the issue and opened negotiations with the Nepal Medical Association.

The Paris-based media watchdog Reporters Without Borders (RSF) has protested to the Nepalese authorities about the implications for news organisations, saying the new law constitutes an “unacceptable censorship tool”.

Journalists in Nepal could face up to three years in prison if they publish information deemed to be “confidential” under the new criminal code, says RSF.

Protection of privacy provisions also pose a “serious threat” to journalism.

Showing ‘disrespect’
“Sections 293, 294 and 295 criminalise publishing private information, recording conversations or taking pictures without permission,” says RSF in its review of the law.

“Under article 306.2, showing ‘disrespect’ towards someone either directly or through satire is also punishable by up to three years in prison.”

Critics of the new laws – replacing the general code, nationally known as Muluki Ain – say there was no consultation on the draft provisions before they were enacted.

Two people given the responsibility to draft the two laws were Khil Raj Regmi, a former de facto Prime Minister of Nepal and former Chief Justice Khel Kalyan Shrestha. Neither of them had discussed the the laws with relevant stakeholders before adopting them.

The two codes were implemented on August 17, replacing a 55-year-old law, which was created during the previous Panchyaat Kall self-government political system in the early 1960s.

The two new codes were passed without any formal discussion with stakeholders – journalists, lawyers and medical doctors, this has led to protests from doctors and journalists.

Doctors protest
“Halting medical services, hundreds of doctors — both government and private — participated in a protest march … The protesting doctors, who were joined by retired doctors as well, wore aprons and stethoscopes,” reports The Himalayan Times.

Reporting on the September 2 rally, The Times quoted senior orthopaedic surgeon Dr Govinda KC as saying the new law would directly affect patients rather than doctors.

“Instead of proposing tougher penalties, it will be more prudent to thoroughly investigate negligence on the part of doctors during treatment,” he was quoted as saying.

After the strike, the government agreed to start talks with the Nepal Medical Association.

But there has been some negative feedback from the public arguing that the government should not have come under pressure to change the penal code as it was undermining government credibility.

Nepal’s media industry has boomed since the monarchy’s overthrow a decade ago after a brutal civil war, spawning dozens of newspapers and TV news channels that have played a key role in the transition towards democracy. Image: Prakash Mathema /AFP/RSF

The government has also taken steps to communicate with the Federation of Nepali Journalists (FNJ) and has decided to amend certain legal provisions in the laws to protect the freedom of speech and freedom of expression.

The government had failed to discuss the laws before passing them through Parliament, says Radheshyam Adhikari a Senior Advocate at the Supreme Court of Nepal.

Stakeholders unconvinced
Also, after passing the codes, the government had failed to convince stakeholders about the new laws.

“In reality [the] penal code has not affected the civil code, although – due to the current government misusing the law by suing people under cyber law – there has been widespread panic within Nepal’s doctor community and the FNJ as well,” says Adhikari.

“Furthermore, the law regarding the press is different and this is a civil law, if we were to choose between the press law and civil law, we will have to choose the press law.

“Press law is the same old law, which clearly states that the journalists shouldn’t be prosecuted for expressing their freedom of speech,” Adhikari says.

“In the press, there is a civil law, that law is not created to target the journalists. Rather, it’s a law to change the relationship among the civilians in order to protect the right to privacy.

However, now there is a new privacy law separate from civilian law.

Government has agreed to the demands of the press and implemented more liberal provisions under the privacy law too, which should “protect the press,” says Adhikari.

‘No need for panic’
“There is no need for much panic over these laws.”

But the major concern in regard for journalists is that when an article is “shared on social media by someone once it is in the public domain, the sharer will be jailed rather than the government questioning the publisher of the content,” says Adhikari

Raju Basnet, editor-in-chief of Khojtalas Weekly and Khojtalasa.com, was arrested on September 10 over alleged cybercrime because of a report exposing an attempt to transfer the ownership of land by Harisiddhi Brick Industries in Lalitpur to a few private individuals.

It was alleged that the transaction of the land had the involvement of the Nepal Communist Party’s (NCP) lawmaker Pampha Bhusal and other leaders in the party, reports Myrepublic.

“I have spoken against this bill in the Parliament, and now the government has taken a high road and the journalist Raju Basnet has been released,” says Adhikari.

“A different person has been jailed for sharing information on social media,” he adds.

The government has taken matters into their own hands and have started prosecuting people.

Misuse of the law
“It is not right for the state to prosecute the individual by using the police force,” he says.

“Should there be an issue of defamation, we can always work under the defamation law. But without evoking the defamation law, going against the constitution is not a right thing,” says Adhikari.

“If there is an issue of defamation and if the subject doesn’t want to take a legal process, there is always an option to express your grievance to the Press Council”, says Adhikari.

“People are not being prosecuted due to the law, however, it is due to the misuse of the law, that has created panic in the country”, says Adhikari.

But Gopal Basnyat, news editor at Radio Nepal, says the new law makes a journalist “reveal their sources,” which is not only a threat to the press but also a threat to whistleblowers.

“We cannot reveal the sources as a journalist, it is our duty to protect them, it is against our press code of conduct,” says Basnyat.

Risk of prosecution
Under the new law, “if we don’t reveal the source, we risk being prosecuted.”

“It does affect free speech. The FNJ has been protesting against this law,” says Basnyat.

Many other journalists who have been protesting against this law, which some describe as more draconian than the Nepali law during the Panchyaat Kall era.

A Practising Advocate at the Supreme Court, Ashish Adhikari, says that the “Act in itself is good but the implication of the Act [by the government] part is questionable”.

He adds: “The first publisher isn’t being convicted but, the person who shares information that is already in the public domain is being charged and prosecuted.”

Rahul Bhattarai is a student journalist on the Postgraduate Diploma in Communication Studies (Journalism) reporting on the Asia-Pacific Journalism course at AUT University.

Diabetes deaths in Fiji worst in the world, says watchdog

APR editor — Tue, 29 May 2018 23:54:22 +0000

By RNZ’s Dateline Pacific

The latest life expectancy world rankings show Fiji has the highest death rate from diabetes in the world with 188 of 100,000 fatalities being attributed to the disease.

The head of Diabetes Fiji says the ranking highlights the magnitude of the problem and the need for a more proactive approach.

Jenny Meyer reports:

LISTEN TO DATELINE

Transcript
Project manager Viliame Qio says people are shying away from medical attention and treatment out of denial and so when they do come forward they have more severe complications from their illness.

He says there needs to be more community education about diabetes and many people turn to traditional healers for help first, which also delays effective treatment.

“We have three amputations that take place in a day in the major hospitals and the main reason is the people are presenting late, they come very late, they are not coming early. So we want to get people to be educated that they have to seek medical attention first before they resort to other traditional methods or herbal methods.”

Viliame Qio says diabetes is the leading cause of disability in Fiji and people need to heed the public health messages about poor eating habits and sedentary lifestyles.

Dr Jone Hawera is a Fijian surgeon and says the diabetes crisis is becoming more widespread now affecting people in rural areas and at younger ages.

‘Bottom of the cliff’
“Just last week we amputated half a foot of a 30-year-old i-Taukei female. It’s not only the rate that’s increasing it’s also the age group that’s involved with the amputations. And that means we have a big disabled and non productive population. The economic impacts that’s going to make for us is huge.”

Dr Hawera says he is part of a group of frustrated, demoralised, under-resourced health personnel working at the bottom of the cliff trying to deal with the ongoing diabetes crisis.

He says there are many factors affecting the rate of diabetes including issues like food security and climate change and policy makers must do more to turn the crisis around.

He says diabetes is a physical manifestation of social issues and preventative policies need to address these.

“It’s preventable and that’s the hope that we continue to have, we know that it’s preventable. A lot of these deaths are preventable. A lot of these complications like amputations are preventable. We are trying to improve our education and our awareness, making people really understand what diabetes is and what causes it and the many ways they can prevent complications once they have it.”

Dr Hawera says he would like to see diabetes education get to a point in Fiji where people are prevented from getting the disease in the first place.

Early detection vital
Viliame Qio says both education and early detection are vital to dealing with the crisis.

“The very important thing is that you get screened and secondly that you adopt a healthy lifestyle. Especially the eating habits.

“Our diet has been transitioning from healthy food to very fast food and with this fast food comes a sedentary lifestyle. We need people to be very health cautious, to be mindful of what they eat and be physically active.”

Fiji’s Ministry of Health says one in three Fijians has diabetes and there is a higher incidence in Fijians of Indian descent.

It encourages regular health checkups and says symptoms include frequent urination, feeling thirsty and hungry, fatigue, blurry vision and pain in the hands and feet.

This RNZ Pacific item is part of the content sharing arrangement with the Pacific Media Centre.

Challenges on the ground in PNG Highlands – what people really need

APR editor — Sat, 10 Mar 2018 01:41:18 +0000

By Scott Waide, EMTV journalist and blogger

Survivors in Papua New Guinea’s earthquake in the Highlands face tough challenges. And so do the relief agencies and government authorities trying to deliver support to them.

Many of the worst affected areas in Hela and the Southern Highlands provinces are in isolated spots.

The people don’t live in large villages that you see on the coast. They live in small hamlets of 5-10 houses spread out over a plateaus or valleys.

They have no road access.

Many have to walk for hours to get within line of site of a mobile telecommunications tower in order to send a text message. Data signals are too weak and problematic.

For other locations, it takes more than a day.

Some of the villages are relatively close to the LNG site. But it looks deceptively close on a map.

Difficult to reach
What you’re dealing with on the ground are terrains that are extremely difficult to reach – even within a day’s walk. That is precisely why helicopters are vital in this disaster.

In some villages, people have had to build helipads on mountainsides to allow for medical teams to land safely.

Chopper pilot Eric Aliawi, who took an EMTV crew to one of the locations, had to land on three logs that had been placed on a spot dug out on a mountain side because the helipad had not been completed.

Even after landing, the crew and the doctors had to walk for about half an hour to get to the village.

A few commentators have said that the people affected are subsistence farmers and that they still have food to eat because they plant crops.

The reality is that their gardens have been destroyed and it is dangerous for them to go into the foothills and the valleys, or mountainsides, because of the ongoing aftershocks.

Trauma of death
They are also dealing with the trauma of the death and destruction that happened in their villages. They will have to adjust to normal life as time goes by.

Their houses have been destroyed and they have moved from the locations of their hamlets to central locations like schools, airstrips and mission stations to seek help.

Congregating in large numbers in one location is unusual for them. Losing their independence and relying on someone to give them food is also not something they are accustomed to.

They need is help to get back on their feet and resume their way of life.

They need the following:
Good quality tarpaulins for shelter – They live in a high rainfall area. The temperature drops rapidly at night and without shelter, young children and older people will get sick.

Food – With limited access to their gardens, food is a priority for them.

Water – Their water sources have been polluted. They need large water containers, tanks and clean water (as an immediate need).

Cooking pots – This is important if they are to boil drinking water.

Warm clothes + blankets – Sweaters, hoodies and simple blankets will help a lot to ease their burden. It is not as important as the others mentioned, but it will help.

Children’s clothing – also not an immediate priority but it will help a lot.

6 to 15cm nails and tools – in order to rebuild their houses, they need nails and tools like bush knives, axes and hammers. It is very difficult to obtain items like this where they are.

Disposable delivery trays, disposable suture trays – during the earthquake, sterilisation equipment at the Tari Hospital was damaged. The doctors need this to send to aid posts so that health workers can handle deliveries and other treatment.

The government contacts are:

Thomas Eluh – PA for Southern Highlands

Joseph Bando – PA Hela Province

Dr Tana Kiak – Tari Hospital

Inbox Scott Waide on Facebook for contact details, or text him on +675 70300459. Or email scott.waide@gmail.com for information. This article was first posted on Scott Waide’s blog, My Land, My Country.

More PNG earthquake reports

Earthquake survivors in Hela province … what next? Image: Scott Waide/EMTV

Earthquake damage in a valley in Hela province. Image: Scott Waide/EMTV

PNG faces ‘catastrophe’ over health if no crisis action taken, warns MP

APR editor — Wed, 18 Oct 2017 02:48:05 +0000

Pacific Media Centre Newsdesk

An unprecedented level of mismanagement of Papua New Guinea’s affairs since 2012 has caused serious health issues, including widespread suffering and preventable deaths, reports Loop PNG.

The opposition’s Shadow Minister for Health and HIV/AIDS, Joseph Yopyyopy, has called for swift and appropriate government action to prevent further deterioration of PNG’s most basic and essential health services.

He warned of “catastrophic consequences” resulting from government inaction while noting that the PNC-led government drastically cut health spending for the past three years, including 2017.

Yopyyopy cited most recent instances, including:

Laloki Psychiatric Hospital in Central Province being on the verge of closure with patients likely to be sent back home to their families due to shortage of medical drugs at the hospital. (Director of Medical Services at the hospital Dr Ludwig Nanawar revealed this as the institution marked World Mental Health Day on Oct 10);
Health workers in Manus Province have been without such medicine for more than a month;
Medicines running out PNG-wide with health facilities lacking essential equipment and in a state of disrepair;
Health workers not being paid properly with doctors and health workers threatening stop work; and
Recent media reports of a story from Abau district where a ward councillor claimed more than 20 people had died in the past two years due to medicine shortage.(People had to be taken to Port Moresby for treatment while some died along the way).

Other unreported cases are indicators of very serious system failure, the shadow minister said.

Yopyyopy noted that from the 2015 to 2017 budget, health funding was cut by 40 percent from K1.7 billion to K1.2 billion.

He also warned of further planned cuts of up to 30 percent over the next five years (to about K850 million).

Yopyyopy cited some “shocking” statistics about PNG’s state of health, including:

In 2016, health cuts hurt many people, but fortunately the impact was softened by external health funding which may not be available;
According to latest reports, PNG’s tuberculosis (TB) crisis is yet to be brought under control;
ChildFund Australia estimates that up to 9000 PNG citizens died from TB in the past three years – one out of four are children);
On PNG’s maternal and child mortality, a government decision in late 2016 to pay for women to give birth in a clinic or hospital was in fact an “admission of defeat”;
Health experts have explicitly expressed that the health funding cuts have destroyed people in rural and remote areas where the need is urgent; and
Up to 1500 women die in childbirth each year, and about 45 babies out of every 1000 die.

The UN estimates that about 12,000 children under five die each year, reports Loop PNG.

Also, a recent Asia Development Bank (ADB) report shows that PNG has some of the worst health indicators in the Asia-Pacific region:

The prevalence of stunting among children under the age of five is 49.5 percent, ranking 29th out of 30 countries with information;
The prevalence of malnutrition (wasting) among children under five is 14.3 percent, the highest rate for 30 countries;
The maternal mortality ratio per 100,000 live births is 215, the equal third highest of 40 countries;
The under-five mortality rate per 1000 live births is 57, the fourth highest of 43 countries;
The number of new HIV aids infections in 2015 is 0.36 per 1000 of the uninfected population – the highest of 21 countries;
The TB incidence per 100,000 people is 432, the second highest of 44 countries; and
The incidence of malaria per 1000 people is 185, nearly double the next highest incidence.

Yopyyopy said facts speak volumes and it is incumbent on the government to stop painting a false picture when in fact, there are very serious underlying health issues affecting PNG.

“The government is not only duty bound, but morally obliged to put the health issues of PNG citizens above all else,” he added.

Jane Kelsey: Labour and the TPPA – time to come clean before election

Pacific Media Centre — Tue, 05 Sep 2017 21:23:38 +0000

ANALYSIS: By Professor Jane Kelsey

It is now certain that any decisions on the future of the Trans-Pacific Partnership Agreement (TPPA) minus the US will take place after New Zealand’s general election this month.

Last week’s meeting of the negotiators from the remaining 11 TPPA countries rebuffed the National government’s wish to proceed with the agreement basically unchanged aside from new provisions for its entry into force.

They have all agreed to suspend (but not remove) some of the most controversial intellectual property provisions that hiked the price of medicines. Other countries want parts of the actual text and countries’ schedules reopened.

Each country has to come back with its wish-list at another meeting in Japan later this month, probably while the New Zealand government is in caretaker mode after the September 23 election.

Post-election, a Labour-led government would inherit a poisoned chalice. But its position to date gives no confidence that Labour will take a stand against the resurrection of the deal, despite the groundswell of opposition from its own core membership.

Cartoon: Malcolm Evans/The Daily Blog

Labour Party leader Jacinda Adern recently defended the party’s “bloody minded” opposition to the agreement. But its only firm position is an objection to a single, very specific provision in the entire 30-chapter deal: the right to discriminate against foreign purchasers of residential property in the schedule on investment.

Does Labour really intend to agree to the TPPA-11 if that minor matter is changed (as it has been in a leaked copy I have of New Zealand’s proposed schedule to the now-suspended Trade in Services Agreement negotiations)?

Hiking the price of medicines
What about the intellectual property provisions the US insisted on that will hike the price of medicines and put taxpayer money into the pockets of Big Pharma – money Labour will desperately need to upgrade our rundown hospitals and fund primary health care for our poorest communities?

To date they will be suspended, but not removed, so they can be reactivated if the US rejoins. If the New Zealand Medical Association can call for those rules to be dropped, surely it’s a safe enough bet for the Labour Party to do so?

Or the investor-state dispute mechanism. David Parker’s position is that Labour would prefer not to have them. Grow a spine! Even Crawford Falconer, the ex-MFAT official who is now the UK’s new free trade negotiator, says it should be dropped from such deals.

Parker also insists that the Treaty of Waitangi exception is the best possible drafting imaginable, and claims the Waitangi Tribunal endorsed it. In fact the Tribunal said:

“The Crown however goes further and says that nothing in the TPPA will prevent the Crown from meeting its Treaty obligations to Māori. We have some reservations about this. … Our concern is that by qualifying the Treaty exception clause to that aspect of the Treaty relationship which may allow the Crown to adopt or implement measures more favourable to Māori, the full constitutional reach of the Treaty relationship may not be as clearly protected and preserved under the TPPA as it might be.”

A Labour Party that is pitching to reclaim all the Māori seats can, and must, do better.

So far as I can see, Labour has not even called for the government’s new modelling on the TPPA-11 to be made public, despite having pointed to the failings of the initial modelling in its minority report on the original TPPA.

Leadership on record
Labour’s leadership needs to go on record before the election with some more detailed and convincing answers to these questions, and its position on other toxic provisions affecting the right to regulate on state-owned enterprises, government procurement, financial services and taxation.

Above all, Labour needs to commit now to a genuine consultation about what position New Zealand should take on the TPPA-11 (given the massive input into the original select committee hearing that was arrogantly ignored); to publish any future mandate it takes into the negotiations (as the EU does in its negotiations); and to support its position with a comprehensive, independent and public cost-benefit analysis.

Or does Labour intend to retreat behind the same wall of secrecy as National has in these renegotiations?

Jacinda Ardern, Grant Robertson, David Parker, anyone in the Labour leadership – can we know your real position on the TPP-11 before the election please?

Dr Jane Kelsey is a professor of law at the University of Auckland and a prominent New Zealand critic of globalisation. This article is republished from The Daily Blog with permission.

20 deaths in two years because PNG clinic has no medicine, says councillor

APR editor — Mon, 22 May 2017 21:38:41 +0000

By Troy Taule in Port Moresby

More than 20 people in a village in Papua New Guinea’s Central Province have died within the space of two years due to lack of medicine.

Ward Member for Paramana village along the Aroma Coast, Kiki Geno, is appealing to authorities for medicine to be supplied for the aid post that has remained neglected for two years now.

The founder of the Paramana Strangers band told Loop PNG that the aid post had been without medicine since it was built back in 2015.

“When people get sick, we have to take them by PMV [local van transport] or any other car down to Port Moresby. Some people have even died on the road,” said Geno.

“Over 20 people have died in the last two years. It’s a real problem.”

He added that many attempts had been made to contact authorities through the ward councillors but all to no avail.

“This is just an aid post with no medicine and no orderly as well. The two buildings are empty,” said Geno.

A father of five, Trevor Wakai, added that he had lost his wife in February of this year after she experienced complications with her pregnancy. She had to be rushed to Port Moresby.

“There’s no medicine in this aid post here so we had to take her to the city. But she didn’t make it,” said Wakai.

“We the people just want someone who can deliver vital services so no more people lose their lives like this.”

Praise for PNG surgery team in 9 open heart operations

APR editor — Tue, 11 Apr 2017 12:36:15 +0000

By Quintina Naime in Port Moresby

The Papua New Guinea National Doctors Association has congratulated the local medical team for successfully carrying out the open heart operation last week.

The team of local doctors — surgeons, physicians and anesthetists — and nurses conducted open heart surgeries on nine patients with less assistance from the usual visiting Singapore team.

They have undergone training at the National Heart Centre Singapore over several years and have been assisted by the Singapore team but are now more self-sufficient and independent.

Those trained in Singapore through Operation Open Heart include two cardiologists, one cardiac surgeon, two clinical perfusionists, six nurses and one echo technician with more expected in the future.

They are based at the Port Moresby General Hospital which is the only level seven hospital for the country.

PNGNDA president Dr James Naipao said PNG could achieve anything without hesitation.

Dr Naipao said: “The only problem in PNG is that we generally do not trust our qualified people in all facets of the workforce.

“PNG must trust its own human resource that have finished training, that are working and those in training.”

Dr Naipao was impressed with the Singapore team having trust and confidence in PNG’s local team operating on heart patients independently.

He said this sent out a signal to the hospital management, Department of Health and the government that Papua New Guinea had a team ready to independently treat heart patients.

Dr Naipao stressed that the higher authorities must now without hesitation support the cardiac team at Port Moresby General Hospital than looking at other options from within Papua New Guinea or overseas.

“These options, if in the planning, will not serve the rural majority and urban poor. PMGH must serve its function as a national referral hospital level seven for PNG.”

Dr Naipao added that patients referred to the hospital must be satisfied rather than being regretful.

Quintina Naime is a Loop PNG reporter.

Life of expectant mother saved by Vanuatu’s telemedicine network

APR editor — Wed, 27 Jul 2016 08:59:41 +0000

By Jonas Cullwick in Port Vila

Prime Minister Charlot Salwai heads a government delegation, including the Minister of Health, Toara Daniel, that travelled to Maewo today to attend the opening of the Maewo Telemedicine Network at Naviso Village on East Maewo.

The official opening of the pilot internet connectivity at Maewo Island’s primary healthcare facilities at Naviso tomorrow will celebrate the communities’ initiative in partnership with government and non-government entities as part of the Vanuatu Inter-Island Telemedicine and Learning Network (VITAL) pilot project.

This effort has been made possible by the Office of the Government Chief Information Officer, TRR, Ministry of Health, Telsat and Kacific Broadband Satellite in concert with Maewo Telecommunications Committee (Inc) (MTC).

MTC serves as the local counterpart for the project.

MTC was established to enable telecommunications access and to use it to promote health and education and to improve all areas of life for Maewo communities.

US Peace Corps volunteer Alexis Lexy Cullen, who is a big help to the Maewo community in the project, says that soon after the system came online, it was successfully used last week to save the life of a mother, who was experiencing bleeding after delivery.

She posted in her Facebook page that the telemedicine system was used and a male nurse at Naviso clinic, Steven Tahi, was able to speak with Dr Basil Leodoro, who got secondary advice for the nurse. The bleeding was stopped and the mother was saved.

‘Seeing’ the patient
Cullen quotes Dr Basil Leodoro describing his first telemedicine encounter, giving advice to Nurse Leo Steven (in between surgical cases at Northern District Hospital) as “fireworks”.

And he said being able to actually “see” the patient was such an improvement to voice only.

Tomorrow’s event will be broadcast through livestream to the world via YouTube and social media platforms.

At the same time the communities of Maewo will showcase their culture and custom at this event with traditional custom dance and singing.

Prime Minister Salwai will speak at the official opening and cut the ribbon.

Jonas Cullwick, a former general manager of the Vanuatu Broadcasting and Television Corporation (VBTC), is now a senior journalist with the Daily Post.

New kava legal challenge in Germany over drugs institute ruling

APR editor — Wed, 17 Feb 2016 22:30:38 +0000

By Jane Joshua in Port Vila

A court case has been filed against the Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM/German Federal Institute for Drugs and Medical Devices) after the institute pushed for weekly liver function tests, making it impossible for kava products to come back on the market in Europe.

A German scientist and kava researcher, Dr Mathias Schmidt, who is representing the Pacific Island kava producing countries, confirmed this to the Daily Post.

This latest hurdle comes almost three months after Vanuatu’s Ambassador to the European Union, Roy Mickey Joy, announced that kava was finally scientifically proven to be without health related problems.

Previously in February 2015, the Upper Administrative Court in Muenster, Germany upheld the ruling of the Administrative Court of Cologne in June 2014 and for the second time, BfArM was told that the ban on kava was inappropriate.

The tests BfArM is pushing for poses a hurdle because kava extract preparations have prescription only status in Germany, and no physician would prescribe a drug where one would have to conduct weekly liver function tests because it is “too expensive, practically impossible, and the patient would not comply”.

“We had a meeting with BfArM for the discussion of this matter,” the German scientist said.

“But BfArM remains adamant – weekly liver function tests. If we cannot do it, it’s our problem. That is why we are going back to court, which may again take some time.

New case preparation
“It is not a new ban but the results of what BfArM does come down to the same effect, which is why a new court case is currently in preparation.”

Some may say the market in Europe is “tiny”.

Dr Schmidt said from the economic point of view they may be right. However, one must “not forget the signal the European discussion sent out to the world: The stain of liver toxicity will then remain forever”.

In Vanuatu’s first ever National Kava Forum in November 2012, the then Deputy Prime Minister and Minister for Trade and Industry, Ham Lini, revealed Pacific Island kava producing countries have been losing over 472 million vatu of export revenue each year since the European Union banned kava trade in 2002.

The positive news is the latest Statistics update on Merchandise Trade Statistics from the Vanuatu National Statistics Office reported that kava constituted the largest share for the main export commodities in October 2015, valued at 198 million vatu (40 percent).

This is an excess of 140 million vatu over 58 million vatu in October 2014, a significant increase.

Gradual improvements on the quality of kava can be attributed to cohesive efforts by the government, stakeholders to kava farmers.

In 2014 then Minister of Agriculture David Tosul launched a major kava campaign to improve the kava quality in Vanuatu by clamping down on the trading of two-day kava, reinforced by amendments to the Kava Act.