Professor Sharon Lewin who will co-chair Aids 2014, an international conference that opens in Melbourne next month, has been to PNG to see how HIV prevention, testing, counselling and treatment services are being implemented in remote and rural regions.
Professor Lewin say she believes strongly that there is an obligation on the private sector to support overburdened and fragile health systems operating in similar environments, and the PNG experience shows just how it can be done.
Presenter: Richard Ewart
Speaker: Professor Sharon Lewin, co-chair, Aids 2014
LEWIN: It's an interesting model, and I think a really important one to be part of the whole HIV response.
I recently went up to Papua New Guinea as a guest of Oil Search and they have a health foundation that's been working in a range of health issues in Papua New Guinea, HIV, malaria, Mother and Child Health, and more recently they've got much more involved with the HIV response, because they are the principle recipients of a big grant from the Global Fund.
Global Fund gives money towards actually testing and treatment and usually gives those grants to governments, but in Papua New Guinea, it's unusual model where the grant is primarily run by Oil Search, of course, in partnership with the government and I believe that's the model that seems to be working very well in Papua New Guinea at the moment. The government seems to be very supportive of it and so far, it seems to be doing a great job.
EWART: Are there though any particular drawbacks with the involvement of a private operation like Oil Search. I mean people might ask what's in it for them?
LEWIN: I think that's a perfectly reasonably question. I think many companies have a number of reasons to get involved in the health of their workforce. Many companies and including Oil Search have social responsibility have now become high on the agenda of many companies and something that shareholders demand and I think that's a big driver in their interest in health. And I think it's a win-win to be honest, I think it's in the company's interest as well as the government's interest to keep their communities health and that's really where I see the main drive is coming from, social responsibility and looking after your workforce.
EWART: It's a model perhaps that is more readily achievable in a country, like Papua New Guinea, particularly at the moment when the whole LNG Gas Project is taking off and the country's economy is showing signs of moving at a very rapid rate. But for the smaller Pacific countries, with perhaps a slower economic growth and without this big private sector presence. Can they achieve a similar model?
LEWIN: I think there are similar models around the world, that it's not just in Papua New Guinea and Oil Search. I'm unaware of similar models within the Pacific, but I think any large companies will be driven by those two factors we discussed earlier and there certainly are similar models happening in countries in Africa and I think could be translated to smaller companies as well. It doesn't need to the mega-companies, such as Oil Search, with the big profits.
EWART: At least part of the role, certainly of the Oil Search experience to raise awareness in Papua New Guinea, because one of the problems I think that people have been struggling with sometime now is to persuade the population of Papua New Guinea that they have a problem that needs to be dealt with, but I gather that situation is changing there?
LEWIN: Yeah, I was quite struck by the awareness, that at least I saw, of course, visiting a limited numbers of sites within Papua New Guinea. I think Oil Search's main roles in HIV have been around providing support and capacity-building in HIV testing and education, which is really important, particularly for people to access treatment, but also to destigmatised the disease and then in running the anti-HIV Drug Program, and that actually requires a lot of sustained capacity and expertise, because once you're on treatment for HIV, you're on treatment for life and so therefore, it's been a big challenge to get people tested and a big challenge to get them back into care when they need treatment, is a big challenge to start to treatment and then you start the treatment for 40, 50, 60 years. You need a pretty robust health infrastructure to do that, which PNG doesn't quite have yet and so part of what Oil Search are doing, together with the Global Fund and together with the Department of Health. This isn't being done in isolation from governments, it's done in partnership is to get those bits in place, to allow the whole spectrum of healthcare delivery, for people with HIV, as well as the prevention messages.
EWART: You mentioned that you're not aware of other similar examples in the Pacific as yet, but this PNG example, I believe will be one of the case studies to be presented at the International Aids Conference, coming up in Melbourne, in July. Would it be a case of saying to Pacific delegates that are at that Conference to take a long hard look at what Papua New Guinea are doing and see whether you can mirror it in some way?
LEWIN: Absolutely. I mean I think it's a model for many countries with fragile health infrastructures or struggling to meet the needs of their actually positive population. I think it's a very, very interesting model.
What makes it unique is this partnership with the Global Fund as the main recipient of the Global Fund grant to Papua New Guinea currently and I think it will be very interesting to see the successes that they'll be able to achieve with that grant and it could be a model used in other places.
EWART: Presumably though, accompanied by checks and balances, money coming into Papua New Guinea from sources like the Global Fund sometimes questions are asked about precisely where that money goes?
LEWIN: The governance structures in companies such as Oil Search, when Oil Search Health Foundation are very different to what has been the experience in some governments and I think that gives the Global Fund some confidence, but I also think it's key that this is still done in partnership with the government and that maybe in years to come, those same governance processes will exist in government and responsibility could then be assumed by the government again.