Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Hansard source

I rise to speak on this motion, as other members have before me, and I thank the member for Leichhardt for bringing such an important motion to this House. It is important when we look at diseases across the world and especially in the Pacific, the South Pacific, the Torres Strait and PNG to appreciate that countries have borders but diseases and illnesses do not. They do not stop at borders and if they are not contained they can spread across borders, including into Australia.

A couple of years ago I had the opportunity as Chair of the House of Representatives Standing Committee on Health and Ageing to visit PNG, Daru Island, the Solomon Islands and Saibai Island. We had an inquiry into health issues in the Pacific that affect Australia, and the aid that we give. Having seen the work that Australia has been doing over there when I led the committee on its visits during that inquiry, I thank the member for Leichhardt for the opportunity to speak on this motion today as I have a very strong interest in these issues. Bringing all this to the attention of the House is very important. However, having said all that, I cannot support this motion because I do not agree that the Australian government deserves censure for the way in which we have been assisting the people of Papua New Guinea, or PNG nationals, to access health care.

The Australian government is doing a great deal of work and spending many millions of taxpayer dollars tackling the economic and social costs, the mortality and morbidity caused by tuberculosis in PNG. That is reflected in the fact that in 2010-2011 alone, the Australian government provided $43 million to help strengthen PNG's health service across the country. That is a big help to the population of Papua New Guinea. Certainly, when we were there visiting health clinics and hospitals in regional communities, such as Daru, the people were very grateful for the assistance that they do get from Australia. That is not to say that we cannot do more. There is always more that can be done and we should always be looking at how we can do more to help some of the most needy people in the world when it comes to health services.

We know that there are risks to Australia, as I said earlier, if this threat is not adequately managed. Disease knows no borders. We come up with borders, as human beings, but diseases, catastrophes and earthquakes et cetera have no borders, and certainly disease knows none, and the impact of one of these diseases, tuberculosis, should not be underestimated.

But as PNG is a sovereign nation, delivering health services for PNG nationals is the responsibility of the PNG government. They made that quite clear to us when we were there. They are happy to receive our assistance and our support, but determining the responsibility for delivering those health services is the responsibility of the PNG government and they could not have made that clearer to us when we were there. They receive the assistance that we give them with open arms and they thank us, but they are a sovereign nation and delivering health services is their sole responsibility. Australian governments can only play a supporting role in delivering those services and assisting the PNG government.

I know this because a few years ago we were there when I had the great fortune of being the Chair of the Standing Committee on Health and Ageing and we conducted an inquiry into regional health issues jointly affecting Australia and the South Pacific. From 6 to 16 October, I led a delegation of the health committee members on the inaugural committee delegation visit to PNG and the Solomon Islands. The member for Swan is here and he was part of that committee and would have heard a lot of the briefings that we received at the time prior to going over there. He was not able to join us but I am sure that he is completely up to date with everything that we heard and saw.

During our visit to both countries, we met with a number of parliamentarians, government officials, health workers, civil servants and other representatives of PNG, as well AusAID and aid agencies that Australia has in PNG and in the South Pacific, to discuss a whole range of regional health issues. We discussed regional health issues that jointly affect Australia and the South Pacific. On our committee's trip, we were warmly received in both countries, both in the Solomons and PNG, and we appreciated the generous hospitality and the support provided by the host parliamentarians and government of PNG as well as our High Commission representatives in each place we went to.

We saw firsthand the hospital systems and the health care that is provided for those people. We saw what the problems were and how Australia was assisting. One of the things that was pointed out quite clearly was that PNG is a very remote, mountainous area. Some of the people who suffer from tuberculosis come into the health clinics, and may even come over to Saibai Island for assistance. They take the antibiotics and feel better, and then go back into their communities. You need to finish the whole prescription of antibiotics and even have a second dose. Because people feel better they decide they do not need the second dose and perhaps the tuberculosis has not fully subsided and it reappears in a more aggressive manner that is harder to treat with ordinary antibiotics. This is why we are seeing this new wave of secondary tuberculosis.

The delegation saw this firsthand. It was a great opportunity for us to learn about how all these things work, about their health services and delivery in countries neighbouring Australia. A benefit of this trip was the strength of the bilateral relationship between the two countries that we have longstanding and important ties with. A big focus of the visit was on tuberculosis and the factors that affect the spread and control of the disease. The inquiry heard in Cairns that TB is much more common in poorer communities where there is overcrowding and a lack of adequate ventilation. When we visited Daru we saw overcrowding. It is a very small landmass with thousands of people living there. We also learnt that patients are less resistant to the disease if they have other diseases, such as HIV, or are malnourished, and many people were.

Professor Maguire of the James Cook University School of Medicine and Dentistry told us that the incidence of tuberculosis is rising in Papua New Guinea. It was very sad to hear that. The rate there is estimated to be 95.3 per 100,000 people. Compare that with the Australian rate of 5.3 per 100,000 per year in 2005. Since 2000, approximately 25 per cent of those cases have been multidrug-resistant forms, known as 163, which add to the complexity and expense of treating the disease. These are usually people who have been diagnosed with tuberculosis, taken a dose of antibiotics, felt better and gone back into their communities where no-one can track them with the disease still in their bodies. The disease comes back in a more aggressive manner that is harder to treat with the ordinary antibiotics that were used in the first instance. We have confirmation that on the PNG side there are some difficulties tracking patients on their release. If we could track them then the health agencies could ensure that they receive the drugs that are required to get rid of the disease from their system. This has been the key contributor to the development of these strains over there.

When we visited Daru diagnostic facilities for identifying people with TB and for identifying people with multidrug-resistant TB were practically nonexistent. These are difficult problems. Sadly, there are no silver bullets or easy answers. I know the Australian government can and does help. Health is a priority for Australia's aid program to PNG. In fact, since we tabled the committee's report in March 2010, the government has announced funding of $1.1 million through AusAID to ramp up PNG's capacity to treat TB cases in the Western Province, which is the region of PNG closest to Australia. (Time expired)

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