Warren Entsch (Leichhardt, Liberal Party) Share this | Link to this | Hansard source

This is an issue that is very close and dear to my heart. After a recent visit to Daru in the Western Province, I remain absolutely committed to raising the profile of this issue and getting some level of resolution to the dreadful situation in which we found ourselves in that area. I welcome the opportunity to speak here today.

The tuberculosis situation has deteriorated over the last decade at the same time as Australian aid funding has continued to increase. Papua New Guinea is now Australia's largest recipient of aid money, receiving more than $490 million in the 2012-13 financial year, yet at Senate estimates last month it was revealed that only $5.8 million is spent on programs relating to tuberculosis. This is despite Papua New Guinea having the highest infection rate of tuberculosis in the world and having a 43 per cent increase in tuberculosis infection rate during the course of the last decade.

I appreciate that managing, distributing and ensuring that the funds are effectively used is not a simple job and there are language and cultural barriers, differences in systems, a lack of accountability—corruption is quite rife—and there are physical barriers such as distance and terrain and technological barriers such as a lack of communication in many areas of Papua New Guinea. But I am stumped as to why time and again this government continues to take advice from AusAID officials who do not accurately reflect the reality of what is happening in that region. The government continues to feed money into World Vision, which, by their own admission, has no presence in the Western Province, with their closest presence being in a village called Tabugal, which is 470 kilometres up into the mountains adjoining Ok Tedi. Tabugal is actually a holiday destination for expats who live in the area and work in Ok Tedi. Access to those areas for treatment of tuberculosis is impossible for people living in the coastal areas of the Western Province. The sea ambulance was bought by AusAID more recently at a cost to the Australian taxpayer of some $460,000 to get it operational. Village leaders of the 13 treaty villages on the Western Province facing the Australian coastline told me in no uncertain terms that they did not want the boat. They said it would not work, it had too deep a draught and it would not get into the waterways it was supposed to access. They were ignored by AusAID; they were told, 'Let's wait and see.' They knew what the problem was going to be, and we understand that this boat has not visited these villages since June. In fact, there was a Four Corners program recently where they decided they should get operational, so they did a run around the harbour and then parked the boat. It is absolutely ridiculous.

They talk about this so-called hospital in Daru. I visited, and it is worse than a pigsty. It is disgusting. To suggest that this is something that is going to give people an opportunity to get well is an absolute nonsense, and a lot of the issues were highlighted in that Four Corners report. While the reporters were there and while the AusAID officials were surrounding them, they had masks, and they steered them into areas they wanted to show them but, as soon as they went back and visited the villages without the officials, we suddenly got a very different show and a very different situation.

Despite the millions that have been spent, you have only to visit the area to see that sufficient medical support and financial resources are not reaching the services on the ground. There is no question about it. Clearly, if the government is making decisions based on the advice of AusAID officials, we need to look very closely at that advice and the agendas of those officials. It is not good enough that they are simply trying to tick boxes and present a front that everything is fine when the reality is that everything is falling down behind them. A perfect example was the ABC Four Corners report, which visited the area to investigate the rise of antibiotic-resistant superbugs. They visited that hospital under the supervision of AusAID and contacted doctors. Masks were on, isolation wards were full—then an hour later they visited and there were no masks in sight and the isolation ward was empty. It is disgraceful.

There is a solution out there, and it comes in three parts. The leaders of the Treaty Village Association know the answers. They have contracted an organisation based in Cairns called the Reef and Rainforest Research Centre, and they have a very strong expertise in tropical research management and delivery. On the PNG side they are a registered corporation. Kebi Salee, from the village of Sigabadu, is the chair; Anton Narua in Daru is head of the anticorruption unit in the Western Province—yet we do not want to listen to these people even though they have a very good story to tell. The Treaty Village Association has contracted the RRRC, funded by the PNG government to the tune of A$7.5 million, to set up a ranger station in those 13 villages. I have met with the minister here and offered the services of the RRRC to provide health workers in the 13 villages so that they can administer the drugs necessary to deal with these problems regarding drug-resistant tuberculosis. Unfortunately, the minister decided to continue to take the advice of these AusAID officials. The RRRC has been incredibly successful.

The second part of the solution is the YWAM ship that is based in Townsville. They have an incredible record and have done a wonderful job up there. They have the confidence of the Papua New Guinean people and they are able to move into areas up there and take people in. They have operating theatres full of volunteers and can access areas that AusAID vessels cannot go near. Again, the government does not want to listen to them.

The third part is to build a new hospital, and that can be done by accessing the $1.46 billion sitting in a trust fund in Singapore. It was supposed to be for the education and health of the people of the Western Province, and for sustainable development. It used to be run by Professor Ross Garnaut. We wonder why, instead of using money to build hospitals and other infrastructure, they are building things like mega wharfs and gas pipelines. You have to wonder why, as a director of Lihir Gold or of Ok Tedi Mining, there is not a conflict there? It is the only place in the world, that I am aware of, where mining companies actually get their infrastructure built by funds that have been set up to help the local people. It is quite unbelievable, and we need to be looking at that area.

This hospital can be built. The Treaty Village Association should be involved in the building of it to Australian standards with quality accommodation for their staff. It can be mentored and guided through by Australian professionals and we can find a solution. We need to start looking at that fund to build this hospital. We need to review their administration of AusAID funding for the provision of the South Fly district tuberculosis management program. The funding should go into programs administered and managed in partnership with the local people who will benefit, not to international organisations who cannot demonstrate outcomes or to corrupt high- and mid-level officials who are buying houses in my area in Cairns.

I therefore call on the Australian government to work in partnership with the PNG government, the PNG Treaty Village Association and RRRC towards establishing long-term solutions. A key element that Labor must review is its priorities within the AusAID budget to enable full funding to be restored to Saibai and Boigu clinics in the Torres Strait to provide necessary support until such time as capacity has been established in 13 Torres Strait villages.

We already see one person die of tuberculosis every two hours in PNG. There is a young girl, unfortunately, in the Cairns Base Hospital, who will live in isolation for the next two years while she gets treatment for XDR-TB, which is extensively drug-resistant tuberculosis. Further, seven cases were discovered in Papua New Guinea last month including two in Daru. PNG minister for health, Michael Malabag, has already describe XDR-TB as, 'A time bomb for PNG, and I dread the day that the first case of totally drug-resistant tuberculosis is diagnosed.' At that point, you are basically going to quarantine the village and let them die because the disease is so virulent it will spread and nothing can cure it. All of this is happening in villages less than five kilometres from the Australian border. If we do not see any policy changes these people will continue to die unnecessarily, and this disease will stake a claim in Australia. I know that as a society we are better than this, and that is why I am urging this House to act now before it is too late.

Richard Marles (Corio, Australian Labor Party, Parliamentary Secretary for Pacific Island Affairs) Share this | Link to this | Hansard source

I rise tonight to oppose the motion that has been put forward by the member for Leichhardt. Whilst I very much respect the work that the member for Leichhardt does within his electorate, which of course includes the Torres Strait, when talking about issues as serious as tuberculosis, when we are talking about the way in which lives are being affected and what is being done, all of us who participate in debates of this kind have a responsibility to get the facts straight. We have a responsibility to actually do the research and look at what is going on so that we get the facts straight, because a little bit of information without knowing the whole thing and without getting the whole thing right can be very dangerous, and that is what we are seeing in this resolution that is being moved in this parliament this evening.

In 2012-13, Australia will commit $104 million to strengthen health services and systems in PNG through the provision of essential medical supplies, through training health workers and through developing infrastructure with other partners within the health system in PNG. Health reforms require improved capacity of the health system to deliver new services and fight diseases such as TB, malaria and HIV, as well as making sure that we improve maternal and child health.

AusAID has already committed $11 million in support to PNG to specifically tackle tuberculosis in the Western Province. $3.5 million of that was spent in 2011-12. AusAID funds specialist TB staff, the training of health workers, provides equipment and medication and a health patrol boat,—and that patrol boat is due to carry out 19 days of TB outreach activities in November—and provides laboratory diagnosis in Australia of drug resistant TB in PNG. We are working very closely with the Papua New Guinea government and indeed the government of the Western Province towards assisting PNG to improve TB services for those in need, including those within the Western Province.

The controversy around TB in the Western Province has arisen out of a decision of Queensland Health's in relation to its funding of the health centres in the Torres Strait. The Australian government's work in the Western Province, through AusAID's support, is and has been initially focused on Daru, the major town on the South Fly coast, where the majority of TB cases are located. We are upgrading Daru's hospital's TB facilities and constructing a new TB isolation unit and a TB ward. We are providing TB staff, including a specialist and a coordinator of the facility. We have put in place an infection control specialist who is also being funded by AusAID to provide advice to staff at Daru Hospital about increasing patient compliance with infection control procedures, which is fundamental to dealing with the issue and the disease of TB. We are funding a master plan, which will be ready in February of next year, which will identify the best course of action for upgrading the hospital and the facilities at Daru.

Daru Hospital has improved dramatically with AusAID's support of its TB services, and these are now among the best that are available in PNG. Two hundred and sixty-eight patients have been treated for tuberculosis in the Western Province since February of this year, including 92 Papua New Guineans who had been treated by Queensland Health in the Torres Strait clinics and transferred back to PNG. Sixty-five of those patients handed back from Queensland Health have now successfully completed treatment, and the rest continue to receive treatment under the supervision of a TB specialist doctor.

Mortality rates—and this is a very important point—from multidrug-resistant TB have reduced from 25 per cent to less than five per cent, which is a very good figure by global standards. The number of Torres Strait Islanders infected has also reduced from nine in 2010 to six in 2011. The independent World Health Organization technical assistance mission that visited PNG in October last year reported that patients diagnosed and started on treatment in Daru Hospital were receiving directly observed treatment to ensure that they fulfilled their course of treatment. This approach is endorsed by public health experts, including none other than the Commonwealth's own Chief Medical Officer and the World Health Organization, as being best practice. The World Health Organization will undertake an annual review of the approach that is being taken in PNG during the course of this month. There are now 63 volunteers and health workers undertaking directly observed treatment of TB patients in Daru and the South Fly region of Western Province. AusAID has helped fund these volunteers' training, and additional volunteers will be trained over the next three years to increase the coverage of directly observed treatments in the Western Province.

When PNG nationals were treated for TB on Saibai and Boigu they would often return to PNG after the initial stages of treatment. This made it very difficult to follow up patients to ensure that subsequent stages of treatment were administered. Patients often had to take medication every day from anywhere within six to 24 months. In September Dr Emma McBryde, the Associate Professor and Head of Epidemiology at the Victorian Infectious Diseases Service, who assessed the burden of TB and other diseases in the Western Province, at the request of the PNG government concluded that the treatment on Saibai and Boigu did not offer a solution to the problem of TB in the Western Province, and had little ability to improve the situation of TB in the Western Province, but had a great capacity to make it much worse. Dr McBryde also concluded that closing the Saibai and Boigu TB services was likely to reduce the risk of multidrug-resistant TB transmission to Australian residents. Australia is working very closely with the PNG government on this issue. At the Torres Strait Cross Border Health Issues Committee meeting on 30 and 31 October in Cairns, senior representatives from the PNG National Department of Health and the Western Province health administration, the Australian government and the Queensland Health met and discussed cross-border health issues including TB. Support for TB was also discussed by officials at the Torres Strait Treaty Joint Advisory Council meeting in Cairns on 25 October this year. A roundtable meeting will be held early next year to discuss best practice approaches to the management of TB in the PNG-Australia border region.

This government's efforts to tackle tuberculosis in Papua New Guinea are working. Dr McBryde reported a 50 per cent drop in the death rates from TB at Daru General Hospitalfrom 2008 to 2011. For all that has been said on the other side, for all the emotional rhetoric that has been brought to bear here, the facts of the matter are that, because of the work AusAID is putting in, there has been a 50 per cent drop in the death rates from TB at the Daru General Hospital. Western Province health figures show an 80 per cent drop in death rates in the Western Province as a whole in the past year. There was an 80 per cent drop in death rates through TB in the Western Province over the course of the past year as a result of the work that the PNG health department, assisted by AusAID, are doing in the Western Province. That is the fact of the matter here. What we are seeing with this motion, at the end of the day, is an irresponsible scare and fear campaign around this issue. PNG Health SecretaryPascoe Kase has acknowledged and thanked AusAID for its support, and said:

We have a big problem with TB in PNG and the Australian Government, through AusAID is a major and valued partner with the Government of Papua New Guinea in helping to deal with this problem.

He particularly noted the importance of the new TB isolation ward at Daru General Hospital, which is funded by AusAID. Australia's approach on this issue is the right one. We will continue to do more to support the PNG government to control tuberculosis. We are committed to working with them to deal with tuberculosis now and in the long term.

Teresa Gambaro (Brisbane, Liberal Party, Shadow Parliamentary Secretary for Citizenship and Settlement) Share this | Link to this | Hansard source

I rise to support the private member's motion of my parliamentary colleague, the Hon. Warren Entsch, the member for Leichhardt. No-one can doubt the member for Leichardt's passion and diligence when it comes to pursuing this issue on behalf of his constituents of Far North Queensland and in consideration for the welfare of our nearest neighbours in Papua New Guinea. As much as I respect the parliamentary secretary who just spoke, there is one difference between him and the member for Leichardt. The member for Leichardt has actually visitedDaruand has actually visited the Western Province more than once. He has visited the hospital, has taken photographs and has shown me and the opposition foreign affairs spokeswoman a range of photographs which display an appalling situation, an appalling excuse for a hospital. I will never forget some of the gut-wrenching scenes that I saw in those photographs. That is where the $11 million that the previous speaker, the parliamentary secretary, was talking about.

The member for Leichardt has for a long time lobbied, spoken to the government and notified us all that he believes AusAID has been asleep at the wheel, and I wholeheartedly support him. He, more than anyone, has had firsthand knowledge and has seen firsthand what has been going on in the Western Province. AusAID has, indeed, been asleep at the wheel in its funding and its management of the failed tuberculosis programs in Papua New Guinea.

During Senate estimates on 22 October this year it was revealed that, out of AusAID's $104 million allocation to the PNG health sector's budget for 2012-13, only $5.8 million was dedicated to programs relating to tuberculosis. As the member for Leichardt quite rightly said, this amount of money is absolutely pitiful. The facts are disturbing, and the parliamentary secretary is quoting figures that have obviously been given to him by AusAID. PNG has one of the highest infection rates of TB in the world and a reported 43 per cent increase in TB infection rates over the last decade, and they are the facts. The most recent World Health Organization country profile—and I really support the World Health Organization; they do great work—said that there were 3,700 deaths due to TB in 2011. The mortality rate was reported as 53 per 100,000 people—hardly a ringing endorsement that the program is doing fantastically well. This is hardly a result that creeps up on you in the dark and it is not something that we should be proud of for our nearest and dearest neighbour.

What is even more disturbing is that this is just an estimate of the size of the problem. We do not really know how bad it is because, according to the School of Veterinary and Biomedical Science at James Cook University, there are insufficient diagnostic techniques and limited resources, and case detection rates of TB in Papua New Guinea are only 19 per cent. So as much as the parliamentary secretary can quote figures that health workers are getting to the problem, it is a huge problem. He spoke about the patrol boat. That particular patrol boat cannot even get to the villages, and they recently also sacked their TB specialist, Mr Morrow. That is pretty disturbing news.

This has been a piecemeal approach by AusAID and what is disturbing is that it is not tackling tuberculosis. The World Health Organization has described the level of multidrug-resistant tuberculosis in PNG's remote south-west as being of crisis proportions. AusAID's commitment of just five per cent of the current foreign aid health sector budget to PNG for combating tuberculosis is like putting a bandaid over an artery, and the epidemic levels of TB infection in PNG pose a huge risk to Australia. More needs to be done to halt the disease in PNG owing to the increased risk of the spread of multidrug-resistant tuberculosis and extremely drug-resistant tuberculosis.

Despite this being an international matter, the federal government has refused to fully fund health services for PNG nationals. Instead, what this government has done is force the Queensland government to accept a funding project agreement or risk losing $8.1 million in funding for 2010-11 and 2011-12. But the actual cost to the Queensland government is not $8.1 million; it is actually $32 million. So not only is this government without vision but it is also penny-pinching and buck-passing onto the Queensland government as a smokescreen for its own failures.

PNG is our nearest neighbour. We need to be doing more. AusAID has to stop and reassess what it is doing in PNG. Unfortunately, so much of the talk is about what has been happening with tuberculosis in PNG and so much of it has been about excuses and not finding solutions. This is not a small problem; it is huge. (Time expired)

Alan Griffin (Bruce, Australian Labor Party) Share this | Link to this | Hansard source

This is an important motion and it covers a very important issue. As all speakers have said so far: it is a serious issue. It is a crisis with respect to tuberculosis for our near neighbour and it is an issue that demands action. However, that is when we start to divert, and the circumstances are very much a matter of what is the best way forward, what needs to be done, what is the real state of the problem and what particular aspects are keys to dealing with these issues.

I put on record my respect for the member for Leichhardt and his commitment to his area. He is a man of considerable ability with a real commitment to the top end of Queensland and with real knowledge of issues around the Torres Strait; however, I would also say I have met a lot of people in politics. It is an old saying—I cannot use the exact words on the record about calling a spade a spade and I think that some would say that Warren calls it a certain type of shovel. That bluntness is something that I admire on many occasions, but I sometimes wonder if it necessarily focuses on what needs to be done in a situation such as this. I think that he raised some important points in his speech and I only caught the last half of it in my office. What I would say is that some of those points probably need to be looked at. The real question is: where do we go from here? What do we need to do to address this issue?

We can all agree: TB in the circumstances that are now being faced in PNG is a very serious problem and there are real concerns about drug-resistant TB developing. We can then go to the question of what is best to do now. The question around Queensland Health's withdrawal of support and funding is something that I think the Queensland government needs to consider itself. What has been occurring in the province with AusAID, their attempts to try and work with PNG authorities, is showing some real signs of starting to work. I think some of the figures quoted by the parliamentary secretary point to the fact that there has been a real financial commitment from AusAID and from the federal government to deal with this issue. There has been a range of initiatives. The parliamentary secretary mentioned numbers in relation to: specialist doctors; training of health workers; the provision of drugs; the refurbishment of an interim TB isolation unit; a new X-ray unit and GeneXpert machine, which diagnoses drug-resistant TB within two hours; improved communications with clinics in the Fly region; annual monitoring by the WHO; and a master plan for the redevelopment of the Daru Hospital. They are all things that need to be done and all things that need to be part of a programmatic approach.

The one thing we can all agree on is that there needs to be an approach which basically works on both sides of the border. There needs to be an approach which maximises the coordination and development of integrated support by Australian and PNG sources. There is an article in this weekend's Cairns Postby Geoffrey Miller. Geoffrey Miller is a public health practitioner who recently returned to Australia after three years based in Daru as the health advisor to the Western Province government. Some might say that he comes with particular views because of his position, but I think he makes some very good points with respect to the circumstances there. His point, in terms of reviews that have recently been done, and his view with respect to the way forward is that there needs to be a continuing development of the approach that is currently being undertaken.

It is going to take time to get this right, but some of the initial figures—for example, something like 80 per cent of the patients who were taken over post the withdrawal from Queensland Health having now completed with treatment—are a very good sign for the future. Therefore, the development of these services is something which I think we can have some confidence in. Is it a serious issue? Absolutely. Are we are in a situation where we are going to be having difficulties with TB in that area for the foreseeable future? Absolutely. But, working off the review of this area by Professor Emma McBryde, Head of Epidemiology at the Victorian Infectious Diseases Service, we can say some important steps are being taken in the right direction. There has been increased funding and there is, through that process and through the development of services, the opportunity to work through these issues and provide better health outcomes for the people of the Torres Strait and for the people of PNG in the Western Province. (Time expired)

Andrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | Link to this | Hansard source

Deputy Speaker, thank you for the opportunity to speak on this incredibly important area of tuberculosis in our region. I think Australians, people living in the Torres Strait and even citizens of Papua New Guinea, will be getting tired of these banal government reports about AusAID's efforts in Papua New Guinea: 'Doing well', 'Could do better', and 'Allow us a little more time.' Time is the one thing that TB patients do not have. A year and a half ago this Prime Minister wrote to then Premier Anna Bligh in response to a request for more financial assistance with the troubles that were being created in TI by the movement of TB infected PNG citizens across that two-kilometre stretch of water. The response from the Prime Minister was simple: 'There is no more money.' I need to make a very clear point to the previous two speakers on this issue of tuberculosis with PNG nationals: the impact of foreign nationals on the Australian health system is the responsibility of the federal government.

Since 1978, we have had a Torres Strait agreement with the Queensland government to compensate that state for the costs of PNG nationals. It is something that every government until this one has proudly compensated Queensland for. As the cost of TB began to escalate, let us remember the previous Premier, Anna Bligh, sought more funding, and it was not forthcoming.

No-one is asking this federal government to solve the issue of tuberculosis in our region. That is what we are talking about. What we are talking about here is asking AusAID at the drop of a hat, within three months, to initiate a tuberculosis program in a part of the world where they have no experience. If you search the website for AusAID, you will see not a single TB program in Papua New Guinea prior to this request. Our only criticism from this side of the chamber is: you should have left more time for the good work that was being done in the Torres Strait to continue until Papua New Guinea picked up its capacity and could stand on its own two feet. I do not care how many WHO reports there are talking about the great work that AusAID has done in a limited period of time. This is a disease that is highly contagious, through spit, through speaking, through coughing, through sneezing or through close proximity with other infected people, particularly in areas where people have low resistance, low autoimmunity and even concomitant HIV. These people are at great risk and they are only two kilometres away from Australia. The surveillance issue has not been raised today, but the presence of qualified physicians at Saibai and Boigu is almost unable to be priced. It is wonderful and important, but it is now gone. To bring those clinics back is the responsibility of the federal government.

It has not been talked about in this place before, but in November last year a nine-year-old Papua New Guinean girl presented for care at Boigu—not once, not twice, but five times. The fourth time she had an extended abdomen and the fifth time she had cerebral TB. At each of those times she was told to go away, for no other reason than that the federal government had decided there was no more federal funding for TB in the Torres Strait. That young girl was evacuated too late to save her life and she died in Cairns. I hope it will be the subject of a coronial inquiry. This was the problem with dropping TI without setting up Papua New Guinea first. We do not ask for Papua New Guinea to solve the problem; we do not expect AusAID to cure the world; we just wanted concomitant care at TI to look after people like that nine-year-old girl.

Where is XDR-TB, multidrug-resistant tuberculosis, right now? There are six cases of it. Nobody has talked about them. Five are in Daru hospital and one is in Cairns hospital right now. One of those cases in Daru is the nurse who was looking after the other XDR patients. There were not enough masks and they were not worn often enough, and the care provider now has multidrug-resistant TB. So do not for a moment think that Papua New Guinea can just pick up the ball and run. There is limited capacity to diagnose this disease and work out appropriate treatments. If people are resistant to rifampicin, isoniazid and the quinolone family, you are left with just amikacin, capreomycin or kanamycin. Doing that in Daru is hard. Doing it in Mabaduan is close on impossible.

I have enormous respect for the people working at AusAID and those they employ, but you cannot expect this to be fixed in months. This is a year-long transition, but the Labor government could not find an extra nickel or dime to continue those clinics, and that has cursed the people of Daru and Western Province to be utterly reliant on an infantile TB program that will not be up and running for years. That is the great tragedy that will not be forgotten by the clinicians in Cairns or the nurses who visit Daru and TI and do the very best that they can with those who cross the Torres Strait.

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

It gives me great pleasure to be able to speak on this motion. I welcome the opportunity to speak on this particular motion of the member for Leichhardt. It goes to the issue of transitional management and treatment of infectious diseases, specifically tuberculosis and drug-resistant tuberculosis. I do so because I had the pleasure of visiting this region with the House of Representatives Standing Committee on Health and Ageing in preparation of our March 2010 report on regional health issues jointly affecting Australia and the South Pacific. We visited Daru and the Western Province, including some of the most isolated villages in the world, on the Fly River.

There was very clear evidence of AusAID's ability to deliver results on the ground. We saw firsthand projects in these villages on Daru where outcomes were being realised. That visit was a couple of years ago and a lot has changed since then, but the evidence is that the work of AusAID is well regarded by everyone that we met in PNG. Whether it was in the capital, Port Moresby, with the minister for health and many others that we met, or whether it was village chiefs in many isolated villages or the head director of the Daru hospital, they told us that AusAID is a vital part of their health program and that they endorsed AusAID's work in the region. Of course, AusAID's work is endorsed by public health experts, including the Commonwealth Chief Medical Officer and the WHO. The assistance given by Australia to PNG through AusAID to assist with the management and treatment of tuberculosis in PNG's Western Province is a very positive step and very positive results are coming from it. Australia is assisting alleviate the problem of tuberculosis. The member's motion asserts that AusAID assistance is not hitting the ground and that medical assistance is not being delivered for the benefit of people's health. Let us be clear about this: the Queensland government cut funding to this region.

AusAID stepped in this February with $11 million over four years. This funding has enabled AusAID to pay for specialist doctors; the training of health workers; drugs to treat TB; the refurbishment of an interim TB isolation unit; construction of a new TB isolation ward, which will be delivered by mid-February 2013; a new X-ray unit; and a GeneXpert machine that diagnoses drug resistant TB within two hours of having the test. That is supported by laboratory diagnoses here in Australia to identify the strains of drug resistant TB. This funding has also been used to improve communications with clinics in the Fly River region. It has also funded annual monitoring by the World Health Organisation, as well as advice on infection control. There is a master plan for the redevelopment of Daru hospital to which AusAID will also commit funding for further capital works. These are things that are being done on the ground in the Western Province in this region, which is one of the world's most isolated. To extend treatment in communities outside Daru, AusAID has also provided a sea ambulance, which has conducted 12 outreach visits to villages on the Fly River coast since May.

The member's motion goes to the AusAID approach not working, being deficient and ineffective. Let us be crystal clear: AusAID's efforts in support of PNG's approach to the effective management of TB in the Western Province are working. Our health and ageing committee saw evidence of this first hand, with PNG officials, the health minister and other people on the ground telling us that AusAID was a vital part—an integral part—of their health system. Advice is that TB mortality rates in the Western Province have fallen by 80 per cent in just one year and fewer Torres Strait people have TB. AusAID support has also led to many more people with TB in the Western Province being detected. It is very important to be able to detect those people so that they can be treated. The member opposite says that we should restore funding to the Saibai and Boigu clinics. And yet the best available advice is that this would make things worse.

Debate adjourned.