Australia cannot afford a failed state on our border

Australia's initial response to the Covid-19 virus crisis in Papua New Guinea was pleasantly well targeted and proportionate.

It is consistent with what I proposed in my last column which was sending medical specialists, important equipment, especially testing units, but not cash!

Since my last column the number of cases reported daily has effectively doubled – from around 100 to 200. About half the cases are in the nation's over-populated capital, Port Moresby.

There are important lessons to be gained from this experience, both for Papua New Guinea and for Australia.

The message for Australia arising from this experience could not be clearer. We simply cannot afford to have a failed health system (Papua New Guinea) on our border!

The Australian Government, having responded effectively and promptly to the PNG Government's call for assistance, must now seek assurances from the PNG Government that it will address the failed health system issues that have long been neglected and tolerated.

Australia also needs to offer affordable and practical assistance if the PNG Government does so. The last thing we need to see in our northern neighbour is more meddling in the PNG health system by the Chinese government and its "apologists" within the PNG government.

Whereas Australia's assistance has been generous – and there could be nothing more generous than our commitment to pay for around one million vaccines – China's has consisted of piecemeal and useless PR stunts!

What is needed is nothing less than a total clean out of the PNG health bureaucracy – from the Health Minister down. Australia should offer to provide experts in health services and hospital management, take over the training of doctors and nurses and look seriously at taking for control of the nation's key hospitals such as Port Moresby, the Angau in Lae, Goroka, Hagen and Madang.

This will be a costly exercise, but it is necessary if we are to overcome a failed health system in PNG. The Covid-19 virus is just the latest indicator of just how "failed" it is. The alarming level of cholera, high infant mortality, and even the return of polio have been poorly managed for years.

This is a unique, and probably never to be repeated opportunity, to clean out the rampant corruption – which industrious PNG bloggers regularly highlight – right across the health system.

Until 2013 an arrangement with the Australia Government saw the country's hospitals and health centres supplied with adequate quantities of drugs, medicines and even basic supplies such as bandages.

In a highly suspicious decision the PNG Health Department switched from the Australian arrangement to one funded by the PNG Government with an Asian importer. Ever since the health system has been plagued with shortages of even basic supplies and well as vital medicines such as antibiotics.

Again the bloggers have been at work disclosing highly suspicious, if not corrupt, purchases and payments that are at the heart of the shortages.

It almost defies comprehension that one of the most corrupt and rorted areas of the whole government structure in PNG is in the health system, at national and provincial levels alike.

Basic health services ought to be the right of every citizen of PNG no matter where they live. The simple truth is that even the most basic services are underfunded, rorted, resulting in a progressive decline in the standard of basic health care since Independence in 1975.

Australians are entitled to demand of their government that it learn the lesson from this crisis, and insist PNG does as well.

But our response will be costly, so how can it be funded?

Our total development assistance budget allocation for Papua New Guinea is around $600 million a year – that is close to 2 billion kina. PNG is the largest recipient of Australia's overseas aid.

The way to fund a takeover of part of the health system (such as major hospitals) is to suspend most of the aid spending on non-health areas and divert it to health care and administration.

Our assistance to PNG to try and reduce the incidence of Covid-19 must extend beyond vaccines and testing equipment. It must also focus on the total rehabilitation of a failed health system that is getting worse by the year.

As just one example last year there were just 109 cases of polio diagnosed in the whole world – 21 of them were in Papua New Guinea!

There are good hard working and well qualified doctors nurses and health workers in Papua New Guinea but their work is undermined by a corrupt and poorly managed overall health care system.

They need our comprehensive support as do the nine million men, women and children of our northern neighbour.

We are in a unique position to insist on genuine and comprehensive reform.

If we do we won't just benefit the good people of Papua New Guinea. We will be advancing the Australian national interest by not having all the dangers of a failed health system – far beyond the impact of the Covid-19 virus – on our border and in our closest neighbour!