It now appears likely that the COVID-19 pandemic, which raged through Europe and the Americas over the last twelve months, will this year spread dramatically to lower-income countries in Africa, Asia and the Pacific. The upsurge of cases in Papua New Guinea in recent weeks—alongside a noticeable increase in new case numbers in other countries in the region that had previously contained the infection rate—may be a sign of things to come.
The first, short, wave of COVID-19 peaked in PNG at 73 new daily cases in August 2020. The second wave, which began in late February, reached a peak of 427 new daily cases on 20 March, with no end in sight. With 3,758 confirmed cases (846 recovered) there have been 37 recorded deaths to date. Significant under-reporting means the real numbers are much greater. If not brought quickly under control, the size and pace of the recent upsurge in new daily infections threaten a health disaster.
PNG health authorities have moved to tighten internal border controls, restrict personal movement, ban mass gatherings, close schools and enforce mask wearing in public to stem the upsurge. But a weak health system, the lack of medical as well as personal protective equipment, and the lack of capacity to provide an effective system of tracing in the wider population, all put PNG at extreme risk of a surging epidemic.
Most concerning is the acknowledgement by PNG authorities that the reported cases are only a small proportion of the actual number because diagnosis and tracking systems are both completely inadequate. Analysts say that the actual number of COVID-19 cases may be ten times higher than reported.
The international support needed to help PNG curb the upsurge may not arrive quickly enough or in sufficient quantities to be effective. The Morrison Liberal government has provided 8,000 doses of COVID-19 vaccinations specifically for PNG front-line health workers and Torres Strait communities bordering Australia, followed by a pledge of 1 million AstraZeneca doses for the wider population. Australia has sent in small medical teams and helped PNG to construct emergency hospital facilities. It is doubtful that the Australian response is sufficient to assist the PNG government to meet or control the rising pandemic, a situation that is paralleled in other lower-income countries.
Where countries are unable or unwilling to control the pandemic through proven interventions including lockdowns, quarantine, tracking and tracing, the recourse to vaccination is the main hope.
To date, about 80 percent of the available global supply of COVID-19 vaccines has gone to a dozen wealthy countries. While India, Bangladesh and South Africa stand ready to mass produce vaccines, prohibitions by the World Trade Organization designed to protect the intellectual property rights of the world’s biggest pharmaceutical companies have blocked this initiative.
Australia was among the list of Western countries that in March gave priority to protecting the revenues and profits of the world’s largest pharmaceutical companies over the protection of national populations and the control of COVID-19 globally.
Along with the US, Canada, EU and UK, Australia again voted to block a proposal launched last October by India and South Africa for a temporary waiver of Trade-Related Aspects of Intellectual Property Rights rules to enable greater production and supply of COVID-19 vaccines, treatments and diagnostic tests. A similar waiver was granted a decade ago during the HIV/AIDS epidemic, but this time it was refused.
This self-serving refusal to permit global mass production of vaccines threatens the health and lives of billions of people who live in countries unable to produce—or even to purchase—vaccines to cover their own populations. The major pharmaceutical companies have focused their marketing on wealthy countries in Europe and North America, and yet appear unable to meet demand even there, as Astra-Zeneca’s current failure to meet demand for vaccines in Europe demonstrates.
While the origin of the COVID-19 upsurge in PNG is not known, commentators in PNG suspect that the virus may have travelled across land and sea borders from Indonesia, where Joko Widodo’s national government has been noticeably inept and irresponsible in its failed attempts to control the pandemic.
Pacific island countries moved collectively last year to establish the Pacific Humanitarian Pathway on COVID-19 to combat the emerging crisis in the blue Pacific. The Pathway underlines a collective responsibility to manage a regional response and effective partnerships supported by necessary, sufficient and appropriate foreign aid.
Australia is the major provider of foreign aid to PNG. Australia was the governing power in Papua from 1906 and New Guinea from 1914/1921 until independence in 1975 and has a particular responsibility to compensate for the neglect of economic and social development—including the failure to build an adequate health system—during those years.
The regional Pacific community alliance and the World Health Organization each support training for PNG health professionals and help to manage supply-chain issues across borders. Meanwhile, the PNG National Department of Health has raised the likelihood that it will exhaust its supply of necessary COVID-19 equipment, including testing kits, meaning test samples will once again have to be sent to Australia for analysis, jeopardising the response to the current upsurge.
Moreover, border closures and interrupted trade routes due to COVID-19 threaten medical interventions, food security and labour movement, leading inevitably to economic and social concerns for PNG and other Pacific island states. The PNG border with Australia is temporarily closed.
Through the activities of the state governments, Australia has led the world in controlling the domestic COVID-19 epidemic through an increasingly effective process of lockdowns, testing and tracing. There is now essentially no community transmission in Australia, almost all active cases being among people who have arrived from overseas.
While vaccination of the Australian population remains essential if borders are ever to open for international travel, the need to cover the domestic population rapidly is much less than in countries where the virus is—or threatens to become—endemic. Australia could therefore do much more to protect populations such as PNG as a priority.
The Australian government has a fractured record of providing support to Pacific island countries, with recent increased interest mostly reflecting concern about China’s growing influence. PNG has indicated that it will not accept COVID-19 vaccines from China, raising the stakes considerably for Australian aid.
For a decade at least, the declared aim of the Australian foreign aid program has been to extend Australia’s own economic and security interests, including health security. A plank in this platform is to prevent potentially affected populations from entering Australia, in contrast to dealing with health concerns in neighbouring countries where they arise.
In these circumstances, there is a concern that the decision by the Morrison government to help PNG to stem the rising COVID-19 tide may reflect more a fear that the virus will spread to Australia than a genuine concern to halt the epidemic in PNG. The purpose of the Australian intervention is first to vaccinate front-line PNG health workers, who make up a workforce of fewer than 5,000 people. A second aim is to vaccinate PNG island communities in the western Torres Strait. Under the terms of the 1978 Torres Strait Treaty, the border with Australia is porous for local communities travelling for work and other interests.
There is also a large PNG community in Cairns, with work and family connections. Travel between Cairns and PNG has been halted. A concern for the Morrison government appears to be—as a priority—to reduce the risk that PNG’s rising epidemic may filter into the Australian states. Speaking of these COVID-19 aid commitments to PNG, Prime Minister Scott Morrison told the press on 17 March, “This is in Australia’s interest”.
The government has also urged the European Union to divert a million doses of the AstraZeneca vaccine (enough to vaccinate 500,000 people), which has been contracted to Australia, for use in PNG. Given the Italian decision to block the supply of 250,000 AstraZeneca doses from the EU to Australia, it is doubtful that the Morrison government’s pledge will be honoured any time soon.
Even should the EU dispatch these vaccines to PNG, the pledge falls far short of the level required to vaccinate fully a national population of 8.4 million—there is evidence that the pandemic is rising rapidly not only in Port Moresby but across the Western Highlands as well as in Torres Strait communities.
Meanwhile, CSL laboratories based in Melbourne have begun the domestic production of a million doses of AstraZeneca vaccine per week, with a target production of 50 million doses. The benefits of diverting a large part of this production immediately to PNG far outweigh the danger of any new, current risk of uncontrollable COVID-19 infection in Australia. But there is no indication that the Morrison government has any intention of taking this initiative.
Australia’s commitment to foreign aid has declined disastrously in recent decades. Interrupted only by a reprieve during the Rudd-Gillard years, federal budget allocations to foreign aid fell from a peak of only 0.48 percent of gross domestic product in the 1960s to 0.25 percent by 2000. It has fallen again under the current government to 0.22 percent. Since the 1970s, the United Nations has recommended a level of 0.7 percent (still a modest target).
The Abbott Liberal government in 2013 ended Australia’s commitment to humanitarian aid and economic development assistance and replaced it with a reduced aid program designed specifically to promote its foreign policy and strategic agenda. Symbolically, it disbanded the Australian Agency for International Development and dissolved aid functions into the diplomatic and strategic programs of the Department of Foreign Affairs and Trade.
In May 2020, a new federal government policy approach shifted funds, and the policy objectives of the meagre aid commitment of about $4 billion annually, nominally to a COVID-19 response and recovery agenda for the Pacific and Timor-Leste—without any overall increase in the aid budget. The aim remains to advance Australia’s own strategic, economic and health security agendas.
More broadly, Australia has committed $80 million to the global COVAX program sponsored by the World Health Organization and other international agencies, which aims to deliver two billion doses of vaccine (enough to cover one billion people) across 92 lower-income countries in 2021. The aim is to vaccinate at least 20 percent of the populations in these recipient countries. It remains unclear to what extent this target will be filled and to what extent the program will cover the necessary population numbers to be effective.