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Monday, 26 November 2012
Page: 13376


Mr MARLES (CorioParliamentary Secretary for Pacific Island Affairs and Parliamentary Secretary for Foreign Affairs) (20:27): 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.