2 Responses

  1. Stephen Howes
    Stephen Howes August 13, 2012 at 12:37 pm

    Ben, Thanks very much for this positive response, and the additional information you provide. In the interests of accuracy, I would note that the authors don’t talk of “evidence” that the new programs will lead to XDR-TB, but rather point to “threats” that, if not dealt with, might lead to this unfortunate outcome. That’s a very different claim, and not one I think you’d disagree with.

  2. Benedict David
    Benedict David August 10, 2012 at 5:43 pm

    TB in PNG and Western Province is one of AusAID’s highest priorities and we welcome the debate on cross-border TB control.

    There has been real progress and commitment from PNG. With AusAID support, PNG TB experts such as Dr. Rendi Moke and his team have shown real leadership and drive. They are making a real difference in Western Province. (See http://www.ausaid.gov.au/HotTopics/Pages/Display.aspx?QID=677)

    AusAID is committed to long term support (10+ years) for TB services in Western Province, including broader support to Western Province’s health system. Our approach is in line with the World Health Organization (WHO) best practice guidelines for TB and addresses many of the issues raised by the authors. These include: the need for long term support to the PNG health system; ensuring access to primary health and appropriate hospital TB services; a strong focus on community engagement in controlling TB; and independent monitoring and evaluation.

    We have an initial $8.5 million program over four years to support the PNG Government to strengthen control of TB in Western Province and it will continue for as long as necessary. We also support Western Province primary and secondary health care services, essential for TB control, though improving the supply of essential drugs, training health workers and health infrastructure. This includes South Fly communities. We also provide core funding to the Global Fund for AIDs, TB and Malaria (GFATM) for PNG’s national TB program (total program US19 million) and core support to WHO – the global technical lead on TB and other communicable diseases. Our total package of support to PNG health priorities (including HIV) in 2011/12 was $113 million.

    Other Australian government agencies are responsible for health and TB services within Australia. AusAID’s mandate is to work within PNG borders. We are working to support cross border coordination, oversight and accountability through the Torres Strait Health Issues Committee (HIC).

    The blog authors note the risks of incomplete TB treatment within Australia, an issue raised by an independent WHO expert assessment in October 2011. WHO plans to undertake a substantive epidemiological risk assessment in September 2012 which will include a specific focus on drug resistant TB cases.

    AusAID support to the PNG South Fly TB program is based on established WHO global standards for an effective TB and MDR-TB response. Our support seeks to ensure continuity of care through a strong community based response and appropriate hospital care. This approach, backed by WHO, is proven to work internationally and to have an impact. There is no evidence that “…the net outcome of these programs will be rapid emergence of XDR-TB.”

    There has been real progress and commitment from PNG. AusAID will continue to work closely with the PNG government, WHO and other Australian partners to monitor progress of our support and adjust accordingly. WHO will be undertaking an independent review of the progress of the strengthening of the TB services in the South Fly in November 2012.

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