Papua New Guinea

WHO/Sophea Aing

Papua New Guinea

Requirements (US$): 5.6 million

Context

Papua New Guinea ranks eighth among countries with the highest disaster risk according to the World Risk Index. This is compounded by disease outbreaks and low immunization coverage, like the recently circulating vaccine-derived poliovirus (cVDP1); the presence of zoonotic diseases (e.g., chikungunya and dengue hemorrhagic fever) and a limited capacity to respond due to the country’s weak health system and infrastructure. Human-induced crises due to conflict, displacement, gender-based violence (GBV) and tribal conflict and health-related climate change risks complicate the public health emergency response due to limited accessibility and geographic remoteness. Building a resilient health system is crucial to improving health security. Using provincial emergency response centers (PEOC) and focusing on the response at the last mile using a one-health approach needs to be prioritized.

As of 109 December 2022, Papua New Guinea reported a total of 46 457 confirmed COVID-19 cases and 669 deaths. The predominant Variants of Concern (VOC) are Omicron BA.2 and BA.5, with a heterogenous prevalence across the 22 provinces. Only 6.8% of the population (approx. 350 000 people) have been vaccinated with at least one dose of a COVID-19 vaccine, and 290 462 people were fully vaccinated; more than 90% of Papua New Guinea's population remains unvaccinated. Vaccination amongst the vulnerable population, including health care providers, is also low.

Papua New Guinea is expected to face considerable challenges from the pandemic in the coming years. The country’s extremely low level of vaccination – one of the lowest rates in the world – means COVID-19 outbreaks could put a significant strain on an already stretched public health system and pose both a risk of increased loss of life and a negative impact on domestic economic activity.

WHO/Sophea Aing
Lab team training in Mount Hagen. June 2022.

Emergency response

The recently endorsed National Health Plan 2021-2030 acknowledges that emerging and re-emergence of pandemics, outbreaks, natural disasters, human-induced crises and other emergency events are unavoidable in the country. The COVID-19 National Emergency Response Plan (ERP), developed in 2020 and aligned with the Asia-Pacific Strategy for Emerging Diseases and Public Health Emergencies (APSED III), remains the basis for the whole-of-government and whole-of-society approach to the pandemic. A multi-stakeholder coordinating body – the National Coordination Centre (NCC) – was established and, along with the enactment of the National Pandemic Act in 2020, displays the Government of Papua New Guinea's commitment to this approach.

Papua New Guinea has responded to three major surges of COVID-19 and the response focused on developing alternative care pathways, building the provincial and district response and case-based approaches for vulnerable populations. The WHO country office has been supporting the COVID-19 pandemic, preparedness and responses since January 2020. Preparedness in-between surges included conducting a surge analysis to predict when health systems would be overwhelmed and developing e-modules for the continuum of care training of health care providers.

The COVID-19 pandemic highlighted the need for a strengthened logistics system. Points of entry and multisource surveillance were able to detect the upsurge in cases and monitor responses. Work is ongoing to reach the long-term goal of building a molecular hub for Whole Genome Sequencing (WGS) for multiple pathogens and emerging variants of interest (VOI) and variants of concern (VOC), as well as for coordinating the rapid response at the provincial and district level based on epidemiological and WGS data.

Priority areas for the joint response to COVID-19 are epidemiology, laboratory and surveillance, partnership and coordination, resource mobilization, risk communication, operational support and logistics, infection prevention and control and clinical and case management. Over 100 personnel have been deployed to support the national response to date. At the same time, WHO continues to provide sound and evidence-based technical advice to the Government.

Strategic objectives

key activities

Support implementation of the COVID-19 ERP to reduce morbidity and mortality from COVID-19 and other respiratory pathogens using Provincial Emergency Operations and a One Health approach
Implement the Papua New Guinea Incident Management System and Team Workplan based on nine pillars (including coordination, risk communication, surveillance, laboratories and diagnostics, vaccination, etc.) to strengthen the health system
Strengthen technical capacity and multi-sectoral coordination using the whole-of-government approach to outbreaks and health emergencies by implementing the NHP key result areas related to international health regulations (IHR) Develop and implement the National Action Plan for Health Security for multi-hazards preparedness
Align the universal health coverage (UHC) Action Framework, build core capacities for the IHR health workforce and accelerate the implementation of the APSED III Pacific focus areas (i.e., field epidemiology, surveillance, risk communication and zoonosis)
Implement and build capacities toward climate-resilient and environmentally sustainable health care facilities

Funding requirements (US$’000)

Success stories

Epidemiology, sampling and interpretation of Variants of Concerns (VOC)

Papua New Guinea has a national sampling strategy developed for SARS-CoV-2 whole genome sequencing (WGS). As WGS is carried out offshore, there is a time lag receiving the results, making planning for the response difficult.

To offset the delays in obtaining WGS results, Papua New Guinea has been working to synthesize and analyze epidemiological, clinical and laboratory data and use data modeling to look at the sub-national heterogenous epidemics. These data are then used for surge planning at the provincial level so that there is increased awareness of any early changes in the behavior of VOCs.

Preparedness and response plans have been developed at the provincial health authorities (PHAs) level, because of the heterogeneity of the micro-epidemics and by training rapid response teams at the last mile. WHO teams are now able to coordinate an appropriate response to the local surge of cases.

There was a need for a strategy for offshore genome sequencing in some of the Pacific countries, such as Papua New Guinea where the lab systems strengthening approach will take a longer time. It is suggested that near the point of care (POC), tests could screen off the known VOC and the unknown emerging variants could then be sent for offshore WGS. This would help shorten the turnaround time for Pacific countries to detect new or emerging VOCs or high-threat pathogens in the future.