AS PAPUA NEW GUINEA continues its battle to contain and prevent malaria, officials say the government's decision to resign as the principal recipient of monies from the Global Fund to Fight AIDS, Tuberculosis and Malaria, will improve its response.
"Stepping down as a principal recipient was a difficult decision to make," said Leo Sora Makita, principal technical adviser for malaria and vector-borne disease for the Department of Health. "We actually had to step down because we need a principal recipient that can effectively manage the funds and report back to Global Fund."
The decision followed a Global Fund audit in September and October 2010, when it found the Department of Health had not complied with grant guidelines and some $7 million had been misdirected.
Makita agreed there were some weaknesses in the system and the funds were not managed effectively. Since April, when the Department of Health announced it would no longer shoulder the management of the $50 million in Global Fund grants, discussions on how to keep the money flowing to this South Pacific island nation have taken place behind closed doors with the Global Fund's country coordinating mechanism.
"In general, when changes of principal recipients occur in countries, there are certain delays and disruptions in program implementation. However, life-saving treatment is never affected," said Marcela Rojo, spokeswoman for the Global Fund in Geneva.
Oil Search, one of PNG's biggest and oldest companies, was appointed the new principal recipient at end-June. In addition to producing oil and gas in PNG, Oil Search has run several successful anti-malarial programs since the 1990s and says it has an expertise that can be tapped for its new role.
"When the Department of Health was looking at pulling out of managing the money, we put our hand up to take on the responsibility," Peter Botten, managing director of Oil Search, said.
Botten said he foresees a more predictable and effective delivery on the Global Fund grant goals with Oil Search at the helm of money management, but working in conjunction with the Department of Health.
With 90% of the nation's six million people at risk of contracting malaria, combined with a growing resistance to Chloroquine, the first line of treatment, the government of PNG considers malaria among the country's top five health issues.
The country achieved a 26% decrease in malaria cases from 2004-09, from 1.9 million reported cases in 2004 to 1.4 million in 2009, according to the World Health Organisation. But such a reduction does not constitute a success story just yet, said Zaixing Zhang, malarial scientist with WHO in Port Moresby.
"Malaria control is one of the priorities of the country and national health plan. It's not under control, but the number of reported cases is going down," he said.
There is a growing fear that positive gains may be undone due to the increased population mobility following the unprecedented boom in resource development.
"There is a big increase in population mobility, allowing for dispersal of malaria parasites across the country as well as changes in the environment due to resource developments like logging, mining, oil drilling and plantation projects that create more vector breeding sites," said Iraingo Moses of Population Services International.
In a paper to a workshop on malaria in Port Moresby in March, Moses said the general worsening of health services and the breakdown in drug supplies in rural areas had also increased malarial risks.
The recent decision by the Department of Health to turn inward, restructure and bolster its capacity reflected this reality, some say.
In his letter to the Global Fund in which the Department of Health requested to cease its principal recipient obligations, Clement Malau, the head of the Department of Health, said the health and financial systems in PNG were fragile and needed continued support to meet all their obligations.
As Oil Search assumes the principal recipient role in the beginning of 2012, the Department of Health will still implement malaria projects while overhauling its operations.
Source: IRIN News, UN Office for the Coordination of Humanitarian Affairs