Table of Contents
Policy making on AIDS in Papua New Guinea has a number of features which set it apart from policy making on other subjects. Most obviously, AIDS presents a new subject for policy, unknown before the mid 1980s; the relevant inheritance from other sectors of policy is not limited to health, since AIDS affects all sectors concerned with development. Because AIDS has been a new issue, the process of its emergence on the policy agenda and the ways in which it has been defined as an issue must be examined; these are taken for granted in other sectors. Finally, because a major part of the strategy for dealing with AIDS concerns prevention through behaviour change, a range of cultural beliefs and practices concerning sensitive issues, particularly those of sexuality and gender relations, are brought to the fore in exceptional fashion; hence examining policy in isolation from practice is especially futile in relation to AIDS.[1]
Although overseas aid has played a significant role in the shaping of public policy in most sectors in Papua New Guinea, the international process of defining AIDS and of establishing a repertoire of policy responses has ensured that external precedents have been unusually forceful in shaping national AIDS policy. Thus it is impossible to discuss policy making on AIDS in Papua New Guinea without locating it within a global setting of policy making.
After the initial identification in the US of clusters of disease among immune-suppressed gay men in July 1981, other groups were found to be affected by what became known as the Acquired Immuno-Deficiency Syndrome (AIDS). In April 1984 discovery of the virus Human Immuno-Deficiency Virus (HIV) was announced and tests to identify those infected were rapidly developed. Although the World Health Organization was slow to mobilize a response to AIDS, it established in 1986 a Global Program on AIDS (GPA) which developed models, initially in Uganda, for short-term and medium-term HIV/AIDS programs for non-Western countries. GPA also convoked consultations among a growing band of AIDS specialists; these identified the principles of community-based health promotion adopted by Australia (Ballard 1998) and a few other Western countries as international best practice in the response to AIDS.
In July 1987, at the request of the Australian government, GPA turned its attention to Asia and the Pacific in a regional ministerial conference held in Sydney. GPA then organized week-long missions to most Southeast Asian and Pacific countries, including Papua New Guinea, to initiate planning for short-term programs. These followed the classical bio-medical template of responses: surveillance of sexually transmitted infection, information and education, and blood screening. From an early stage, GPA also brought together country AIDS managers for orientation and training. Up until the mid 1990s GPA provided substantial technical assistance as well as over K100,000 per year for research and projects, but little of this was actually spent.
GPA’s successor UNAIDS, apart from regional conferences and training, gave low priority to the Pacific. In recent years technical assistance on AIDS has come from governments, notably Australia, while international non-government organizations, most of them faith-based, have been increasingly involved in financing, sponsoring and providing AIDS projects in Papua New Guinea, often in the context of wider health programs.
[1] The term AIDS is used here in relation to policy, despite the common elision of HIV/AIDS to cover HIV as virus with AIDS as a syndrome of diseases produced by deterioration of the immune system.