Powerful partnerships to End TB

by PNG Business News - September 13, 2022

Photo credit: B4H

This week in Kokopo the Businesses for Health (B4H) TB project partnered with leading businesses to address PNG’s ongoing Tuberculosis crisis. Even though drugs that eradicate TB have been around since 1944, worldwide 1.5 million people still died of the illness in 2020.

TB has been in PNG a long time. In the 1930s it was the largest cause of death at the Nonga hospital in East New Britain. In 2022, TB remains the most common reason for admission to hospital both in ENB and at the Port Moresby General Hospital in the National Capital.  This year PNG will record at least another 4300 deaths from TB. B4H is working with businesses to change this.

B4H works hand in hand with business to generate workplace TB leaders who learn to address TB issues in their workplaces as well as with their families and local communities.  “TB is a serious development challenge for Papua New Guinea. At B4H we work to grow leaders in the workplace who can speak up and act.  Awareness alone is not enough.  Ignorance, stigma and complacency about poor health kills people, says Dr Ann Clarke B4H project manager, “to help address this every workplace needs policies and people trained to deliver activities to enable early case finding and swift return to work.

This is why Kokopo businesses sent people to our 3-day workplace TB course. They will now go on to change the mindset and improve health seeking behaviour. Employees leave our training knowing that coughing is not normal. They learn coughing is a sign of disease, and all people with persistent coughs need kindly and respectfully to be supported to get checked.  It is completely unacceptable to let workers, family or community members die of this preventable and treatable disease.”

Over thirty local business leaders attended our TB update evening hosted by the Rabaul Hotel in ENB. PNG Air flew us here, The Gazelle Hotel hosted our team to deliver workplace training, the Remington Group printed our training manuals. These businesses know exactly how much just one ignored, or badly managed case of TB can impact their people and profits. TB is a massive burden on the PNG economy, Dr Clarke continued.

“By teaching people about the long and complex clinical pathways for TB, introducing them to the provincial health teams and services we build confidence in and access to free TB services.  We are so pleased to include local experts like Dr Grace Baiwan, Physician at NONGA. Dr Grace made it very clear, we can end TB if people bring her patients quickly before they create more TB patients. The trainees also met the TB and HIV teams at Butuwin Health Centre as part of our course. This is not just sit-down training. This is about building health leadership and learning to speak up, B4H TB HEO Koratsi explained.

TB is not just an East New Britain issue; this is a regional issue. We need everyone in our region to pitch in with all their political, economic, and humanitarian might.  The suffering generated by 40,000 TB cases in PNG is a crisis for anyone seeking to live, work or study overseas or enjoy a long and healthy life in PNG.

B4H is grateful for some support for the project managers role from the Global Fund’s COVID-19 response grant to PNG. Without it, Dr Clarke would be unable to be here at all. Her task is to restore business participation in their mission to end TB. The trainees in Kokopo are strong women (and a few men) who are now empowered to speak up. We leave ENB knowing we have 19 more loud and informed voices to drive change and save lives.  B4H is a brilliant example of what we achieve in partnership with the Department of Health, the private sector and donors.  Dr Clarke said.

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Photo: TB HEO and No Buai Day campaign leader Teresa Koratsi. World No Buai Day is Friday October 7.  As COVID-19 restrictions ease, Businesses for Health is encouraging people who want to end their chewing habit to sign up for their “World No Buai Day” campaign.  COVID-19 has disrupted work and social lives in so many ways. It’s also had some unexpected consequences.  Whilst the infection control benefits of mask wearing are well known, in PNG masks have enabled people to hide their workday chewing.  With fewer mask wearing requirements in place, we are kicking off our campaign to get the workers of PNG to consider the health and financial costs of chewing buai.  We have set the campaign to run over seven fortnights or 96 days.  This gives chewers time to think, analyse, plan, and to find colleagues and friends to support them in reducing their chewing habit.  B4H understands that chewing is part of many people’s usual routines, so planning is required if people are going to be successful in reducing their dependency on PNG’s favourite addictive drug – betel nut! B4H Campaign leader and participant TB HEO  Teresa said “the sooner people reduce their chewing, the better it is for their health.  But people we also recognise that chewing is an addiction and it’s not something they can successfully achieve without talking to family, friends, and colleagues. Addicts need encouragement or friends to join them in the campaign.” The campaign is structured so quitters like me can think and plan, before cutting back.  Its only a good idea to make announcements on social media about quitting buai chewing during the working week, when we have gathered support and carefully analysed the size and scope of the challenge.  I am being encouraged and rewarded by my colleagues, but I need to know my family and friends will help me avoid situations where everyone else is chewing.  We need to be surrounded by people who recognise that chewing is associated with so many threats to long-term health and well-being.  My parents were health workers, I grew up knowing chewing was unhealthy and unacceptable at work.  I know chewing is associated with diseases like TB that thrive when the immune system is put under pressure.  I also know I am addicted and COVID has put us all under so much strain. When I was wearing a mask 24/7 it was easy for me to sneak in some extra chewing without my colleagues knowing. Making October 7 my quit date is easier than starting on January 1 when we are all holidays,” says HEO Teresa. “At Businesses for Health I train people in early case finding for Tuberculosis and support people to kind to people terrified by a diagnosis of TB or HIV.  In supporting people with TB or HIV we use care, kindness, and support to help people to achieve better treatment compliance, and it reduces fear.  We recommending people wanting to quit chewing use the same strategies. On B4H campaign Chew Challenge chart we have set some challenges. We are offering to send people reminders and notes of support. Best of all the campaign end date is well before Christmas holidays,” said Teresa. The Campaign specifically states we are aiming to quit workweek chewing and is not advocating for a global lifetime buai ban.  It would be disrespectful and foolish to expect people not to chew at haus krais or other events at which chewing maybe an ancient tradition.  We also want people to learn to manage their habit, keep on trying and go gentle on themselves. We recommend registering with the B4H campaign to get reminders and encouragement along the way to NOT chewing in the working week by World No Buai Day,” said Dr Clarke B4H project manager.   A poster and resource pack for participants and their supporters is available at https://businesses4health.com/buai-challenge  .  In the pack, is a chewing diary, a challenge chart to mark off each day of the campaign.  People who register for the campaign are invited to contribute stories about their successes and challenges to our Facebook page@B4HTB. Businesses for Health is PNG not for profit association. The PNG team is 100% supported by PNG’s private sector supporters who are working to reduce the burden of TB deaths and disease on businesses, their employees, and their families.  In 2022, Dr Clarke’s time to PNG is supported by the Global Fund for TB/HIV and Malaria.

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Paul Oeka - September 29, 2022


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Paul Oeka - September 28, 2022


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PNG Business News - September 28, 2022

PNG’s minimum wage

Commentary by Stephen Howes, Kingtau Mambon and Kelly Samof The urban minimum wage has been an important part of Papua New Guinea’s economic history. In the last few years before independence (in 1975), it was greatly increased. In the decade or so after independence, it was widely regarded as too high. In 1992, it was slashed, merged with the rural minimum, and hardly increased again for more than a decade. We can compare the minimum wage in PNG today with other Asia and Pacific developing countries using International Labour Organization (ILO) data. As Figure 1 shows, PNG’s minimum wage is 18% below the average of the 19 countries shown if the market exchange rate is used to compare minimum wages. It is 37% below the average if differences in cost of living are also taken into account (with conversions made on the basis not of market exchange rates but so-called purchasing power parities or PPPs). The greater difference in terms of PPPs reflects PNG’s relatively high cost of living. Of the countries shown, only Samoa and Kiribati have a lower minimum wage than PNG when a PPP comparison is made. This is very different to the past. Raymond Goodman, Charles Lepani and David Morawetz in their 1985 report The economy of Papua New Guinea compared minimum wages in PNG with a subset of the countries above back in 1978. Then, the PNG minimum wage was about twice as big or more than the other comparators. Today (using market exchange rates, and the earlier authors do), PNG comes in the middle of the pack, as Figure 2 shows. So far, we have shown that around the time of independence minimum wages were very high in PNG by international standards, and that they no longer are. Figure 3 shows how this change came about – also, for interest, comparing trends in PNG with those in Australia. Both the PNG and Australian weekly minimum wages are shown in Figure 3 measured in Australian dollars. The PNG minimum wage is converted into Australian dollars using the current exchange rate. Both wages are then adjusted for inflation and expressed in 2021 prices. The two series follow diametrically opposed paths. The Australian minimum wage fell with the high inflation of the 1970s and industrial relations reforms of the 1980s, and by the early 1990s was little more than half its value in the 1970s. It then increased in the late 1990s and 2000s during the resource boom, and has continued to increase. Adjusting for inflation, it is now almost back to where it was in the early 1970s. The PNG minimum wage does the opposite. It increased in the 1970s and was then held stable due to indexation, until the big bang reforms of 1992. Adjusted for inflation, PNG’s minimum wage continued to fall until 2004. There have since been some significant increases, but today PNG’s minimum wage is only about one-third of its value at independence, and below its value even in 1972, which is when the steep minimum wage increases began. The Australian minimum wage has always been significantly higher than the PNG one, but the ratio has changed a lot over time. The lowest that ratio has ever been is 2.2 in 1986, the highest 45 in 2004. The gap between the two wages is much higher now than at independence: the ratio of the Australian to the PNG minimum wage was 14.5 in 2021, compared to only 3.2 at independence (1975). This reflects PNG’s 1992 deregulation, and the faster growth in the Australian economy, which has enabled an increase in the Australian minimum wage. The solution to low wages in PNG is not necessarily to increase the minimum. In some sectors, where there is a lot of international competition, a higher minimum wage might lead to job losses. For example, in tuna processing, one of PNG’s main competitors is the Philippines. From Figure 1, we can see that PNG’s minimum wage is lower than the Philippines' on the basis of PPPs, but actually higher on the basis of market exchange rates. While the former is what matters for the welfare of workers, the latter is what matters for international competitiveness. Whether PNG’s minimum wage should be increased will require a lot more analysis. The point of this blog is simply that PNG’s minimum wage does not look high any more by international comparisons, as it has fallen a lot since independence. PNG is often described as a high-cost economy, and this is a fair description. However, with regards to unskilled labour, it is no longer a high-wage economy.   Data note: The PNG Economic Database provides the weekly minimum wage of PNG going back to 1972, and the PGK-AUD exchange rate. Wikipedia provides the Australian weekly minimum wage data (hourly and weekly, on the assumption of a 38-hour week) starting from 1966. The Australian CPI is from the Australian aid tracker. There are some years where Australian minimum wage rates change more than once in a year. For such cases, we took the average as annual minimum wage rate. The data for Asia-Pacific comparisons are from the International Labour Organization and the World Bank. The different frequencies of minimum wages for each country in 2019 in the ILO’s report are adjusted to convert to weekly rates. World Bank data is used to obtain market exchange rates and PPP conversion factors. For the Goodman, et al., data go to Table 3.6 on p.61 in their report.\ Disclosure: This research was undertaken with the support of the ANU-UPNG Partnership, an initiative of the PNG-Australia Partnership, funded by the Department of Foreign Affairs and Trade. The views are those of the authors only. This article appeared first on Devpolicy Blog (devpolicy.org), from the Development Policy Centre at The Australian National University. Stephen Howes is Director of the Development Policy Centre and Professor of Economics at the Crawford School of Public Policy, at The Australian National University. Kingtau Mambon is currently undertaking a Master of International and Development Economics at the ANU Crawford School of Public Policy, for which he was awarded a scholarship through the ANU-UPNG Partnership. Kelly Samof is a lecturer in economics at the School of Business and Public Policy, University of Papua New Guinea.

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