Advocates, alarmed by appalling global response to MDR-TB outbreak in Papua New Guinea, call on international agencies to take action

TB CAB Treatment Action Group
April 21, 2016, 8:09 p.m.
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Advocates denounced the global response to an MDR-TB outbreak in Papua New Guinea and urged international agencies to immediately intervene.

On March 23rd, the Global TB Community Advisory Board (TB CAB) and Treatment Action Group (TAG) sent an open letter to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Health Organization (WHO), the United States Agency for International Development (USAID), and the Western Pacific Region Green Light Committee (GLC) Chair regarding the insufficient global response to the multidrug-resistant TB (MDR-TB) outbreak in Papua New Guinea.

MDR-TB infects over 170 people in Papua New Guinea each week; only one-third of notified cases are receiving treatment, and far more cases go undetected. In Daru Island, the hotspot of the epidemic, over 1% of the general population has MDR-TB.

In November 2015, the government of Papua New Guinea issued a cry for help calling on international agencies for support to ensure successful implementation of the government plan to address the MDR-TB outbreak. To date, global actors have left this call unanswered and in fact, have advised Papua New Guinea not to scale up new tools that are critical for diagnosing and treating MDR-TB.

The letter outlines steps that need to be undertaken to successfully address the MDR-TB outbreak in Papua New Guinea and urges international agencies to immediately take action.

The advocates requested an emergency call with the involved agencies and expect a response to the letter by 1 April 2016.

To read the full letter, click here.


On 8 April 2016, the WHO Global TB Programme, the Global Fund, and USAID sent the TB CAB a joint response, expressing that they share the concerns about the crisis of MDR-TB in Papua New Guinea, pointing to recent programmatic improvements-- including new policies released by the National TB Programme of PNG for MDR-TB care delivery, available here, and agreeing that the response to the crisis of MDR-TB in PNG needs to be intensified and accelerated:

"Considerable needs remain in PNG despite the accelerated efforts of the last 12 months... We are hoping that TAG and TBCAB will join us in providing support and advice to strengthening of the rGLCs by attracting interest from civil society as one of the key rGLC constituencies."

You can download their full response to the open letter here.


On 21 April 2016, the TB CAB reacted to the joint response sent by the international agencies earlier in April by requesting again an emergency call to discuss the MDR-TB crisis in Papua New Guinea and further steps. Here is the email sent by Erica Lessem on behalf of the TB CAB:

Dear colleagues,

We received your reply and are encouraged to hear you share our concerns about the inadequacy of the response to the MDR-TB situation in Daru, Papua New Guinea and welcome our participation in finding solutions. However, we are disappointed that your reply failed to address many of the specific issues and action items we outlined-- most notably, the request to schedule an emergency teleconference to discuss these matters.

In particular, we did not see anything in your response addressing our concerns about the lack of transparency of the rGLCs or plans to make rGLC documents publicly available; which we specifically requested. We have not heard from you about concrete plans to meaningfully and sustainably engage communities in Papua New Guinea. And we still have not received confirmation that it has been explicitly communicated to the Papua New Guinea government that the roll-out of GeneXpert and new and repurposed drugs for MDR-TB in line with WHO guidance is encouraged, and that Global Fund funding is available to do so.

We would appreciate it if you could please provide immediately some date and time options for a teleconference during the first week in May so we can discuss these issues more fully.

I will be out of the office next week but my colleague Lindsay McKenna can help set up the time with the TB CAB, and I look forward to speaking with you when I return.

Erica Lessem on behalf of the Global TB Community Advisory Board