HIV mainstreaming in Papua New Guinea, and its role in supporting good governance

The HIV epidemic in Papua New Guinea is demanding increased attention, both as a health and a development issue. The current prevalence level is accepted to be about 2 per cent with a steady upward trend.1 The worst affected age group is that between 20 and 35 years; in other words, the most productive age group and the next generation of leaders and voters. There are multiple factors contributing to the epidemic in Papua New Guinea; these include gender inequity, poverty, high and increasing mobility and urbanisation, high incidence of multiple sexual partners, high levels of sexually transmitted infections, low literacy, and lack of access to services. Although prevention remains at the heart of the government’s response, increasing global attention to access to anti-retroviral drugs (ARVs) emphasises the importance of the health sector’s contribution to fighting the disease. However, few developing countries can afford to focus only on the health aspects of HIV. This is, in part, because ARVs are too expensive as a sole strategy in spite of their diminishing cost and because more fundamental social and political changes are required for sustainable reduction of vulnerabilities to infection. In response, the National AIDS Council has developed a comprehensive HIV and AIDS strategy (NACS Strategic Plan 2006– 2010). The strategy focuses on prevention, care and treatment and includes a commitment to mainstreaming in recognition of the fact that HIV touches on every aspect of society: social, religious, political, economic and cultural.