IMAGE: Burnet's new RID-TB program staff Dr Khai Huang, Dr Peter Wallis and Dr Amanda Wallis

Burnet Institute has launched phase II of the Reducing the Impact of Drug-resistant Tuberculosis (RID-TB) Western Province project (2016-17) with the appointment of three new field staff, based in Daru, Western Province, Papua New Guinea (PNG).

Daru Island in South Fly District (SFD) is the epicentre of an outbreak of drug- resistant tuberculosis (DR-TB), including extensively drug-resistant TB (XDR-TB) with rates that are very likely the highest recorded in the world at a sub-national level.

The alarming situation in Daru carries a specific international risk and provides urgency and focus to address both drug-sensitive (DS-TB) and resistant strains of the disease and accelerate the comprehensive plans of the National TB Program of PNG.

The Burnet field staff includes husband and wife, Drs Peter and Amanda Wallis, who will be based at Daru Hospital for the next 12 months.

Peter is the Field Team Leader and Amanda, as Medical Implementer, will be the first point of contact for the program for patients previously undiagnosed.

With backgrounds in paediatric and emergency medicine, the couple have extensive experience working in the PNG Highlands, with Médecins Sans Frontiers in Africa, and TB programs in Kenya.

They’re joined by Dr Khai Huang, who will serve as Field Technical Co-ordinator for six months before returning to Burnet in Melbourne to take up the role of Infectious Diseases Officer.

“In the first couple of weeks we’ll be trying to observe and get a good grasp of what’s working well and get an understanding of the system and stakeholders and people involved,” Dr Huang said.

“Hopefully moving forward from that we can recognise ways that things can be done better to help improve the program.

“The eventual goal is to expand the program, decentralise care, reduce the suffering caused by TB and ultimately try to stop the epidemic.”

Peter Wallis said the trio is looking forward to working in partnership with the provincial team already on the ground in Daru to strengthen their systems around the diagnosis, treatment and care of TB in general and drug-resistant TB in particular.

“Drug-resistant tuberculosis is a disease that requires long courses of treatment with multiple antibiotics, which have a lot of side effects that can be difficult for patients to take, so it’s a relatively complicated disease to treat,” he said.

“Mathematical modelling projections have shown that if drug-resistant TB programs are not expanded, the disease will continue to spread and overcome the drug-sensitive strain in Western Province.

“The situation in Daru is particularly unique, as there is evidence of person-to-person spread of DR-TB in the community, including XDR-TB, which is an outbreak.”

Burnet Infectious Diseases Specialist Dr Suman Majumdar said Burnet is well placed to build capacity in the local systems and response, and apply the best available global knowledge and practice.

“An outbreak response includes involving and engaging the community, actively searching for all cases in households, effectively treating all forms of TB (DS/DR) and preventing and treating exposure to TB (infection),” Dr Majumdar said.

“The rapid uptake of research and innovations – new tests, shorter treatments and preventive medications for DR-TB – could break the back of this epidemic in PNG if delivered effectively.”

Burnet Director and CEO Professor Brendan Crabb said the Institute values its strong partnership with the Western Province Health Office and the Governments of PNG and Australia.

“We congratulate the Australian Government for recognising this and supporting the TB response in PNG and investing in the research and development of new tools,” Professor Crabb said.

“These investments need to continue along with the broader investments in regional health and development assistance to promote a healthier and more prosperous region.

“TB affects people in their productive years and can lead to catastrophic social costs for families and community. TB is a major barrier to social and economic development in PNG.

“The region and the world cannot afford to be complacent with TB any longer. It is a curable disease.”

The Papua New Guinea National Department of Health and the World Health Organization called a meeting with their partners and community representatives on 25th November 2015 to discuss how to accelerate assistance for tuberculosis (TB) control and the multidrug-resistant TB (MDR-TB) epidemic in Daru Island, Western Province.

The joint statement from the meeting can be downloaded here.

To find out more about Burnet’s TB program in Western Province, click here.