Tackling antimicrobial resistance in Papua New Guinea

Today we're going to walk through something truly remarkable, the story of a six year journey in Papua New Guinea to build a national antimicrobial resistance surveillance system, basically from the ground up. It's a powerful story of partnership, of persistence, and ultimately of a nation taking full control of a serious threat to its health.

So to really appreciate this achievement, let's set the stage. Antimicrobial resistance, or AMR, is often called the silent pandemic, and for good reason. It's a huge global threat, not just to our health, but to our food security and our economies. It really threatens to undo so much of modern medicine as we know it.

And in a place like Papua New Guinea, that global challenge gets even more complex. You have the country's incredible geography, a high burden of infectious diseases to begin with, and the unique realities of its health system. All these factors create a very specific and very tough environment for tackling AMR.

So recognizing all this, a very deliberate journey began back in 2020. And the goal was never just a short term project. The idea was to build a lasting, nationally owned system that could truly stand up to this threat for years to come. Let's dive into how they made that happen.

Now. This is absolutely crucial to understand. This transformation wasn't the work of just one organization. It was a strategic coalition, a real partnership, and it was all built on a foundation of national leadership.

Right from day one, the government of Papua New Guinea was in the driver's seat. They provided the essential leadership and that sense of national ownership that really anchored the entire initiative. It ensured everything was aligned with the country's own priorities.

Of course, a vision this big needs fuel to make it go. And that's where the Fleming Fund came in. They provided that critical catalytical investment that took this idea from a plan on paper and turned it into a tangible reality. And backing that investment was UK International Development. This was a clear signal of a shared global commitment to health security for everyone, everywhere.

So who was doing the work on the ground? Well, that was the Burnett Institute. They served as the implementing partner, working shoulder to shoulder with national institutions to build up that local capacity and create systems that were designed to last. And finally, to make sure a program of this scale ran smoothly, Mott McDonald's served as the fund manager. They provided that really important governance and oversight, making sure everything was accountable and on track.

OK, so we've met the team. Now let's get into the transformation itself. This wasn't a quick fix. It was a methodical step by step process of building a very complex system over six dedicated years.

This table, I mean it really says it all. The transformation is just night and day. Before 2020, what you had was a patchwork, inconsistent labs, no clear reference role, no standard way of reporting. Now Fast forward to 2026 and the picture is completely different. You've got 5 functional Sentinel sites, clear oversight from national laboratories, standardized testing across the board, and a formal yearly reporting process to global systems.

It's a total shift from fragmentation to a truly coordinated national system, and you can see on this timeline just how that progress was built piece by piece. It started in 2020 with figuring out where things stood. By 2022, that core network of labs was up and running.

Then a huge moment in 2023, the country's first ever data submission to the WH OS global Surveillance system. By 2024, the first national report was out, all leading to this moment in 2026, the formal handover of a mature functioning system.

So after all that work, what does it all add up to? Let's look at the actual outcomes. Because this isn't just about collecting data, it's about building permanent institutional capacity for the entire nation.

At the very heart of this new capacity are 5 operational human health Sentinel laboratories. And these aren't just five separate buildings. Think of them as the interconnected backbone, the nervous system of a truly national surveillance network.

OK, so the bedrock of this entire system really rests on 2 central Illars, the National Reference Laboratories. These are the anchors for both human and animal health. Let's take a closer look at how these crucial foundations were put in place.

First up, the Central Public Health Laboratory. It's been completely transformed, renovated and equipped with some really state-of-the-art diagnostic technology. We're talking about automated systems like the BD Phoenix for rapid identification and resistance testing, plus confirmatory testing with the Breuker, Sirius, MALDI, TOF for highly accurate identification.

What this all means is that the CHL is now the National Data Coordination Center. It's the hub that generates the official annual National AMR Surveillance report, a huge shift to structured national oversight.

And at the same time, the National Animal Health and Food Testing Laboratory was fully renovated. It now leads active surveillance in key sectors like poultry, swine and aquaculture. And here's a major first For the very first time, AMR data from animal health has been systematically analyzed and submitted to help shape national policy. This is a perfect example of the One Health framework in action.

All right, so we have this strong national framework, but what does that actually look like on the front lines of healthcare? Well, now we turn to the individual stories of the Sentinel hospitals. This is a true roll call of excellence right across the nation.

Let's start our journey in the nation's capital at Port Moresby General Hospital. The work here has been foundational. A modern standardized BSL 2 microbiology lab was established, a safe, high quality environment. They've also brought in automated blood culture and testing systems, which has dramatically improved their diagnostic capability. And that's led to real tangible clinical tools like the hospital's very first antibiotogram. And it's also driven the launch of a structured antimicrobial stewardship program. Just fantastic progress.

Next up, we traveled to the Eastern Highlands and to Goroka Provincial Hospital. What happened at Goroka was a truly massive milestone, not just for the country, but for the entire Pacific region. With its new automated systems running, Goroka started submitting surveillance data to the WH OS Global Antimicrobial Resistance and Use Surveillance System. That's GLASS. This made Papua New Guinea the very first Pacific Island country to contribute, putting it firmly on the global stage.

Our roll call continues on to the Western Highlands at Mount Hagen Provincial Hospital. The story of Mount Hagen is really one of incredible resilience and quality. Think about this, even while their lab was being renovated, surveillance operations just kept on going without any interruption. And despite a high volume of specimens, contamination levels stayed consistently low, which is just a crystal clear sign of a strong quality management system at work.

From there, let's move over to Mirobe Province and Angao Memorial Provincial Hospital. At Angao, the big focus has been on strengthening that absolutely critical link between the laboratory and the clinic by improving communication. Lab results are no longer just data points on a page, They're the start of a conversation between technicians and clinicians, helping to support better, more informed patient management every single day.

And our final stop on this hospital journey takes us to East New Britain and Rabal Provincial Hospital. Now, Rabal faced some pretty significant logistical hurdles, but despite those challenges, the team there successfully completed their lab repairs and got new automated systems installed as one of the newer sites. The rapid progress is just a testament to their incredible institutional commitment and a real drive to accelerate development.

OK, so we've seen the national reference labs in the Sentinel hospitals on the ground. But how does this all connect to that bigger picture of one health, particularly on the animal health side? Well, this is where the regulatory authority comes in to tie it all together.

The National Agriculture Quarantine and Inspection Authority, or Nakia, provides that crucial oversight. Their process is so systematic. It starts with field surveillance, collecting specimens from farms, Then come secure lab transport for testing. The data is then reported internationally. And here's the critical part. That evidence is used to drive policy, which led to Papua New Guinea's first ever antibiotic prescribing guidelines for animal health.

And all of this incredible work brings us right here. The conversation is no longer just about building the system, it's about sustaining it for the future. And that means a deliberate, thoughtful transition to national stewardship.

Now, sustaining a system like this means being honest and clear eyed. There are incredibly strong components in place. The lab network, the reference labs, the reporting, that's all now embedded. But we also have to acknowledge the vulnerabilities, things like logistics for getting specimens where they need to go, keeping a skilled workforce and securing consistent budgets for equipment. These are real challenges that will need ongoing national focus and investment.

And that brings us to what is really the core message of this moment. Today doesn't mark the end of a project. It marks the proud beginning of national stewardship of a vital public health asset. The foundation has been laid, and the responsibility now transitions into capable hands.

This entire system was built in partnership, drawing on the strengths of so many different groups, its future, its strength, and its power to protect the health of this nation. All of that will be secured by sustained national leadership.

The journey continues.