Dr Anasaini Cama of the Fred Hollows Foundation conducts tropical disease training in the Solomon Islands. Credit: Shea Flynn/RTI International

By Catherine Wilson
SYDNEY, Australia, Feb 25 2026 (IPS)

Two Pacific Island nations have been applauded for their successes in the global health campaign to eliminate the infectious eye disease, Trachoma.

Better disease data, effective treatment campaigns and improved access to water and hygiene contributed to the major progress now being celebrated as 27 nations worldwide are declared Trachoma-free by the World Health Organization (WHO). But, above all, experts say that the key to the permanent riddance of diseases is a genuine buy-in to the eradication programmes by entire communities.

“Trachoma elimination efforts are most effective when communities understand the disease, trust the interventions and are actively involved in prevention activities,” Dr Anasaini Cama, Pacific Trachoma Technical Lead at The Fred Hollows Foundation, a global non-government organisation working to eradicate preventable blindness, told IPS.

Finally eliminating Trachoma in countries such as Papua New Guinea is a major achievement when more than 80 percent of people live in rural and remote communities, where the risk of infection is especially high.

“This milestone reflects the power of public health at its best…It is a reminder that equity, visibility and prevention must be at the heart of our health system,” Elias Kapavore, Minister for Health in PNG, the most populous Pacific Island nation of more than 10 million people, told the media last year.

The infectious eye disease is one of 21 Neglected Tropical Diseases that, under Sustainable Development Goal 3.3, are being targeted for global eradication by 2030. And reports reveal that strides are being made. Between 2002 and 2025, a period of little more than two decades, the global population at risk of Trachoma fell from 1.5 billion to 97.1 million people, WHO reported in January.

Children in rural communities in southwest Pacific Island countries, including Papua New Guinea, were highly vulnerable to eye infections, such as Trachoma. Now the country has been applauded for its campaign to eliminate the disease. Credit: Catherine Wilson/IPS

“Trachoma, once a leading cause of blindness in Fiji, was widespread in the 1950s, with prevalence exceeding 20 percent among children in some areas. Today, following sustained national action, the prevalence of active Trachoma has fallen to below 1 percent,” Fiji’s Health Minister, Dr Ratu Antonio Lalabalavu, told local media.

Trachoma is the leading cause of blindness around the world and is found primarily in tropical climate zones and rural communities affected by poverty and lack of basic services. It is caused by a micro-organism, Chlamydia trachomatis, known to be carried by flies, with children and those living in overcrowded conditions the most vulnerable. In advanced cases of the disease, there is chronic scarring of the underside of the eyelid, which can then turn inward, resulting in the eyelashes inflicting permanent damage to the eye’s cornea.

Trachoma was first identified in PNG and Fiji when health surveys were conducted in the 1950s. Studies also revealed that it was endemic in the Solomon Islands and Vanuatu. More recently, in 2015, extensive studies were carried out in the provinces of Central, Madang, Morobe, East New Britain, Southern Highlands and Western in PNG as part of the Global Trachoma Mapping Project. The prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years was found to be between 6 percent and 12.2 percent, exceeding the WHO threshold of 5 percent.

The disease can be debilitating and make it increasingly difficult for a child to attend and participate in school classes and, thus, hinder their development and increase their exposure to poverty and malnutrition.

Changing the conditions and habits through which the disease thrives is, therefore, crucial. And this is a vital part of WHO’s recommended approach, called the SAFE strategy. That is, surgery for patients with an advanced stage of the disease, including blindness, prescribing antibiotics to diminish infection, encouraging facial cleanliness, and environmental improvements.

Today, the development charity Mercy Works is working to boost better health in very remote villages in Kiunga in Western Province, close to the far western border of PNG, by ensuring supplies of clean water. Here, “safe water remains a daily challenge,” Andrew Lowry, Head of Mercy Works’ Programs, told IPS. “Frequent flooding contaminates water sources and damages infrastructure. Many communities have no road access, so materials and tradespeople travel by plane or boat, and often on foot. Schools and health centres often operate without a reliable water supply, making basic hygiene practices difficult to sustain.”

Mercy Works installs rainwater collection and storage systems in schools, health centres, and villages in both the Western Province and the Simbu Province in the Highlands region.

Nearly 4,000 kilometres southeast of PNG in Fiji, Cama has witnessed the impacts of eye diseases and interventions that have been effective. In the north of the country, she visited villages that were kept clean and neat and it was difficult to see if there was overcrowding in the households. “Generally, extended families living together is considered normal. What we did notice, and similarly in nearby villages, was the water issues, where water was not always available and water trucks would cart water to the village,” Cama told IPS.

In the community, “children were active and did not appear unwell in any way,” she recounted. “It was only when health care workers flipped the child’s eyelids that the inner surface of the eyelid would have follicles that were typical for Trachoma.” Once a child was diagnosed, Tetracycline eye ointment was prescribed to be applied twice a day for six weeks, together with recommended regular face washing.

This year, WHO announced that, for the first time since world records began, the number of people requiring healthcare intervention for Trachoma has fallen below 100 million. Yet the future cannot be one of complacency. Rising climate extremes across the Pacific Islands could reverse this achievement.

“Climate change can impact Trachoma programmes and cause re-emergence of Trachoma, meaning long-term vigilance is required,” Cama emphasised. “Flooding and warmer temperatures can damage sanitation systems that lead to a reduction in environmental hygiene, causing an increase in the presence of flies in the community, which can increase the spread of Trachoma. Through drought and low rainfall, accessibility to water is decreased, making regular face washing and hygiene more challenging.”

Boosting the number of trained health professionals is also critical in countries where national health services battle against limited resources, medical supplies and manpower. “One of the biggest challenges in the Pacific is the shortage of trained eye care specialists,” Cama said.

This is the case in both Fiji and PNG, where “only 8 of 22 provinces actually have an eye doctor”. To overcome this deficit, the Fred Hollows Foundation established the Pacific Eye Institute, the region’s first ophthalmic training institute, in Suva, Fiji. “Our goal is to have at least one eye doctor and a team of eye nurses in every province [in PNG],” she said.

The dividends of extinguishing diseases, such as Trachoma, are profound for people and communities. And aspirations of national development can be realised when health services contend with a diminished burden of illness, more children can finish their education and more people of working age can contribute to their communities and the economy.

Note: This article is brought to you by IPS Noram in collaboration with INPS Japan and Soka Gakkai International in consultative status with ECOSOC.

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Logistic and communication challenges to rolling out the COVID-19 vaccine are immense in the rural and remote highlands region of Papua New Guinea. Credit: Catherine Wilson

By Catherine Wilson
CANBERRA, Australia , Jul 13 2021 (IPS)

Papua New Guinea (PNG), like many other Pacific Island countries, successfully held COVID-19 at bay last year, aided by early shutting of national borders. However, by March this year, the pandemic was surging in the most populous Pacific Island nation, and by July, it had reported 17,282 cases of the virus and 175 fatalities.

PNG has a steep battle against the virus ahead, made more problematic by a high rate of refusal by health workers to take the vaccine. PNG’s Health Minister, Jelta Wong, stressed in an interview with Australia’s Lowy Institute for International Policy in April that “the vaccine will be the key to containing COVID-19 in our country.”

But in Eastern Highlands Province in the country’s rural interior, Dr Max Manape, the province’s Director of Public Health, told IPS that “in our province, there is a huge COVID-19 hesitancy due to so much negativity of COVID-19 vaccinations in social media and we are finding it very hard to convince our fellow frontline workers, including health workers.” By early July, only 23.3 percent of all health and essential workers in the province were vaccinated, including 329 health workers.

The situation is causing wider community concern. “Health workers are the frontline and first responders in this pandemic, and their refusal places them at a greater risk to contract the virus. This will lead to the feared collapse of our struggling health system, and the roll-on effect of other deaths from preventable diseases and maternal health issues created by a lack of manpower,” a spokesperson for the PNG National Council of Women told IPS.

In April, the country was supplied with 132,000 doses of the AstraZeneca vaccine, the first batch of a total supply of 588,000 doses by COVAX, the global alliance of organizations, including the World Health Organization (WHO), working to achieve equitable vaccine access. The Australian Government also supplied eight thousand doses. The national vaccination rollout began in early May, with priority given to frontline responders.

Yet progress has been very slow. By this month, only 59,125 people in a national population of about 9 million had been vaccinated, including 7,844 health workers. The largest group of healthcare recipients, about 1,150, were located in the capital, Port Moresby.

PNG’s Health Minister says there are numerous challenges to achieving widespread inoculation. “In this country, we’ve never had an adult vaccine go out, we’ve always had the children’s ones, and that has worked really well. It is going to be a real challenge for us to do this vaccination rollout…The biggest thing will be education. Our people need to be educated enough to know that this vaccine will help them in the future,” Wong said.

More than 80 percent of people in PNG live in rural and remote areas where logistic and communication challenges are the greatest. Here scepticism of the vaccine is high. Only 12 percent of all health and essential workers in remote Enga Province in the northwestern highlands region have been vaccinated. “The uptake of the vaccine is very poor in Enga Province. Frontline health workers at the hospital have mostly refused the vaccine,” Dr David Mills, Director of Rural Health and Training at Kompiam District Hospital in the province, told IPS.

However, it’s a nationwide issue. PNG’s newspaper, The National, conducted a public online survey last month, reporting that 77 percent of respondents did not want the vaccine. In May, a survey of students at the University of Papua New Guinea by the Crawford School of Public Policy at the Australian National University, Canberra, revealed a high level of indecision among respondents. Only 6 percent said they would accept the vaccine, 46 percent had not decided either way, while 48 percent planned to refuse it.

Doctors and health care leaders claim that major reasons for the low uptake are cultural and religious opposition, misinformation and conspiracy theories being touted on social media. And lack of public trust in the country’s health system, which, for decades, has struggled with an insufficient workforce, very poor infrastructure, and resources.

However, Dr Mills said that the government was very active in responding to conspiracy theories with facts and authoritative health information. “There is plenty of information, too much information. It’s a blizzard of information but sorting it out is the hard part. Keep in mind that there is a high level of mistrust and scepticism generally in this society. People don’t take anything at face value. It’s fertile soil for believing alternative hypotheses,” he said.

Confusion was one of the biggest reasons for indecision among respondents to the Australian National University’s survey. And they were more likely to trust the information provided by local Christian leaders (32 percent), followed by family and friends (31 percent) and the WHO (29 percent). In contrast, faith in the government as a source of information was negative (-8) percent, leading to the study’s conclusion that ‘distrust of institutions of authority and vaccine hesitance goes together.’

Despite having an economy based on natural and mineral resource wealth, PNG has a relatively low human development ranking of 155 out of 189 countries and territories, and basic service delivery beyond urban centres, hindered by lack of investment and corruption, has been deficient for decades. There are 0.5 physicians and 5.3 nurses per 10,000 people in the country, according to the WHO.

Distrust of the vaccine by healthcare staff has consequences. “High vaccine refusal amongst health workers, particularly nurses, confuses the general public and fosters vaccine scepticism. And unvaccinated health workers can be a danger to the very vulnerable patients that we have as inpatients in hospitals,” Professor Glen Mola, Head of Reproductive Health, Obstetrics and Gynaecology at the School of Medicine and Health Services, University of Papua New Guinea in Port Moresby, told IPS.

Although uptake by health staff in the capital could change following a new ruling at the Port Moresby General Hospital. “Recently, the hospital board approved a policy of the hospital management that any new health workers, contract renewals and trainees, like interns and medical students, must be vaccinated before they can enter the clinical care areas of the hospital,” Professor Mola said.

However, in the highlands, Dr Mills said the challenges were too great for vaccinating everyone. “For the broader population, vaccination was never going to be the way out (of the pandemic). The uptake is too small, the delivery too small, and delivery mechanisms too weak. We will get to herd immunity the hard way, which is by getting most people infected,” he claimed.

Nevertheless, in June, further funding of US$30 million was approved by the World Bank to boost PNG’s COVID-19 inoculation program, where it is now being offered to all citizens aged 18 years and over.

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Following an almost unanimous 97.7 percent referendum vote in November of last year for Independence from PNG, the people of Bougainville returned to the polls last month to decide on a new government. Bougainville's main town of Buka. Credit: Catherine Wilson/IPS

By Catherine Wilson
CANBERRA, Australia, Sep 29 2020 (IPS)

Ishmael Toroama, a former revolutionary leader and fighter during the decade long civil war which engulfed the remote islands of Bougainville in Papua New Guinea (PNG) in the 1990s, has been elected the autonomous region’s new President ahead of high-level talks about its political future.

“I, as your mandated President, am ready to take Bougainville forward, focussing on law and order, anti-corruption policies, the [referendum] ratification process and improving the fiscal self-reliance of Bougainville,” Toroama said in a public statement on the occasion of his swearing in as President in the region’s main town of Buka on the Sept. 25. He will be supported in a caretaker government for the next two weeks by his new Vice President, Patrick Nisira, MP for Halia constituency in North Bougainville, and Therese Kaetavara, Women’s Representative for South Bougainville.

Toroama, who defeated 24 other presidential candidates, is a strategic choice. Following an almost unanimous 97.7 percent referendum vote in November of last year for Independence from PNG, the people of Bougainville returned to the polls last month to decide on a new government. It is now tasked with carrying the autonomous region on a challenging political journey toward the long held local aspiration for nationhood.

“The referendum was a turning point…looking at all the 25 candidates, people were looking for who could deliver and successfully talk about Independence [with the PNG Government],” Aloysius Laukai, Manager of the local New Dawn FM radio station, told IPS. Laukai claims that “the election was conducted well” and widely accepted as free and fair. The campaigning and voting periods were reported as organised and peaceful, in spite of some alleged cases of misplaced voting papers.

The islands of Bougainville, with a population of about 300,000 people, are located more than 900 kilometres east of the PNG mainland. Bougainville hit the world headlines in 1989 when an indigenous landowner uprising against the then Rio-Tinto majority owned Panguna copper mine on Bougainville Island escalated into a civil war which raged on until a ceasefire in 1998. The peace agreement, signed in 2001, provided for establishing an autonomous government, which occurred in 2005, and a referendum on the region’s future political status.

Despite having only one recorded case of COVID-19, to date, the Bougainville government declared a state of emergency in March, which led to the delay of the general election, originally planned during the first half of this year.

Former President John Momis, who has led Bougainville for the past 10 years and been a prominent local political leader and figure of stability for more than four decades, bowed out of the race, having served the maximum two terms in office.  The field then mushroomed into an unprecedented more than 400 candidates vying for 40 parliamentary seats and 25 hopefuls for the presidency.

Alluding to the stakes ahead, Momis called for unity as voters turned out to cast their ballots from Aug. 12 to Sept. 1. “Let us all walk this journey together as one people and one voice to decide our leaders for this next government that will lead us to our ultimate political future that is within the confines of democratic values and international best practice standards,” Momis stated on Aug. 17.

While also a pro-Independence advocate, Momis, a former Roman Catholic priest with extensive experience in peacetime politics, is a contrasting figure to Toroama. His achievements include serving in the national parliament, playing a major role in the region’s peace negotiations and serving as Bougainville’s governor after the conflict from 1999 to 2005.

The new President was a commander in the Bougainville Revolutionary Army, a guerrilla force which instigated an armed uprising following grievances about the environmental devastation and economic inequity associated with the foreign-owned Panguna mine. He has not been a political leader or served in government administration, although he played a vital role in the peace talks which ended the conflict. More recently, he has been a successful cocoa farmer.

Geraldine Valei, Executive Officer of the Bougainville Women’s Federation, offered another perspective on the overwhelming support Toroama received at the ballot box. “The reason why we say that he is the right person is because, in our Melanesian way of resolving conflicts, if you start the war then you are the one to resolve it,” Valei told IPS, adding that, “he [Toroama] will, of course, need support from very good advisors to lead as President.”

Toroama’s rivals for the top office included James Tanis, who held the office of President briefly from 2008 to 2010, another former rebel ex-combatant, Sam Kauona, and local businessman, Fidelis Semoso. There were also two female candidates in the running: Ruby Miringka, a healthcare professional who has also worked for the Bougainville Referendum Commission, and Magdalene Toroansi, a former Bougainville Minister for Women.

Bougainville’s fourth government will face enormous challenges in the next five-year term to build a weak economy, improve governance and the capacity of institutions, all still in need of reconstruction and development following widespread destruction on the islands during the conflict. 

Valei told IPS that she would like to see the new President “strengthen good governance, have zero tolerance of corruption, strengthen law and order and advocate for the ratification of Independence from Papua New Guinea”.

Toroama also faces huge public expectations to bring about the region’s long held dream of Independence.  Aspirations for self-determination in the region pre-date both the civil war and PNG’s Independence. The islands of Bougainville were brought under the umbrella of the new Papua New Guinean nation in 1975. But they are geographically located far from the PNG mainland and the islanders trace their ethnic and cultural kinship instead to the Solomon Islands, an archipelago to the immediate southeast of Bougainville.

However, the decisive result of last year’s referendum is non-binding. Long and complex negotiations between the PNG and Bougainville governments to agree the region’s new political status will occur over the coming months and years. Talks at the national level will be informed by input from local forums in Bougainville, comprising representatives of communities, ex-combatants, business leaders, women and youths. The final decision will then be ratified by the PNG Parliament. There is no deadline for this process, but Toroama has indicated he would like a decision reached within two to three years.

PNG’s Prime Minister, James Marape, has voiced his support and respect for the process ahead and the wishes of the Bougainville people. “I look forward to working with President-Elect Toroama in progressing consultations on the outcome of the recent referendum and securing long term economic development and a lasting peace for the people of Bougainville,” Marape said in a statement issued soon after the election results were announced.

Yet, the PNG Government is known to not favour full secession, preferring the region to remain within a ‘united’ PNG under a form of greater autonomy.

Looking ahead, economic experts claim that, with a weak economy and heavy dependence on international aid and funding from the national government, Bougainville would face a long period of transition to being an economically viable state, potentially up to 20 years.