As the Covid-19 pandemic has highlighted critical problems ^[1] in Papua New Guinea’s vaccination programs and threatened the country’s health security and economic prospects, how, and why, must Australia help?

Australia provides development aid to PNG ^[2] of more than $600 million a year. Some of that has been redirected towards a Covid-19 response plan ^[3] focusing on health security ^[4], stability and economic recovery.

This is not just about being a good neighbour. Australia has its own interests at stake in PNG. Covid-19 and any of its future mutations are only a boat ride away. Villages in the PNG–Australia shared treaty zone were cut off from Australian deliveries ^[5] in September and had to source food from Daru and Port Moresby in PNG where there are large numbers of Covid-19 cases. In conditions like these, the Delta variant of the disease could well spread into the Torres Strait.

Other looming threats include PNG’s alarming rates of antibiotic-resistant strains ^[6] of tuberculosis, HIV and malaria. In the past decade, PNG has had outbreaks of polio, measles and cholera ^[7].

The rural and isolated Western Province has sometimes fallen into the ‘too-hard’ category for both the PNG and Australian governments, resulting in infrastructure gaps ^[8]. PNG’s government only recently confirmed that Daru, the provincial capital, needs a hospital ^[9]. Ever observant of such gaps, China has focused on Western Province ^[10], raising questions about the security implications of Belt and Road Initiative projects on Australia’s doorstep and reminding policymakers not to overlook PNG’s critical strategic geography.

But Australia’s considerable interests in this picture shouldn’t be the key driver for support. PNG, like our other Pacific neighbours, would likely welcome Australia elevating bilateral health and security partnerships—but only if they’re built on goodwill, mutual respect and consultation. Australian policymakers must keep asking PNG representatives and communities what problems they want assistance with and how they think Australia can help.

PNG has among the lowest vaccine rates globally ^[11] for Covid-19, measles, hepatitis B and the combined diphtheria, whooping cough and tetanus shot. The short- to medium-term imperative is to vaccinate the population, which means convincing people that vaccines are safe and essential. The two-pronged approach should be to give people information they need, and to combat misinformation.

Misinformation has eroded public trust in health workers ^[12], the PNG and Australian government ^[13]s, and institutions like the World Health Organization. PNG’s health ministry is broadcasting Covid information online ^[14], but many citizens lack internet access and the government has put the onus on Facebook ^[15] to combat misinformation. Although PNG’s government is now pursuing stronger, clearer messaging, more effective sources are needed to fill the information void.

Religious leaders have a significant influence in the mostly Christian country and can play a big role in combating misinformation. A recent statement ^[16] by the PNG Council of Churches endorsed Covid-19 vaccinations, pushing back against increasing ‘vaccine apathy’ ^[17] caused by beliefs that the virus won’t harm the pious. An Australia-backed ‘sleeves up’ program enlists well-known ^[18] former rugby league player Mal Meninga in a country where the sport is extremely popular.

As more public figures endorse the vaccine, Australia should project credible messages using the most widely accessible medium ^[19]. Radio has huge potential as a public health and safety resource in PNG and, as reflected in a recent Lowy Institute report ^[20], it may be critical in ‘bridging the information divide’. While the report focuses on how radio can support democratic processes, there’s also significant potential for it to combat misinformation.

Australia should support PNG’s national broadcasting network, which lacks coverage and requires transmitter maintenance. It should reinstate ^[21] ABC shortwave radio programs. To help rebuild public trust in PNG’s medical institutions and government, Australia could broadcast a dedicated Covid-19-related channel featuring health experts and PNG public figures.

But even if an effective vaccination program is delivered, PNG’s economy will still face significant issues and Australia can help address them. Pandemic restrictions have undermined productivity, crippled the tourism industry ^[7] and inhibited crucial fly-in, fly-out, or FIFO, work. As soon as it’s feasible, Australia should reopen opportunities for bilateral economic integration.

Australia’s agriculture sector is crying out for more labour, and the newly reformed ^[22] Pacific Labour Scheme and Seasonal Worker Program ^[23] is set to double recruitment caps and reduce red tape ^[24]. The scheme can provide PNG citizens with employment and experience while meeting Australian worker shortages.

Agriculture is key to PNG’s economy ^[25] and will likely become more important. Australia should help skilled PNG workers to develop further training and expertise, particularly in FIFO-dependent industries ^[25] and the health sector. Considering PNG’s sizeable informal economy, ^[26] specialised small business training and private-sector mentorship programs could be highly effective.

Overdue improvements to the situation of women could bring major economic benefits. While women make up nearly half of PNG’s workforce ^[27], most work in the informal sector ^[28], which is dogged by ^[29] lower incomes, limited advancement prospects and dangerous working conditions. Many women are raising children. Soaring rates ^[30] of abuse ^[31], affecting two in three women ^[32], significantly impact their participation and productivity in the workforce. Domestic violence in PNG requires its own sustained and dedicated public and civil-society response ^[33].

This situation costs PNG a large part of its potential workforce and things will only improve if more women, along with PNG’s burgeoning youth population ^[34], are able to access education and training.

Education is a globally recognised Australian export which could provide PNG comprehensive programs for children and training for adults to increase school retention rates and give mothers opportunities to build skills. Education empowers recipients and sets the groundwork for sovereign-led development. Increasing PNG’s skilled workforce is the first step to reducing its dependence on foreign expertise ^[35].

The broad consequences of Covid-19 may well push PNG’s government to create a dedicated ministerial portfolio to coordinate the national response to the virus, as it did for HIV-AIDS ^[36]. Australia could finance expert support in this area.

Problems in PNG’s health system are well researched and it’s time for decisive action. A report ^[37] by the parliamentary Public Accounts Committee last year details reasons for widespread failures in medicine procurement, supply and distribution. Another by the Australian National University explains failures ^[38] to implement prior health reforms.

Australia can’t commandeer the response to these issues, but it can do more to make itself an active partner on the road to recovery. In the short term, equipment donations and AUSMAT deployments should continue.

But follow-through is paramount. In July, Minister for International Development and the Pacific Zed Seselja officially opened parts of ANGAU Memorial Hospital redeveloped with Australian funding. Yet, ANGAU’s persistent shortages ^[39] mean patients are sent to buy their own dressings and drugs from elsewhere.

Celebrated upgrades sit incongruously with persistent structural gaps. It’s time to think longer term about PNG’s health system and acknowledge that these gaps will keep demanding Australian development resources—unless, perhaps, Australian industries engage more heavily with PNG.

Domestically, Australia’s engagement with PNG is surprisingly low-key, especially in terms of media coverage and public awareness. But elements of academia, healthcare, civil society and business have strong ties to PNG. They’re pushing for more trade and business investmen ^[40]t, researching ways to improve on past health reforms ^[38], encouraging PNG citizens to build expertise in Australia ^[41] and volunteering in PNG’s hospitals ^[42].

Australian policymakers should do more to grow this community and encourage more Australians to engage with PNG. The stronger these links, the more Australia’s development assistance will be naturally supplanted by multi-industry cooperation, and both nations will be better for it.