Nancy Karipa tested positive for HIV in 1999 after battling the disease for many years. She had just given birth to her first child at the time. “This was a crossroads moment for me, I was afraid of being denied, but I chose to act,” Karipa, now in her 50s, said at an AIDS awareness event in Papua New Guinea’s capital, Port Moresby, in December. Both she and the baby received treatment, and the baby remains healthy.
Karipa, who comes from East Sepik in northern Papua New Guinea, is unusual in sharing her story. The stigma of the disease is high in this Pacific nation, but speaking out has never been more important. This year, Papua New Guinea declared HIV a “national crisis.”
UNAIDS, the United Nations agency that fights HIV/AIDS globally, said Papua New Guinea has one of the fastest-growing AIDS epidemics in the Asia-Pacific region, along with Fiji and the Philippines.
The number of new infections has doubled since 2010, and it is estimated that only 59% of people living with the virus know they are HIV-positive. UNAIDS said rising infection rates among women and children were particularly worrying.
Related: Aid cuts have shaken HIV/AIDS treatment to its core – and will mean millions more will be infected in the future
“Transmitted [the virus from] Papua New Guinea has a very high mother-to-child rate, one of the highest in the world. ” said Manoela Manova, UNAIDS Country Director in Papua New Guinea.
Changes in HIV support and prevention funding have hit Papua New Guinea hard. The Trump administration suspended U.S. foreign aid this year, affecting hundreds of clinics. Deep cuts in global funding to UNAIDS are also worrying health service providers, with calls growing for the Papua New Guinea government to do more.
Manova said awareness of HIV has declined over time and now “it feels like the epidemic doesn’t exist.”
“That’s the perception of the public and the political class.”
The crisis in the country of about 10 million people is compounded by factors including insufficient testing and lack of awareness. UNAIDS said Papua New Guinea is expected to see 11,000 new cases in 2024, with nearly half of new infections among children and people under 25 years old.
In 2024, an estimated 2,700 infants were infected with HIV in Papua New Guinea. In most cases, mothers are unaware of their HIV infection and do not receive the necessary antiretroviral treatment (ART) that would prevent the virus from being transmitted to their children.
“Many people don’t know their status, and this is the first step in responding to the epidemic. [and] Get treatment,” Manovar said.
US aid freeze cracks down on clinics
The government declared HIV a national crisis in June and set out contingency plans including more testing, treatment and support.
Deputy Health Minister Ken Wai said that while the government is responsible for drug supply, other support services and community outreach rely heavily on U.S. aid. In January, the Trump administration cut foreign aid allocated through the U.S. Agency for International Development (USAID), but Wei said some funds have been restored for specific projects.
“USAID funded an organization called FHI360; they helped us record the data, and a laboratory coordinator assisted at the central public health laboratory,” Wai said.
National AIDS Council chairman Wepu Kanavi said the government must do more to tackle the crisis. The committee works to prevent the spread of HIV and provide treatment nationwide. The Papua New Guinea government does not receive direct funding for HIV drugs from USAID, Kanavi said, but Papua New Guinea does seek funding from global nonprofits that receive USAID donations. He said this would support a number of HIV programs in Papua New Guinea, including paying staff salaries.
Canaway said more than 200 government- or church-run clinics providing HIV services lost funding after the U.S. suspended foreign aid earlier this year, but he did not provide further details about the services provided by the clinics. Kanavi wants the government to take more action, saying about 45-50 million kina ($10 million) is needed each year to deal with the epidemic.
“Many of our centers are still operating but are scaling down operations,” Canaway said.
Cowher Clinic in Port Moresby, which provides HIV and other medical services, is one of the centers affected by the funding freeze. Rose Marai, a social worker at the clinic, said when the Trump administration suspended aid, the clinic’s wages were withheld because there was no funding.
“We didn’t receive a second plan and we were told to close the clinic, which had an impact on the community,” Malay said. “I used to receive 1,000 kina ($235) to run a day awareness program in the community, but since the funding stopped, I now receive 240 kina a month.
“I started doing voluntary counseling for referred patients, STIs and gender-based violence couples who had already tested positive.”
The U.S. Embassy in Papua New Guinea did not respond to questions about USAID or U.S. funding. It said in a statement that the United States was “committed to our partnership with Papua New Guinea.”
“U.S. foreign assistance to Papua New Guinea is administered through the Department of State and other U.S. agencies and includes robust programs in security cooperation, disaster preparedness, and health.”
Meanwhile, UNAIDS has suffered what it called a “historic funding crisis” this year due to U.S. foreign aid budget cuts and cuts from other donor countries. A December report from UNAIDS said the sudden reduction in funding and continued funding shortfalls “are having a profound and lasting impact on the health of millions of people,” although it noted that funding for some HIV programs has been restarted.
UNAIDS in Papua New Guinea said the country had so far not been hit because Australia stepped in and provided additional funding. In October, the Australian government said it would “increase annual HIV development funding to nearly A$10 million this financial year”.
Manoa said the additional funding from Australia would help sustain the UNAIDS office in Papua New Guinea for “another two years”.
Still, Papua New Guinea is increasingly concerned that the pandemic has highlighted the fragility of the health sector and its heavy reliance on foreign aid amid a surge in infections.
Foreign Minister Justin Tkachenko said the country needed a “fallback position.”
“The long-term strategy is to do it ourselves. We cannot keep relying on other donor partners to help us,” he said.
Rebecca Bush contributed to this report
