After more than 10 years of being declared Polio free by the WHO, the disease is back! And there are many other diseases that were once on the decline in PNG are now back and the number continue to increase each year. These re-emergence of diseases once thought to be decreasing is a direct reflection of the declining and now fragile public health service in PNG.

A rapidly increasing population (around 3% p.a) compounded by constraints in health resources has resulted in a decline in the quality of primary health care in PNG. I also think a major contributor to disease outbreak is the uncontrolled growth and unregulated growth of settlements in PNG creating the ‘urban poor’ population. When settlements spring up without planning for other support services such as water, sanitation and health service, diseases such as polio and other vaccine preventable diseases start to emerge. And that is what we are seeing in the urban PNG.

The focus of training for the health workforce therefore should be public health and primary health care. Much has been written about the resource constraints for the health service but this has to be fixed, focusing on resourcing urban clinics and rural health centers for the delivery of basic primary health care and public health services.