One Health AMR and biodiversity in Papua New Guinea

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Following the Burnet Institute’s presentation at the Royal Zoological Society of New South Wales, we speak to Programme Director Professor Robert Power and One Health Animal Officer Paula Pupune on the threat of growing antimicrobial resistance (AMR) in Papua New Guinea (PNG).

The Burnet Institute is the Fleming Fund country grantee in PNG. They bring together experts in animal and human health, microbiology, and data surveillance to support PNG’s in-country AMR response – including establishing bacteriology diagnostics for hospital patient care, and surveillance of bacteria affecting poultry agriculture.

Taking place in Sydney, Australia, the One Health forum showed how interactions with nature can drive new infectious diseases which impact animals and people, and can alter entire ecosystems. As strains of these diseases become resistant to antimicrobials, they can no longer be effectively treated; in the future, they may be entirely incurable. We found out how the Fleming Fund in PNG is addressing this.

Daniel Kelly, from NAQIA, presenting on the AMR response in PNG at the Royal Zoological Society's New South Wales Conference in Sydney, Australia.

With an ecosystem that ranges from mangroves, montane, savannah and tropical forest to coral-rimmed sands and sea, PNG harbours some of the world's most biologically rich diversity. The forest provides subsistence for food, building materials, and economic activity for over 80% of the 8.5 million population.

The previous deforestation practice and free-range animal production system were not feasible with increased national and global demand. This has been caused by a rising population, pressure on open land with urbanisation, growing domestic and international markets, and increased commercialisation of lucrative crops. In response to these changes, agricultural inputs including fertilisers, pesticides, fungicides, and veterinary medications have been introduced to increase production.

The use of agricultural inputs (fertilisers, pesticides and animal medicines) can lead to soil degradation and water pollution, which disrupts the ecosystem. The chemical residues from these inputs are detrimental to the public’s health; agricultural teams are exposed through handling, and the public consume the residues on food produce. If veterinary antimicrobials are not used responsibly, this can lead to AMR.

Global AMR Call

PNG has joined the global call addressing AMR through the development of the National Action Plan (NAP) from 2019 to 2023. These efforts are coordinated by the AMR Secretariat, which is mutually facilitated by the National Department of Health (DOH), Department of Agriculture and Livestock (DAL), National Agriculture Quarantine and Inspection Authority (NAQIA), and Conservation and Environment Protection Authority (CEPA) and supported by partners.

A One Health Memorandum of Understanding (MoU) signed by the four partners (DOH, DAL, NAQIA & CEPA) enables delivery of the NAP. Many of the activities are implemented by the UK Department of Health Care’s Fleming Fund in PNG.

AMR Response

The AMR challenges in PNG are substantial. The country’s health system and animal health field and laboratory services have limited resources to conduct sample testing and monitoring. Human resources have focused on other viral infections, such as COVID-19, African Swine Fever, and recently Lumpy Skin Disease and Foot and Mouth Disease.

The Fleming Fund, through their country grant in PNG, has supported the development of the Central Public Health Laboratory (CPHL) as an AMR national reference laboratory.

The CPHL strengthens biosafety standard operating procedures and laboratory information management systems (LIMS); trains staff; and equips laboratories to perform isolate identification and antibiotic susceptibility testing (AST) to detect AMR. Strengthened LIMS and staff training has also been extended to the National Animal Health and Food Testing Laboratory (NAHFTL), and will be implemented to other surveillance sites in phase II.

The Doherty Institution based in Melbourne, Australia is supporting the professional development of eight PNG fellows. As a critical initiative for AMR and AMU surveillance, the fellows lead the implementation of the country’s AMR NAP and play a key role in the success of the broader Fleming Fund country grant activities with the Burnet Institute. The ongoing activities include providing the necessary training, coaching, and mentoring of PNG lab technicians and clinicians through its AMR journey – funded by Burnet in-country.

National Biosecurity

As the veterinary authority in PNG, the National Agriculture Quarantine and Inspection Authority (NAQIA) provides quarantine and biosecurity services for the animal microbial samples used in the AMR data surveillance analysis. NAQIA supports the Fleming Fund fellowship programme, helping to develop capacity in AMR and AMU surveillance including training and upskilling laboratory technicians.

The Fleming Fund supports the National Animal Health and Food Testing Laboratory (NAHFTL) in AMR data surveillance by:

• Helping to produce reliable blood culture samples, bacterial identification, and AST results.
• Strengthening AMR surveillance in the animal health sector by a formal sampling plan of sample collection, and testing; with analysis and reporting of AMR results by NAQIA.
• Developing the AMC and AMU surveillance system, and ensuring data is analysed and reported by NAQIA.
• Working with NAQIA as a leader in knowledge management and policy development for AMR, AMU, and AMC in animals, and providing updated information to multi sectors under the AMR Secretariat.

AMR milestones

The recent launch of NAQIA’s ten-year biosecurity policy 2022-2032 broke an AMR milestone. This focuses on PNG’s trade, as well as addressing the challenges of safeguarding and protecting biodiversity and the importation of goods. AMR is also a focus area under the policy as a One Health approach.

The Fleming Fund grant programmes in PNG have been fundamental in setting the platform for sectors to collaboratively implement and advocate for AMR.

The subsequent AMR NAP has resulted in the establishment of robust AMR governance, a One-Health multisector collaboration, an annual AMR symposium, registration of PNG with WHO Global AMR Surveillance System (GLASS) – with the development of surveillance and diagnostic capacity – and training of national fellows to provide sustainable leadership.

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The oral presentation’s authors at the Royal Zoological Society of New South Wales were the Fleming Fund country grant One Health and Animal Health Officer, Ms. Paula Pupune; FFCG Senior Technical Advisor, Dr Amrita Ronnachit; the Chief Veterinary Officer; and Dr Ilagi Puana, Animal Health Officer and Mr Daniel Kelly, from NAQIA.