Nancy Caripa tested HIV positive in 1999 after battling the disease for years. She had just given birth to her first child. “It was a crossroads moment for me because I was afraid of rejection, but I chose action,” Karipa, now 50, said at an AIDS awareness event in Papua New Guinea’s capital, Port Moresby, in December. She and the baby were treated, and her baby is healthy.
Karipa, from East Sepik in northern PNG, is unusual in sharing her story. Stigma around the disease is high in the Pacific nation, but speaking out has never been more important. This year PNG declared HIV a “national crisis”.
UNAids, the United Nations agency fighting HIV/AIDS worldwide, says PNG has the fastest-growing epidemic in the Asia-Pacific region, along with Fiji and the Philippines.
New infections have doubled since 2010 and it is estimated that only 59% of people living with the virus know they are HIV positive. The increase in infections among women and children is particularly worrying, says UNAids.
Related: Aid cuts have shaken HIV/AIDS care to its core — and mean millions more infections.
“The transmission of [the virus from] Papua New Guinea has a very high mother-to-child ratio, one of the highest globally,” says Manoela Manova, UNAids Country Director for PNG.
Changes in funding for HIV support and prevention have hit PNG hard. Hundreds of clinics have been affected by the suspension of US foreign aid by the Trump administration this year. Sharp global cuts in funding for UNAids are also worrying health providers, and calls are growing for the PNG government to do more.
Manova says that HIV awareness has been declining over time and now, “it’s like the feeling that the epidemic doesn’t exist”.
“This is the perception of both the public and the political class.”
In a country of about 100 million people, the crisis is compounded by a combination of factors including inadequate testing and lack of awareness. UNAids says PNG will record an estimated 11,000 new cases in 2024, with about half of new infections among children and people under 25.
An estimated 2,700 infants were infected with HIV in PNG in 2024. In most cases, mothers were unaware of their HIV status and did not receive the necessary antiretroviral therapy (ART) that could prevent transmission to their children.
“Many people do not know their status and this is the first step in addressing the epidemic [and] Treatment should be done,’ says Manobha.
US aid freezes clinics hit
The government declared HIV a national crisis in June and put in place an emergency response plan, including more testing, treatment and support.
Undersecretary for Health, Ken Wai, says that while the government is responsible for drug supplies, other support services and community access are heavily dependent on US aid. In January, the Trump administration cut foreign aid, which was distributed through the United States Agency for International Development (USAID), although Wye said some funds have been restored to special programs.
“USAID funds an organization called FHI360; they help us with data recording, and a laboratory coordinator supports the central public health laboratory,” says Wai.
The president of the National AIDS Council, Wep Kanawi, says the government must do more to address the crisis. The council works to prevent HIV infection and provide treatment across the country. Kanawi says the government does not receive direct funding from USAID for HIV drugs, but PNG seeks funding from global non-profit organizations that receive contributions from USAID. That supports some HIV programs in PNG, including paying staff salaries, he says.
Kanawi says more than 200 government or church-run clinics that provide HIV services have lost funding after the U.S. suspended foreign aid earlier this year, without elaborating on the services the clinics provide. Kanawi wants the government to do more, and says K45-K50m (US $10m) is needed annually to fight the epidemic.
“Many of our centers are operating but they are lacking in operations,” says Kanawi.
Port Moresby’s Cowegare Clinic, which provides HIV and other health services, is one of the centers affected by the funding freeze. Rose Marai, a social worker at the clinic, says when the Trump administration suspended aid, salaries at the clinic stopped because there was no funding.
“We were not given a second plan and we were asked to close the clinic, which affected the community,” says Marai. “I used to get K1,000 (US$235) a day to conduct awareness programs in communities but now I get K240 monthly since the fund stopped.
“I started doing voluntary counseling of referral patients who were already positive, STI and gender-based violence couples.”
The US Embassy in PNG did not respond to questions about USAID or US funding. In a statement, it said the US is “committed to our partnership with Papua New Guinea”.
“US foreign assistance to PNG, managed through the State Department and other US agencies, includes robust programs in security assistance, disaster preparedness and health.”
At the same time, UNAids has seen what it describes as a “historic funding crisis” this year due to cuts in the US foreign aid budget and cuts from other donor countries. A December report by UNAids said sudden funding cuts and continued funding shortfalls were “having a profound, lasting impact” on the health of millions of people, although it noted that funding for some HIV programs had resumed.
UNAids in PNG say the country has so far been spared the hit because Australia has stepped in with additional funding. In October, the Australian government said it would “increase its annual HIV development funding to around A$10 million this financial year”.
Manova says additional funding from Australia will help sustain the UNAids office in PNG for “the next couple of years”.
Still, concerns are growing in PNG that the epidemic highlights the health sector’s weakness and heavy reliance on foreign aid, amid a surge in infections.
Foreign Minister Justin Takatchenko said the country needed a “fallback position”.
“The long-term strategy is to do it ourselves. We cannot rely on other donor partners for continued support,” he says.
Rebecca Bush contributed to this report
