The Torres Strait Cross Border Health Issues Committee (HIC) met by teleconference, on Thursday 27 April 2017. The HIC is a biannual forum to identify health issues arising in the Torres Strait Protected Zone and South Fly coast of Papua New Guinea (PNG), and members work collaboratively to identify appropriate strategies and resources to address these concerns.

Members endorsed the minutes of the meeting of 24 November 2016 and noted progress on actions arising from previous meetings.

The Committee acknowledged that there has been significant progress made on the tuberculosis (TB) Emergency Response in PNG including the considerable success with increased case findings, zero loss to follow up of patients at Daru, and the introduction of rapid diagnostic testing. However, substantial challenges still remain, including the funding gap to support the National TB Strategic Plan 2015-2020. A lack of human resources, poor understanding and implementation of the basic principles of Directly Observed Treatment Short Course (DOTS) and weak laboratory capacity were identified as challenges in PNG.

Shortage of PNG Government funding continues to pose a challenge for proceeding with building works, including addressing deteriorating infrastructure at Daru General Hospital (DGH) and upgrades to the Bula, Buzi, Mari and Sigabaduru Aid Posts to Community Health Posts. However, some building works have commenced at the DGH, including the construction of five new staff houses.

Members noted the Department of Foreign Affairs and Trade's (DFAT's) ongoing support for TB management and health infrastructure in Western Province, PNG. Construction of the new Mabadauan Health Centre will commence shortly and traditional inhabitants confirmed support with clearing the site. The Mabadauan Health Centre will be redeveloped through the Rural Primary Health Services Delivery Project (RPHSDP), which is a partnership agreement between DFAT, Asian Development Bank and PNG National Department of Health (NDOH).The RPHSDP will include staff training, capacity building and the roll out of the electronic National Health Information System (eNHIS).

There was extensive discussion around the movement of PNG nationals and the referral pathways for PNG nationals to receive medical treatment. In this regard, DGH agreed to expedite the recruitment of a Cross Border Communications Officer, to help improve coordination efforts with Queensland Health. Transportation of PNG patients with non-urgent medical conditions continues to be a problem as well as the perception of overcrowding at DGH. However, the retrieval of urgent medical cases from Queensland health facilities to DGH has improved.

The consideration of re-establishing the Clinical Collaboration Group (CCG) or another mechanism where operational and clinical issues can be discussed is being facilitated by Queensland Department of Health (QDOH), in consultation with key stakeholders.

Torres and Cape Hospital and Health Service is reviewing its draft policy on the treatment of PNG nationals in their public health facilities following initial comments by HIC members in accordance with the Torres Strait Treaty and immigration provisions.

Australian Border Force is investigating the CCG's request for options to facilitate cross border medical evacuations and members noted that following legal advice, a further update will be provided.

The HIC also noted reports from:

• QDOH on TB and communicable disease surveillance;
• PNG's Provincial Health Office on health activities in the South Fly District of Western Province, noting declining infrastructure and activities due to lack of human resources, funding constraints and transportation challenges; and
• DGH on the proposed Rural Outreach Programs for Western Province.

The next HIC meeting is tentatively scheduled for late 2017 as a face-to-face meeting in PNG in the lead up to the Joint Advisory Council (JAC) and in a location and date to be determined by PNG Department of Foreign Affairs.