The Torres Strait Cross Border Health Issues Committee (HIC) met on Thursday Island, Australia, on Thursday 24 November 2016. 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 welcomed new members, including from the Torres Strait Regional Authority, Queensland Government Departments of Health (QDOH) and Premier and Cabinet, and Australian Border Force (ABF). Members sadly noted the passing of the Honorable Aide Ganasi, Mr John Stokes and Mr Richard Aria from PNG Western Province.

Members endorsed the minutes of the meeting of 28 April 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 since the release of K8 million by the PNG Government in January 2016. However this progress remains fragile and the Emergency Response has been extended for a further 12 months.

There are substantial challenges including the lack of release of the remaining PNG funding to implement the accelerated response plan to address multi-drug resistant and extensively-drug resistant TB in PNG. There is a funding gap to support the National Strategic Plan 2015-2020. A lack of human resources and weak laboratory capacity were also identified as challenges in PNG.

Shortage of PNG Government funding also continues to pose a challenge for proceeding with building works; including addressing deteriorating infrastructure at Daru General Hospital and upgrades to the Bula, Buzi, Mari and Sigabaduru Aid Posts to Community Health Posts. Funding for infrastructure is uncertain due to the redirection of funds to support the 2017 PNG national elections and preparations for the APEC meeting in PNG in 2018 among other key priority programs of the PNG Government.

Members noted DFAT's ongoing support for TB management and health infrastructure in Western Province, PNG. Construction of the new Mabadauan Health Centre has been delayed due to ongoing land issues. Members noted the considerable efforts by NDOH and Western Province authorities to resolve the issuance of the Certificate of Authorising Occupancy so that work can commence.

There was extensive discussion around the movement of PNG nationals and the referral pathways for PNG nationals to receive medical treatment. The importance of communication was discussed, and there is strong support for ongoing education and awareness raising in the Torres Strait and PNG treaty villages. In this regard, members supported the recommendation that Torres Strait Councillors participate in future treaty awareness visits to the PNG treaty villages.

The HIC recommended further investigation is needed to either re-establish the Clinical Collaboration Group (CCG) or another mechanism for which clinical issues can be discussed.

QDOH also presented for comment the first draft of their policy on the treatment of PNG nationals in Queensland public health facilities and would appreciate any comments for consideration by the end of December 2016. Queensland Health will be monitoring the policy and associated procedures and ensure its ongoing effectiveness.

ABF are still investigating the CCG's request for the HIC to investigate options for facilitating 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 outreach activities and immunisation coverage due to lack of human resources, funding constraints and transportation challenges; and
• Daru General Hospital on the progress made and the gaps in rural health services.

The next HIC meeting is tentatively scheduled for April 2017 in Cairns, Australia.