SYDNEY – Papua New Guinea appears to have survived the worst coronavirus crisis for a long time. But a spike in cases since February has brought the remote Pacific island’s largest hospital to the brink of collapse.

For the much larger neighbor, Australia, the outbreak is seen as a serious threat as well as a critical moment in a broader “vaccine diplomacy” campaign.

“If the infection continues at the same rate … it won’t be long before we get down to staffing levels where it is impossible to continue with healthcare,” said Professor Glen Mola, a senior and longtime gynecologist. staff member at Port Moresby General Hospital in the capital. “This is really mind-boggling.”

Papua New Guinea has about 500 doctors for its 9 million population, or one for every 17,000. Coronavirus cases have tripled in a month, bringing the total to 5,349 with 49 deaths, and low testing rates perhaps hiding the true scale of the outbreak. Prime Minister James Marape believes a quarter of the population may be infected.

The virus is now infecting hospital workers. Within one week, 120 staff members at the General Hospital contracted COVID-19 and were forced into isolation.

After a photo of a woman dying in a hospital parking lot circulated on social media, the facility’s CEO warned of such a possible death.

The risks extend beyond the coast of Papua New Guinea: In the south, the Australian state of Queensland has recorded a high number of cases in its hotel quarantine program and has the most active infection anywhere in the country. The majority of positive cases in the hotel quarantine are people returning from Papua New Guinea.

Although Australia has handled the pandemic well, the outbreak in its hotel quarantine system has highlighted the precarious nature of the success. In Victoria state, the failure to quarantine has been blamed for 768 deaths, more than 18,000 infections and months of lockdowns in Melbourne last year. When it comes to Queensland, the country’s cultural, geographic and economic ties to Papua New Guinea mean the island’s struggles pose a real and current danger.

The Australian government has pledged to help Papua New Guinea with the outbreak. The organization has delivered nearly 8,500 doses of vaccine to immunize frontline workers in its former colonies and is considering distributing more once it starts increasing local production of AstraZeneca injections.

These efforts are only a fraction of Australia’s vaccine diplomacy in the Pacific. As a member of the Quad – an informal group but growing in popularity with the US, India and Japan – has committed AU $ 100 million ($ 76 million) to help distribute 1 billion vaccines to Asian and Pacific Island countries by the end of 2022. This is above AU $ 523 million Australian Regional Vaccine Access and Health Security Initiative for the Pacific and Southeast Asia.

Even after the crisis at its doorstep is dealt with and the pandemic waning, some analysts expect Australia to play an integral role in helping the Pacific region repair damaged economies and move forward. They are competing for influence with China, which in January declared its willingness to supply vaccines to Pacific countries as well.

The Australian government already has a “Pacific Step” initiative, which former Prime Minister Malcolm Turnbull disclosed in 2016. The policy aims to increase regional engagement in the region and counter Beijing’s growing influence.

At the heart of this “upgrade” is the Australia Infrastructure Financing Facility for the Pacific, which will finance infrastructure through a combination of a loan of AU $ 1.5 billion and a grant of AU $ 500 million. Operating since 2019, it has supported three major projects: a solar power plant in Papua New Guinea, a hydropower system in the Solomon Islands and a submarine cable in Palau. Canberra will sign AU $ 300 million in funding for other projects in the coming months.

The Asian Development Bank estimates the Pacific will need $ 30 billion in infrastructure investment by 2030. The challenge is identifying commercially viable projects, according to Jonathan Pryke, director of the Lowy Institute’s Pacific Islands Program.

Many investors are wary of bankrolling projects in small and remote economies. China does not appear to share these concerns. “But the reality is these projects [backed by China] it has now been produced and it turns out to be too expensive and the quality varies, “said Pryke.” I think Pacific governments have become much smarter, because they only get so many bites on these projects because of their limited access to debt. “

He said infrastructure had become a “hotly contested space” between China and Australia, and that vaccines were another “geopolitical battleground”. Welcoming the Quad vaccine commitments, he said the reality was that launches across the Pacific were likely to be “messier, more bilateral, and mutually driven.”

A road in Port Moresby built with Chinese government funds: The Asian Development Bank estimates the Pacific will need $ 30 billion worth of infrastructure investment by 2030. © Reuters

After all, the island nation needs a vaccine – and fast.

“The economic damage to the Pacific is severe and Papua New Guinea is a real health crisis,” said Pryke. “These countries can’t wait, their economies will start after the trip, and that won’t happen until there is a significant vaccine rollout.”

But like China, Australia can experience skepticism about its foreign policy ambitions.

In the past, Australia has been criticized for only engaging with the Pacific in times of crisis. Australia’s action on climate change at home, or lack thereof, also looks negative in some of the most vulnerable island nations. Last year, 14 Pacific leaders condemned Australia’s Paris climate targets as “one of the weakest” in Prime Minister Scott Morrison’s open-ended leadership.

“There is a fair amount of doubt in the region that the only reason Australia is showing interest now is because China is showing interest, and if China leaves Australia will forget about the region again,” said Tess Cain, project leader. for the Griffith Asia Institute Pacific Hub.

Cain believes there is not only an economic opportunity, but also a moral imperative, to work with China in supporting Pacific development. He said Australia should not allow geopolitical concerns “whether they be pushed from Canberra or Washington, to deter countries facing a humanitarian crisis.”

Cain suggested further easing of labor mobility laws to boost regional economies. This could develop under existing seasonal employment programs that allow people from eight Pacific island nations and East Timor to work in parts of Australia facing personnel shortages.

This is the view shared by one of Australia’s top banks, ANZ, which is also advocating faster vaccine rollouts across the region and infrastructure support to spur a tourism-led job recovery.

But these are things for Australia to ponder next time. Now, time for Papua New Guinea is running out. Mola at Port Moresby General Hospital said the country faced enormous logistical challenges when it came to distributing vaccines and stopping the outbreak. Several reliable roads connect Port Moresby with the remote countryside of the countryside.

With a large proportion of the elderly population living in the latter region, the country will be in serious trouble if an outbreak spreads.

Another complication is the growing skepticism of vaccines – especially after opposition leaders called for a suspension of Australian-donated shots over safety concerns.

Mola believes the situation is so dire that Australian Defense Force personnel may have to deploy to assist Papua New Guinea, as in previous crises. In the end, he saw no easy solution.

“It’s hard to see how this will all work, actually,” he said. “Pray for us.”