PNG Institute of Medical Research Annual Report 2020
Content Director’s report ....................................................................................................................... 2 Research units........................................................................................................................... 4 Infection and Immunity.......................................................................................................... 4 Sexual and Reproductive Health ............................................................................................ 4 Population Health and Demography...................................................................................... 5 Vector-Borne Disease ............................................................................................................ 5 Six PNGIMR researchers awarded PhDs.................................................................................... 6 Dr Celestine Aho .................................................................................................................... 6 Dr John B Keven ..................................................................................................................... 6 Dr Nalisa Neuendorf............................................................................................................... 7 Dr Maria Ome-Kaius .............................................................................................................. 7 Dr Pamela Toliman ................................................................................................................. 7 Dr Gwendalyn Vengiau........................................................................................................... 8 A coalition to buttress PNGIMR............................................................................................... 10 Buttressing Coalition Fund................................................................................................... 10 Buttressing Coalition Fund Projects ..................................................................................... 10 Governance.......................................................................................................................... 11 Responding to COVID-19......................................................................................................... 12 Diagnostic testing................................................................................................................. 12 Supporting national leadership............................................................................................ 12 Supporting communities and provincial governments......................................................... 12 Research............................................................................................................................... 13 Impactful research................................................................................................................... 14 Ensuring the quality of bed nets to prevent malaria ........................................................... 14 Eliminating lymphatic filariasis ............................................................................................ 16 Connecting the head and the heart through arts based research....................................... 17 Detecting artemisinin resistance in Papua New Guinea ...................................................... 19 2020 PNGIMR Council Members 2020.................................................................................... 20 Organisational chart................................................................................................................ 21 Visitors hosted in 2020............................................................................................................ 22 Vale Sophie Ase....................................................................................................................... 24 Farewelling staff members...................................................................................................... 25 New research projects............................................................................................................. 26 2020 publication list................................................................................................................ 28 2019 and 2020 financial report............................................................................................... 32 Annual Report 2020
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Director’s report The Papua New Guinea Institute of Medical Research (PNGIMR or, within PNG itself, simply the IMR) is a statutory body of the Government of Papua New Guinea, established in 1968. We research solutions to the health problems of people in PNG and perform vital public health functions such as disease surveillance. Our vision is to be a centre of excellence in public health and medical research within the country and globally.
Our vision is to be a centre of excellence in public health and medical research within the country and globally.
I am proud to present a record of PNGIMR’s achievements in 2020 in this Annual Report. PNGIMR employed more than 300 research and administrative staff members in 2020, located in our headquarters in Goroka and in our facilities in Madang, Port Moresby, Wewak and Maprik, Kokopo and Alatau. Our research projects addressed diverse health priorities, including the prevention and control of malaria, influenza surveillance, elimination of lymphatic filariasis, detection of anti-microbial resistance and the prevention and treatment of sexually transmitted diseases. The COVID-19 pandemic made 2020 an exceptionally challenging year. In February and March, we reorganised our laboratories to conduct real time polymerase chain reaction, or RT PCR, tests for the emerging novel coronavirus (SARS-COV2). On 20 March 2020, the first positive case for COVID-19 in PNG, which had been confirmed in our Goroka laboratory, was announced. By the end of 2020, PNGIMR had tested nearly 20,000 samples in our Goroka and Port Moresby labs. In collaboration with the COVID-19 National Control Centre, Central Public Health Laboratory and our partners in Australia, I am proud that PNGIMR has performed this critical role in the national response. I acknowledge the hard work of our lab teams and support personnel who made this possible. I am also grateful for the financial assistance from the PNG and Australian governments, who contributed equipment and funded consumables and salaries. Despite the pandemic, we had many reasons to celebrate in 2020. Six Papua New Guineans from PNGIMR gained their PhDs and have started to develop their own research programs. This annual report introduces these early career scientists and describes their work. Another seven Papua New Guinea staff members will complete their PhD studies in the next three years. PNGIMR researchers published nearly 50 peer-reviewed papers in 2020, including impactful evidence of the poor quality of long-lasting insecticidal nets or LLINs used in PNG and other countries and the potential emergence of drug-resistant malaria in PNG. These studies are featured in the Research Impact section of this annual report. With collaborators, PNGIMR attracted funding for 17 new research projects, all of which were approved by our Institutional Review Board.
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2020 was the first year of the Buttressing Coalition Fund, composed of contributions from Australia’s Indo-Pacific Centre for Health Security and seven of our international collaborating research institutes. The Buttressing Coalition Fund supported several strategic initiatives, including the upgrading of our IT system, renovation of our office building in Port Moresby and provision of reliable electricity at our facility in Yagaum, outside of Madang. Thanks to the Buttressing Coalition Fund, seven of our early career researchers were awarded internal competitive small grants to study aspects of COVID-19 in PNG. This annual report has more information about the Buttressing Coalition. In 2020 we mourned the passing of Sophie Ase, a research officer in the Sexual and Reproductive Unit. This young woman contributed to many important research projects, and the whole Institute joins her colleagues in expressing their sorrow to her family. Also in 2020, we thanked seven staff for their long periods of service and wished them the best for their retirement. 2020 brought fiscal challenges for the Government of PNG and international research funding bodies. However, our financial report shows that our core operating account and project funding remained at 2019 levels. We are grateful to the government and our partners for their continued faith in the importance and quality of PNGIMR’s work. PNGIMR’s role in the national pandemic increased the public’s understanding of our mission and activities. Posts on our re-launched Facebook page engaged tens of thousands of readers and attracted nearly 5,000 followers. We were also privileged to host many visitors: parliamentarians, representatives of the National Department of Health and the pandemic National Control Centre, bilateral representatives from Australia, Japan, Switzerland and the United States, and development partners including the World Health Organization, UNFPA and the European Union. As I write this in early 2021, the pandemic in PNG is accelerating. I am more grateful than ever for the commitment and expertise of PNGIMR staff, the generosity and wisdom of our research collaborators and the hardworking and talented government and development partner officials with whom we work.
-----------------------------Professor William Pomat Director
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Research units INFECTION AND IMMUNITY Infectious diseases remain a major cause of death and illness in Papua New Guinea. The I&I unit is responsible for globally important work on the effectiveness of the pneumococcal vaccines in preventing respiratory illnesses in children. Other research examines prevalence and drug and vaccine efficacy in rotavirus, typhoid, cholera, osteomyelitis and polio infections. Recent work with colleagues in Western Australia and Boston is laying the groundwork for the prevention of severe illness in early childhood through probiotics. With bacteriology, immunology and virology laboratories and clinical field staff, the I&I unit (in partnership with lab-based colleagues in Sexual and Reproductive Health) monitor emerging drug resistance in a range of diseases in children and adults. I&I hosts the WHO National Immunization Centre and has been responsible for rotavirus and influenza surveillance and the COVID-19 diagnostic testing in Goroka.
SEXUAL AND REPRODUCTIVE HEALTH SRHU conducts policy-relevant clinical, laboratory, qualitative and health systems research to improve the sexual and reproductive health of women and men in PNG. Our research has investigated the epidemiology of HIV and sexually transmitted infections (STIs) among general and at-risk populations in PNG and increased knowledge of socio-cultural and behavioural drivers of transmission. Field and laboratory-based studies have, for example, identified that PNG has among the highest levels of resistance to first line antiretroviral treatments for HIV and that key populations at risk of HIV also have a high prevalence of undiagnosed tuberculosis. SHRU’s work has contributed to changes in treatment protocols. A new project is increasing provincial level capacity to test for viral load in HIV positive patients. Testing at point-of-care will enable clinicians to prescribe the most appropriate treatment.
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SRHU researchers have also demonstrated the effectiveness of using point-of-care testing for human papillomavirus (HPV), the major cause of cervical cancer. A similar approach is being tested in the WANTAIM trial, which screens and treats pregnant women for STIs within health facilities to improve the health of their babies. SRHU’s scientists work closely with the NDOH in the surveillance and diagnosis of HIV and STIs and with the National AIDS Council and NDOH to evaluate PNG’s response to HIV and STIs. All projects with HIV positive people involve respectful partnerships with non-government organisations and other services and advocacy groups to ensure that affected communities benefit. SRHU’s team of experienced social and behavioural, clinical and laboratory-based researchers regularly collaborate on projects led by other units.
POPULATION HEALTH AND DEMOGRAPHY PHDU was established in 2011 to conduct multidisciplinary research to describe social changes and their effects on population health. The results inform the national and provincial responses to emerging population and health issues. The unit has two large programs, each with several projects. The first program concerns the control and prevention of malaria. It is conducted in partnership with the National Malaria Control Program, with financial support from the Global Fund. The Malaria Indicators Survey (MIS) is conducted every 2-3 years in a representative sample of communities, tracing the prevalence of malaria over time and across different environments. The MIS is a unique source of high-quality data showing policy-makers and researchers the gains and reversals in the control of malaria. In 2020, a related study measured malaria prevalence in schoolchildren to determine patterns of malaria transmission across different environments and altitudes. The second program is the Comprehensive Health and Epidemiological Surveillance System (CHESS). Funded by the GoPNG through Department of National Planning and Monitoring, CHESS generates data for reporting health and related Sustainable Development Goal targets from a purposive sample of urban, peri-urban and rural sites. Embedded within CHESS is SUNRISE, a multi-country study on the physical activity of children.
VECTOR-BORNE DISEASES The VBDU conducts basic biomedical research, clinical trials and applied research on interventions to control disease. This breadth of work enables PNGIMR scientists to apply discoveries from basic research into clinical research and public health programs. Observations from field trials, community work and clinical settings inspire new basic research. The basic biomedical research program includes studies on the epidemiology of human malarias using longitudinal cohort studies, studies of host genetic adaptations to malarial infections, the invitro culture of P. falciparum and P.vivax and studies in the natural acquisition of immunity and immunopathology. Basic entomology research investigates the ability of mosquitoes to transmit malaria. Clinical trials have investigated the efficacy and effectiveness of drug therapies for prevention of malaria in pregnant women, treating P.vivax, and elimination of filariasis. Intervention studies have investigated the effectiveness of bed nets, PNG’s main tool for controlling malaria. Annual Report 2020
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Six researchers awarded PhDs DR CELESTINE AHO The title of Celestine Aho’s PhD thesis is ‘Understanding pathogens with relevance to otitis media management in Papua New Guinea’. She chose to study otitis media (OM) because her brother suffered from recurring ear infections as a baby in the Eastern Highlands. As a result, he lost hearing and struggled at school. The microbes causing most cases of OM in the Eastern Highlands are not known, making it difficult to develop prevention and treatment strategies. Dr Aho’s early research had found that the 7 valent pneumococcal conjugate vaccine (PCV7) given to PNG infants had limited impact on some microbes that might cause OM, particularly Streptococcus pneumoniae. For her PhD, Dr Aho analysed ear discharge samples from children in Australia’s Northern Territory. She found the presence of the bacteria Haemophilus influenzae in ear discharge is associated with treatment failure for chronic suppurative otitis media (CSOM) in Australian Aboriginal children. (CSOM is characterised by persistent ear discharge for more than 2 weeks and is an important cause of preventable hearing loss.) DR CELESTINE AHO
In the final year of her PhD studies, Dr Aho won the AUD30,000 (K70, 800) Deborah Lehmann Research Award supported by the Wesfarmers Centre of Vaccines and Infectious Diseases. The award supports early career researchers in the Pacific investigating infectious diseases in children. In 2020 she laid the groundwork for a research project to look at the prevalence, aetiology and risk factors associated with OM in children attending urban clinics in Goroka. The first of such studies in PNG, she will start data collection in 2021. Understanding the OM burden of the PNG population and its microbial causes is essential for developing early and effective strategies to prevent and treat the condition. She hopes her research will raise awareness of OM in the community and in primary health care and lead to a long-term OM research program at PNGIMR. DR JOHN B KEVEN Dr John B Keven was awarded his PhD from Michigan State University. He joined PNGIMR in 2009 as an honors student. After his honors program, Dr Keven became a scientific officer with the entomology section of the Vector Borne Diseases Unit in Madang. In 2011, he received a US Fulbright scholarship to do his Master’s in Entomology at Michigan State University (MSU). After graduating, he served as a senior scientific officer at PNGIMR, and then returned to MSU to DR JOHN B KEVEN do his PhD in Microbiology and Molecular Genetics. His PhD research investigated the behaviour of local mosquitoes to explain why malaria is resurging in parts of PNG despite high distribution of bed nets. Since graduating in 2020, Dr Keven has been doing post-doctoral research at MSU. The pandemic frustrated his plans to split his time between the United States and PNG. Nevertheless, he hopes that his work will lead to more research and training partnerships between PNGIMR and MSU and that he will be able to re-join PNGIMR’s entomology team soon.
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Dr Keven says ‘I was fortunate to be mentored and inspired by some of the best people at IMR and to be part of a great research community that helped to propel me to where I am now. The success of my PhD could not have been possible without the support of my colleagues at IMR, particularly the staff of the entomology section in Madang.’ DR NALISA NEUENDORF
DR NALISA NEUENDORF
Dr Nalisa Neuendorf is a Research Fellow in the Sexual and Reproductive Health Unit. She received her PhD in Social Anthropology from James Cook University in Cairns, Australia in 2020. Her PhD research titled ‘Luksave em bikpela samting! Witnessing gender violence in Papua New Guinea’ was based in a remote community in the Gulf Province. Participants shared their experiences of witnessing acts of gender violence in their community and their own and other’s responses to those acts. Telling their stories, as witnesses to these events, allowed people the space to express the meaning of these acts in their local communities and enable them to form what they define as ‘appropriate’ responses to acts of gender violence that occur. Her insight will assist anti-gender violence programs to be more culturally meaningful.
Dr Neuendorf’s ambition for 2021 is to lead a study on social media, information sharing and public health in the time of COVID-19. Dr Neuendorf says, ‘Being part of a dynamic and vibrant team has been both challenging and rewarding. It will be great to continue the important social and public health research that this unit supports. Whether here at the PNGIMR or in any other future role, I want the research and academic work I do to benefit the people and the nation.’
DR MARIA OME-KAIUS Dr Maria Ome-Kaius was awarded her PhD from the University of Melbourne. Her PhD investigated the effect of malaria and other infectious diseases in pregnancy and childhood on birth weight and child growth and development in PNG.
DR MARIA OME-KAIUS
She considers herself very fortunate to have started her research career with PNGIMR, where she has been mentored and inspired by many great local and international researchers. She has gained the skills to develop advanced statistical models and the confidence to independently analyse data. Dr Ome-Kaius is well equipped and highly motivated to lead research at PNGIMR that addresses critical gaps in our evidence base to improve health in PNG.
Her ambition is to become an independent researcher and leader at PNGIMR, and to work with collaborating institutions such as the School of Medicine and Health Sciences to strengthen the analytical capacity of her fellow clinicians and researchers.
DR PAMELA TOLIMAN Dr Pamela Toliman was awarded her PhD through the Kirby Institute at the University of New South Wales, Sydney. She researched an innovative approach for cervical cancer screening by evaluating the performance of a novel point-of-care ‘test and treat’ algorithm. The potential impact of HPV testing in reducing cervical cancer burden has been established but comparatively high cost and resource requirements have prevented many low- and middle-income countries (LMICs) from adopting high-risk Human Papillomavirus (hrHPV) testing screening. A DR PAMELA TOLIMAN significant development has been the GeneXpert HPV Test (Xpert HPV: Cepheid, Sunnyvale, CA); an easy-to-use, rapid (60 minutes), highly accurate HPV test that can be offered at point of care (POC) to inform clinical management. Annual Report 2020
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Dr Toliman’s research demonstrated that patient-collected vaginal swabs were comparable to swabs collected by a clinician and that the Xpert HPV test was accurate in detecting hrHPV and predicting underlying high-grade disease (cervical pre-cancer). In PNG, cervical cancer is the leading cause of cancer death in women; the country has one of the highest rates in the world. The body of work produced by Dr Toliman contributes evidence for a national cervical cancer screening program and clinical guidelines on testing and treatment. Since the Xpert HPV test can be done at a clinic or hospital, PNG and other LMICs could potentially offer women same-day test-and-treat cervical screening. In recognition of her outstanding qualities as a scholar and emerging leader, Dr Toliman was awarded the Allison Sudradjat Prize at the commencement of her candidature. She plans to use the prize for post-doctoral research into COVID-19 population trends in PNG. DR GWENDALYN VENGIAU
DR GWENDALYN VENGIAU
Dr Gwendalyn Vengiau was awarded her PhD at the University of Queensland through the Australian Awards Scholarship. She started as a researcher with the Vector Borne Disease Unit in Goroka and moved to the pneumococcal conjugate vaccine (PCV) project with the Asaro demographic surveillance project. She was selected to undertake Honours study at the University of Papua New Guinea through the PNGIMR Fogarty program. Later, she did her Master’s Degree by research at the University of Tokyo through an Asian Development Bank scholarship. Upon returning from Japan, she co-ordinated the first population-base study into the prevalence of NCDs risk factors in PNG. The nutrition, food security and physical activity components of the research became the basis of her PhD.
Dr Vengiau’s thesis, ‘Nutrition Transition in PNG’, documents the changes in nutrition, physical activity and food security in different parts of the country. A major contribution of her research was to develop data collection instruments specific for PNG’s diverse communities. Her results highlight the complex relationship between economic opportunity and access to land on the nutrition transition. Dr Vengiau’s research provides vital information for developing appropriate and effective public health measures to tackle the double burden of NCDs and infectious diseases. In 2021 Dr Vengiau will lead a program within PNGIMR’s Public Health and Demography Unit on non-communicable diseases, nutrition and food security. Through that program, she will collaborate with researchers in other units to incorporate nutrition data.
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A coalition to buttress PNGIMR Quality research, especially in health fields, requires robust collaborations and mutual support. A buttress is a metaphor for these research partnerships. It is a structure that supports a building and roots that give trees strength and nourishment. Buttresses are designed to help; they do not take away from the integrity of the buildings and trees they assist. Formed in 1999, the Buttressing Coalition is a platform for partners and friends of PNGIMR to support the Institute in all areas relevant to its responsibilities to conduct public health and medical research for PNG and internationally.
BUTTRESSING COALITION FUND The Buttressing Coalition introduced membership fees in September 2019. These fees comprise a Fund for the development of the institute administered by the University of New South Wales. Australia’s Indo-Pacific Centre for Health Security will contribute to the fund for three years, from fiscal years 2020 to 2022. Seven Institutional Members contributed to the fund in 2020: Burnet Institute James Cook University The University of Melbourne Kirby Institute, University of New South Wales, Sydney Swiss Tropical Public Health Institute Walter and Eliza Hall Institute Wesfarmers Centre for Vaccines and Infectious Disease, Telethon Kids Institute
BUTTRESSING COALITION FUND PROJECTS Thanks to the generous contributions of the Buttressing Coalition members and the Indo-Pacific Centre for Health Security, PNGIMR was able to make significant improvements to infrastructure and support our early career researchers. Projects funded in 2020 were: Assessment of information technology needs (Jan-Feb 2020) Information Technology upgrades, including migration to Microsoft Office, installing anti-virus software, upgrading to Windows 10, and purchasing new servers and networking equipment for Goroka and Yagaum sites (March 2020 – present) Renovation of administration and project building in Gordons, Port Moresby (June – November 2020) Independent valuation of land and buildings (October 2020 – January 2021) Upgrading of electrical system in Yagaum (September 2020 – January 2021) Internal competitive research grants on COVID-19 for early career researchers (November 2020 – present)
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GOVERNANCE The Buttressing Coalition is chaired by Professor William Pomat (Director, PNGIMR) and Co-chair Professor John Kaldor (Program Head, Kirby Institute). An Executive Committee meets quarterly to oversee the fund and identify other strategies to support PNGIMR. Members of the Executive Committee in 2020 were Prof Bernard Crabb, Burnet Institute Dr Manuel Hetzel, Swiss Tropical and Public Health Institute A/Prof Angela Kelly-Hanku, PNGIMR and Kirby Institute UNSW Sydney Prof Christopher King, Case Western Reserve University Dr Moses Laman, PNGIMR Prof Ivo Mueller, Walter and Eliza Hall Institute A/Prof Leanne Robinson, Burnet Institute and Walter and Eliza Hall Institute Information on Buttressing Coalition activities and how to become a member are on the PNGIMR website.
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Responding to COVID-19 DIAGNOSTIC TESTING On 30 January, the World Health Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern, activating a global response to the outbreak. The Government of Papua New Guinea through the National Department of Health appointed PNGIMR to conduct COVID-19 related testing for the country. PNGIMR is a WHO accredited National Influenza Centre. We routinely test for a wide range of respiratory pathogens. Under Dr Janet Gare’s leadership, our laboratory team quickly adopted a reverse transcription polymerase chain reaction (RT-PCR) protocol for COVID-19 detection recommended for National Influenza Centres within the WHO network. Samples began arriving at our Goroka laboratory on 31 January, some directly from clinicians and provincial health authorities and, increasingly from the Central Public Health Laboratory which took the lead role in receiving, registering and forwarding samples to PNGIMR and international laboratories. Our molecular laboratory in Port Moresby started testing samples in April, after training staff in Goroka. At the end of 2020, PNGIMR laboratories had tested over 20,000 samples, approximately half of all reported test results. Successfully adjusting from research to diagnostic laboratory work required assistance from our partners. Our existing laboratory supplies and equipment were not sufficient to meet demand. The Government of Australia provided critical support by purchasing additional PCR machines and devices for extracting and purifying RNA. The Government of PNG gave funds for laboratory supplies, minor renovations, transport and staff. Our COVID-19 team was led by Dr Janet Gare. In Goroka laboratory staff included Dagwin Suarkia, Valentine Siba, Ben Toto, Tobby Maure. Tamarah Koleala led the Port Moresby COVID-19 lab team of Rosemary Simbil, Rebecca Narakobi, Shadrach Jally, Nomin-Dora Tenakanai.
SUPPORTING NATIONAL LEADERSHIP Deputy Director Science, Dr Moses Laman worked from Port Moresby in 2020. He served on several advisory groups for the NDOH and the National Control Centre (NCC) and was a member of the Medical and Scientific Advisory Committee, the principal scientific group advising the government. In June Dr Laman, Dr Maria Ome-Kaius and field workers from PNGIMR Maprik helped NDOH conduct a seroprevalence survey to measure exposure to SARSCoV-2 antibodies in selected provinces. The results gave the government an early indication of exposure to the virus. Near the end of 2020, Dr Pamela Toliman worked with NDOH and NCC representatives to develop a validation protocol for the rapid antigen test to be rolled out.
SUPPORTING COMMUNITIES AND PROVINCIAL GOVERNMENTS PNGIMR assisted NDOH, WHO and provincial health authorities to disseminate accurate information about preventing infection throughout the country. Starting with our own staff, PNGIMR experts taught clinicians, field and lab workers the proper use of personal protection equipment. Many staff meetings
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were held to inform research and support staff about the risk of infection and to empower them to keep themselves, families and communities safe. Senior staff based in Goroka, Madang, Kokopo, East Sepik and Milne Bay participated in COVID-19 Taskforce and made research teams available for community awareness sessions. Director Prof William Pomat was routinely approached by newspaper, radio and television journalists for objective science-based information.
RESEARCH As the evidence of how SARS-CoV-2, the virus that causes COVID-19, grew PNGIMR researchers meet fortnightly to stay up-to-date on new findings on laboratory techniques and clinical protocols. Prof William Pomat was an author on an article in the international journal Global Health Research and Policy urging more support for COVID-19 related research to be done in low- and middle-income countries, addressing questions specific to this context. Senior researchers worked with NDOH and multilateral partners on protocols for research on social and behavioural responses to the pandemic and validation of antigen and seroprevalence testing. At the end of 2020, the Buttressing Coalition Fund supported a small competitive grants scheme on COVID-19 for PNGIMR’s early career researchers. Seven applicants were successful. Their projects will initiate a larger research program on the social and health impacts of pandemic and laboratory-based techniques to improve testing and surveillance. Our other research work was impacted by the pandemic. Equipment and laboratory staff and space were reassigned to diagnostic testing, and field work that was potentially unsafe and had to be postponed. Yet, fortunately, by the end of the year most activities resumed, major projects were on track and new projects started.
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Impactful research ENSURING THE QUALITY OF BED NETS TO PREVENT MALARIA 2020 was an important year for PNGIMR’s on-going work on monitoring the effectiveness of long-lasting insecticidal nets, known as LLINs. The PNGIMR entomology team’s research, published in Nature Communication, led to a change in international procurement practices and attracted an Australian National Medical and Health Research Council grant to continue their work. For many years, scientists in PNGIMR’s insectary in Yagaum outside of Madang have conducted cone bioassays, the method recommended by the World Health Organization to assess the bioefficacy of nets treated with insecticide formulations. To do accurate cone bioassays, scientists carefully transfer five mosquitoes into each of four cones attached to a piece of LLIN. This process is repeated on five different pieces of a LLIN, totalling 100 mosquitoes in 20 cones. After the mosquitoes have been on a piece of LLIN for three minutes, they are taken out of the cones and put in holding cups. After 60 minutes scientists count the number of mosquitoes in the cups that are knocked down. After 24 hours, they count the number of dead mosquitoes in the cups. LLINs should show a 24 hours mortality rate of greater or equal to 80 per cent or 60 minutes knockdown of at least 90 per cent. The study found that only 17% of LLINs distributed in PNG and manufactured between 2013 and 2019 met World Health Organization standards. Most bed nets made in this period were not effective at knocking down mosquitoes. The results were concerning. Pedro Alonso, Director of the WHO Global Malaria Programme in Geneva tweeted about the paper: ‘Important evidence linking decreased bio efficacy of LLINS and resurgence of #malaria in PNG. An area that deserves a lot more attention.’ PNGIMR scientists shared the findings with our partners before publishing. National and international agencies responded to the evidence by purchasing and distributing other LLIN brands. They took prompt action because of PNGIMR’s excellent reputation for objective science and close relationships with partners. Scientific officer Nakei Bubun joined PNGIMR after finishing her Bachelor of Science at UPNG in 2019. She has been part of the team studying bed net bio-efficacy. She says, ‘My work is important for malaria control in PNG. I believe finding
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the best quality LLIN will definitely help to control the mosquitoes transmitting malaria and hence help reducing malaria in PNG.’ The entomology team is now testing new LLIN brands, with support from partners and funders. PNGIMR research team: Moses Laman, Stephan Karl, Rebecca Vinit, Nakei Bubun, Michelle Katusele, Mukier Sakur, Lincoln Timinao, Peter Kaman Partners: National Department of Health, National Malaria Control Program, Global Fund, Rotarians Against Malaria, World Health Organization and James Cook University Funding: Global Fund and Australia’s National Health and Medical Research Council (NHMRC). Publications: R Vinit, L Timinao, N Bubun, N. et al. 2020. Decreased bioefficacy of long-lasting insecticidal nets and the resurgence of malaria in Papua New Guinea. Nature Communication 11, 3646.
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ELIMINATING LYMPHATIC FILARIASIS PNG has the highest prevalence of lymphatic filariasis (LF), commonly known as elephantiasis, in the South Pacific. LF is a mosquito-borne disease that damages the lymphatic system, leading to severe disfigurement, pain and disability. Dr Moses Laman, Deputy Director Science says, ‘PNGIMR has played a critical role in trialling better treatment options aimed at reducing transmission and eventually eliminating LF in PNG and other countries.’ The original study, conducted in Maprik, East Sepik, identified a triple drug therapy as superior to the standard treatment. The treatment targets the parasites in the blood of infected people and reduces the risk of transmission. Following those findings, WHO requested more data to determine its safety. This led to the formation of the multicountry Death to Oncosacariosis and Lymphatic Filariasis (DOLF) consortium. PNGIMR has been a major partner in DOLF, which aims to eliminate LF globally. To document the triple drug safety, PNGIMR and Case Western Reserve University conducted a trial of two rounds of mass drug administration (MDA) in 24 villages in Bogia district of Madang Province between 2016 and 2019. Researchers in India, Haiti, Fiji and Indonesia also contributed the safety data. This collective effort resulted in over 26,000 participants enrolling in the DOLF studies. WHO introduced new guidelines for LF elimination efforts in 2017, based on the results of the DOLF studies. The drug company Merck announced an expanded drug donation program of an annual 10 million doses of ivermectin (one of the three drugs in the in the new therapy) through to 2025 to accelerate the elimination of LF in endemic countries. In PNG, East New Britain (ENB) was the first province to benefit from the drug donation program through WHO and the National Health Department. The Provincial Health Authority led the implementation of MDA using the triple drug therapy, treating 300,000 people in the province to eliminate LF. In 2019 and 2020, PNGIMR scientists conducted the independent monitoring and evaluation of the ENB program. The results will be available in the near future. In Madang Province, PNGIMR’s Vector Borne Disease Unit will to conduct the 4th year follow-up of the second round of triple drug MDA in the 24 villages that participated in the safety trial in 2016 – 2019. The work will begin in August of 2021 and will be the first study to investigate the long-term effectiveness of two rounds of the triple drug therapy. PNGIMR PIs: Moses Laman, Stephan Karl, William Pomat. Partners: East New Britain, Madang and East Sepik Public Health Authorities; National Department of Health; Christopher King and Daniel Tisch, Case Western Reserve University; Leanne Robinson, Burnet Institute. Publications: King CL, Suamani J, Sanuku N, Cheng Y-C, Satofan S, Mancuso B, et al. A Trial of a Triple-Drug Treatment for Lymphatic Filariasis. N Engl J Med. 2018 7 November;379(19):1801–10; Weil GJ, Bogus J, Christian M, Dubray C, Djuardi Y, Fischer PU, et al. The safety of double- and triple-drug community mass drug administration for lymphatic filariasis: a multicenter, open-label, cluster-randomised study. PLoS Med. 2019;16(6):e1002839.
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CONNECTING THE HEAD AND THE HEART THROUGH ARTS BASED RESEARCH Assoc Prof Angela Kelly-Hanku had used visual methods in her work with people with HIV in Australia so, in 2009, she was keen to introduce them as a research method in PNG. Agnes Mek, then an HIV research cadet at PNGIMR, was immediately taken by the use of visual methods to describe lived experiences in ways other than words. So, in PNG’s first study of people living with HIV, Mek and Kelly-Hanku invited people to tell about their experiences of treatment visually. From there on, Mek and Kelly-Hanku have used participatory visual methods such as body mapping, photovoice and film in their research projects. In the early 2010s, treatment protocols for newly diagnosed HIV positive pregnant women changed, enabling them to start treatment at diagnosis and continue treatment for the rest of their life. In 2015, PNGIMR’s Sexual and Reproductive Health Unit started a large multidisciplinary project to understand how these treatment changes affected HIV positive women’s retention in care. Mek and Kelly-Hanku worked directly with HIV positive young women who had been diagnosed with HIV in their pregnancy - using arts-based tools of photography and documentary film. Mek ran a five-day workshop on photovoice and storytelling with HIV positive young women in Port Moresby, assisted by three mentors, older women living with HIV who had been infected in their youth. Photovoice is a transformative tool to raise the critical consciousness of participants, putting them in control of what they say and tell. In the workshop, women took photographs and shared their stories of heartbreaks and hope and the importance of being supported by others to seek and stay on antiretroviral therapy and live rewarding lives with HIV. The book from the project, I Can, I Want, I Will, tells these women’s stories. The publication – available online – offers solidarity and hope for younger women to prevent and to live with HIV.
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The SRHU project also did a documentary film, Young and Positive, to illustrate the intersectionality of living with HIV and seeking essential sexual and health services. DVDs were distributed throughout the country; it has been shown on national television in Indonesia and at film festivals in PNG and Tahiti; it is on You Tube. Development partners, moved by the documentary, have expanded sexual and reproductive health programming to include young people. In recognition of their pioneering arts-based research, Mek and Kelly-Hanku were invited to present at the online 10th Asia Pacific Conference on Reproductive, Sexual Health and Rights in November 2020. They stated in their final remarks, ‘While all research methods have their place in the response, visual methods like those we have discussed today offer an opportunity to connect the head and the heart, to glean “data” and “findings” while at the same time evoking an intimate visceral response.’ PNGIMR continues to support and advance these pioneering approaches to health and well-being. Funding: UNICEF Partners: Centre for Social Communication and Social Media – University of Goroka, University of New South Wales and UNICEF PNG Office Publications Agnes K Mek and Angela Kelly-Hanku 2017. I can, I want, I will: Photo stories of young girls and HIV in Papua New Guinea. Papua New Guinea Institute of Medical Research, Goroka. Kelly-Hanku, A., Mek, A., Homiehomnbo, P., Vallely, L.M., Nankinga, J., Worth, H., Vallely, A.J., and Kaldor, J. 2017. Young and Positive: Adolescent girls and young women living with HIV in Papua New Guinea. Papua New Guinea Institute of Medical Research and Kirby Institute, UNSW Sydney; Goroka, Papua New Guinea. Angela Kelly-Hanku and Agnes K Mek, 2020. I can, I want, I will and Young & Positive: Two visual method projects with young women living with HIV in Papua New Guinea. Session 12, HIV/AIDS and sexual and reproductive health and rights in Asia and the Pacific. The 10th Asia Pacific Conference on Reproductive, Sexual Health and Rights, 23 November, 2020. https://www.citizen-news.org/2020/11/apcrshr10-virtual-12-hivaids-and-srhr.html?fbclid=IwAR2l452S y4p1IB1ZpM5jlWkgwyD3Gfz_bAxqjFjV0xQ79C9jZsVjhEWtk8Q
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DETECTING ARTEMISININ RESISTANCE IN PAPUA NEW GUINEA In many parts of the world, resistance to antimalaria drugs poses a great threat to controlling malaria. Artemisinin drug resistance has not been a problem in Papua New Guinea. Nevertheless, for many years PNGIMR scientists have been leading studies to investigate if drug resistance is emerging. In 2020 PNGIMR researchers published or submitted for publication several independent studies that showed molecular markers of artemisinin resistance detected in PNG. These studies include molecular investigations led by PNGIMR PhD student Dulcie Lautu and her colleagues as part of the STRIVE PNG program. Although the presence of molecular markers such as the Kelch 13 propeller gene found by the PNGIMR studies confirms the presence of artemisinin resistance, its presence cannot definitively prove that drug resistance is causing clinical treatment failure. Since the discoveries of molecular markers, PNGIMR has been supporting the National Malaria Control program to monitor the efficacy of PNG’s first line artemisinin-based antimalarial drug, artemetherlumefantrine. The most reliable way to determine the clinical significance of artemisinin resistance is through therapeutic efficacy studies (TES). Clinically, delayed parasite clearance, detected by microscopy, is an early indicator of treatment failure. To test if delayed parasite clearance is occurring, patients who voluntary participate in TES are followed up intensively during the acute phase of their illness (Days 0 to 3) and after recovery (weekly over a period of one month). In 2019, the TES PNGIMR conducted in collaboration with the National Department of Health in Madang, found three cases with that molecular markers of artemisinin-resistance. These patients have delayed parasite clearance, indicating that the first-line treatment was effective. However, to be sure there were no clinical failures, the National Malaria Control Program and WHO requested a new TES to enrol patients with high parasite counts of ≥1000 parasites/uL. This work began in Madang in September of 2020. Fortunately, to date, no participants have shown delayed parasite clearance. This story highlights some of the highly relevant research PNGIMR continues to conduct to support the National Health Department and the Government of PNG. Funding: TES is funded by The Global Fund to Fight AIDS, Tuberculosis and Malaria through Rotarians Against Malaria; genetic testing of parasites is supported by STRIVE, a grant from Australia’s Indo-Pacific Centre for Health Security. PNGIMR researchers: Dr Moses Laman, Dr Livingstone Tavul, Ms Dulcie Lautu Partners: TES team Mr Leo Makita, National Malaria Control Program, NDOH; Dr Leonard Nawara, NMCP, NDOH); Ms Pauline Mukura, NMCP, NDOH; Dr Munir Ahmed, Rotary Against Malaria Other Dr Alyssa Barry, Walter and Eliza Hall Institute; Dr Leanne Robinson, Burnet Institute; Prof Francis Hombhanje, Divine Word University Publications: Miotto O, Sekihara M, Tachibana S-I, Yamauchi M, Pearson RD, Amato R, et al. Emergence of artemisinin-resistant Plasmodium falciparum with kelch13 C580Y mutations on the island of New Guinea. PLOS Pathog. 2020 15 December;16(12):e1009133; Dulcie Lautu et al, manuscript in preparation; Leonard Nawara et al, manuscript in preparation.
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PNGIMR Council members 2020 COVID-19 dominated the first Council meeting of 2020, held on 20 March – the same day as the country’s first positive case was announced. Following meetings were cancelled because of travel restrictions. The last meeting of the year was held in December. The Council endorsed new policies on Child Protection and Fixed Assets, received a draft of the Corporate Plan and discussed the research program and financial health of the Institute.
Council Chairman Professor Sir Isi Kevau
Dr Evelyn Lavu Director of Central Public Health Laboratory
Dr Nick Dala National AIDS Council Secretariat
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PNGIMR Director Professor William Pomat
Professor Frank Griffin Vice Chancellor of University of Papua New Guinea
Mr Tony Lupiwa Proxy member to Dr Nick Dala
PNGIMR Deputy Director Dr Moses Laman
Professor Nakapi Tefuarani Dean of School of Medicine and Health Science, UPNG
Dr Osborne Liko Health Secretary, National Department of Health
PNG Institute of Medical Research
Organisational chart PNGIMR Council Director Corporate Affairs & Support Services Division Human Resource
Finance
Buildings
Payroll
Procurement
Transport
Science Division Deputy Director, Science Infection & Immunity
Sexual & Reproductive Health
Vector-borne Diseases
Population Health & Demography
Training Housing & Security Library & Archives
Media & Communications
Lab Management & OHS
IT
Site Management Madang
East Sepik
Port Moresby
Alotau
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East New Britain
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Visitors hosted in 2020 The closing of international borders curtailed visits from our overseas research collaborators. However, PNGIMR was proud to host many visitors from national and provincial governments and multilateral and bilateral development partners. PNGIMR was privileged to host Minister for Health and HIV/AIDS, Hon. Jelta Wong; Minister for Commerce, Hon. Wera Mori; Governor of Eastern Highlands Province, Hon. Peter Numu; CEO of EHPHA Dr Joseph Apa and EHP PPC Teine and Minister for Communication and Information Technology, Hon. Timothy Masiu.
Minister for Communications and Information Technology, Hon. Timothy Masiu also visited the Institute. Ms Emeline Cammack of the Australian High Commission had a tour of PNGIMR’s molecular laboratory in Port Moresby.
French Ambassador, Phillippe Janvier-Kamiyama accompanied by the representative of the Government of New Caledonia to Papua New Guinea, Alexandre Lafargue.
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US Ambassador to the Independent State of Papua New Guinea, Erin Elizabeth McKee.
World Health Organization (WHO) country representative, Dr Luo Dapeng and WHO team leader, Dr Anup Gurung.
Mr Barry Ropa from National Department of Health Surveillance team accompanied Dr Anup Gurung from WHO. He discussed with the PNGIMR team plans to continue influenza surveillance and testing alongside COVID-19 testing.
Member for Yangoru-Saussia, Hon. Richard Maru.
Head of UNFPA, Ms Marielle Sander-Lindstrom and team.
The National COVID-19 Response team. Annual Report 2020
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Vale Sophie Ase
Sophie Ethel Ase passed away on 31 October 2020 after a short illness. A social researcher with the Sexual and Reproductive Health Unit, she made an outstanding contribution to all aspects of SRHU’s work. She had a wonderful work ethic and approach to working with communities. Director of PNGIMR, Professor William Pomat and his wife Mrs Norries Pomat spent time with Sophie’s family and conveyed their deepest condolence to them. Associate Professor Angela Kelly-Hanku, the head of SRHU, announced that a book on peer reseearch, in which Sophie co-authored a chapter, will be dedicated to her. Sophie was farewelled by PNGIMR staff and friends at the Goroka Airport on 6 November 2020 as she was flown to be buried at her place of origin in the Oro Province. Sophie’s memory lives on. She left a significant mark on the life and culture of the SRHU.
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Farewelling staff members Staff in Goroka and Madang bid farewell to a number of long-serving staff in 2020. We acknowledge the contributions of the following staff and wish them the very best for their retirement. Andrew Raiko
Cynthea Leahy
Mexy Kakazo
Rhodni Thomas
Morgan Menafo
Magdelene Marem
Anem Ove
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New research projects Seventeen projects were approved by the PNGIMR Institutional Review Board in 2020.
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Project title
Principal investigators
Prevalence and aetiology of otitis media in children under the age of 15 years attending outpatient clinics in Goroka, Eastern Highlands Province
Dr Celestine Aho
Same day HIV viral load testing in HIV treatment care and support clinics, Western Highlands Provincial Hospital
A/Prof. Angela Kelly-Hanku
Optimally targeting investment to improve maternal and child nutrition and health in Papua New Guinea (Duration of study: 1 year (2019-2020)
Dr Nick Scott, Dr Christopher Morgan and Dr Moses Laman
Evaluation of a novel diagnostic platform for malaria in Papua New Guinea limits of detection and species differentiation in a malaria co-endemic setting
Prof. Quique Bassat, Prof. William Pomat and Dr Moses Laman
NATNAT: Newly adapted tools and network against mosquito borne disease transmission
Dr Moses Laman, A/Prof. Leanne Robinson, Dr Stephan Karl, Mr Leo Makita, Mr Tim Freeman and Dr Melinda Susapu
Characterisation of insecticide resistance mechanisms and the impact of vector control interventions on malaria vectors of Papua New Guinea
Ms Michelle Katusele, Mr Elias Omera, Dr Stephan Karl, Dr Lisa Reimer, Dr Moses Laman, Dr Leanne Robinson, Prof. Quique Bassat. Dr Barbara Baro, Dr Pere Millat and Tim Freeman
Prevalence of G6PD deficiency in the Madang community, Madang Province, Papua New Guinea
Dr Brooni Moore, Dr Paula Tesine, Dr Sze-Ann Woon, Dr Moses Laman and Dr Laurens Manning
Investigation of genetic variants of the SARS-CoV-2 spike protein and the ACE2 and TMPRSS2 receptor that are implicated in the establishment of a SARS-CoV-2 infection
Ms Tamarah Koleala and Mr Nigani Willie
Use of saliva, an alternative Real Time Polymerase Chain Reaction (RT-PCR), and disease correlates to boost COVID-10 diagnosis and surveillance in Papua New Guinea
Mr Dagwin Luang Suarkia, Dr Moses Laman, Mr Valentine Siba, Ms Sarah Javati and Dr Janet Gare
PNG Institute of Medical Research
Project title
Principal investigators
Social Media use in the time of COVID-19: Information sharing and public health in PNG
Ms Nalisa Neuendorf
Exploring the lived experiences of adolescents and young people living with HIV in Eastern Highlands Province in the Context of COVID-19 pandemic: A PhotoVoice study
Ms Agnes Kupul Mek and A/Prof. Angela Kelly-Hanku
Correlation of SARS-CoV-2 viral RNA concentration with duration and severity of infection among COVID-19 patients
Dr Maria Ome-Kaius
Impact of COVID-19 on household food and nutrition security: experiences and coping strategies of three diverse populations (the urban poor, rural, and urban-employed) in Goroka
Dr Gwendalyn Vengiau
COVID-19 in Papua New Guinea: A qualitative and visual method study to examine socio-cultural knowledge, attitudes, practices and impacts of COVID-19 and COVID-19 related stigma and discrimination
A/Prof. Angela Kelly-Hanku
A mixed method assessment of the impacts of and responses to COVID-19 within primary health care and infectious disease programs in Papua New Guinea
A/Prof. Angela Kelly-Hanku
ACT UP-PNG: Accelerating the uptake of point-of-care HIV viral load testing and introduction of HIV drug resistance monitoring for the management and control of HIV in Papua New Guinea
A/Prof. Angela Kelly-Hanku, Dr Steven Badman, Dr Janet Gare, Prof. Andrew Vallely and Dr Peniel Boas
NG-AMR Study (PNG antimicrobial resistance study)
Mr Barne Willie, Associate Prof. David Whiley
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2020 Publication List PEER-REVIEWED ARTICLES 1. Hakim AJ, Badman SG, Weikum D, Amos A, Willie B, Narokobi R, Gabuzzi J, Pekon S, Kupul M, Hou P, Aeno H, Neo Boli R, Nembari J, Ase S, Kaldor JM, J Vallely AJ, Kelly-Hanku A On behalf of the Kauntim mi tu Study Team. Considerable distance to reach 90-90-90 targets among female sex workers, men who have sex with men and transgender women in Port Moresby, Papua New Guinea: findings from a cross-sectional respondent-driven sampling survey. Sex Transm Infect 2020;96:143–150. 2. Carlota Dobanoa C, Azucena Bardajia, Swati Kocharb, Sanjay K. Kocharb, Norma Padillac, Marta Lopezd, Holger W. Ungere, Maria Ome-Kaiuse, Maria Eugenia Castellanosc, Myriam Arevalo-Herreraf, Dhiraj Hansg, Flor E. Martinez-Espinosah,i, Camila Botto-Menezesh,j, Adriana Malheirosk, Meghna Desail, Aina Casellasa, Chetan E. Chitnisg,m, Stephen Rogersonn, Ivo Mueller, Clara Menendeza, Pilar Requenaa. Blood cytokine, chemokine and growth factor profiling in a cohort of pregnant women from tropical countries. Cytokine 2020;125:1-11. 3. Keven JB, Artzberger G, Gillies ML, Mbewe RB, Walker ED. Probe-based multiplex qPCR identifies blood-meal hosts in Anopheles mosquitoes from Papua New Guinea. Parasites & Vectors 2020;13:1-8. 4. Gruenberg M, Hoffman NE, Nate E, Karl S, Robinson LJ, Lanke K, Smith TA, Bousema T, Felger I. qRT-PCR versus IFA-based Quantification of male and female gametocytes in low-density Plasmodium falciparum infections and theirrelevance for transmission. J Infect Dis 2020;221:598-607. 5. Morgan CJ, Saweri OPM, Larme N, Peach E, Melepia P, Au L, Scoullar MJL, Reza MS, Vallely LM, McPake BI, Beeson JG. Strengthening routine immunization in Papua New Guinea: a cross-sectional provincial assessment of front-line services. BMC Public Health 2020;20:1-10. 6. Macleod CK, Butcher R, Javati S, Gwyn S, Jonduo M, Abdad MY, Roberts CH, Keys D Koim SP, Ko R, Garap J, Pahau D, Houinei W, Martin DL, Pomat WS, Solomon AW. Trachoma, Anti-Pgp3 serology, and ocular Chlamydia trachomatis infection in Papua New Guinea. Clinical Infectious Diseases 2020;20:1-8. 7. Kelly-Hanku A, Redman-McLaren M, Boli-Neo R, Nosi S, Ase S, Aeno H, Nembari J, Amos A, Gabuzzi J, Kupul M, Willie B, Narokobi R, Hou P, Pekon S, Kaldor JM, Badman SG, Vallely AJ, Akim AJ. Confidential, accessible pointof-care sexual health services to support the participation of key populations in biobehavioural surveys: lessons for Papua New Guinea and other settings where reach of key population is limited. PLOS ONE 2020;15:1-16. 8. Persson A, Kelly-Hanku A, Mek A, Mitchell E, Nake Trumb R, Worth H, Bell S. Polygyny, serodiscordance and HIV prevention in Papua New Guinea: a qualitative exploration of diverse configurations. Asia Pac J Anthropology 2020:1-17. 9. Kelly-Hanku A, Aggleton P, Boli-Neo R. Practical justice as an innovative approach to addressing inequalities facing gender and sexually diverse people: a case example of Papua New Guinea. Culture, Health & Sexuality 2020:1-17. 10. Ahmed S, Mvalo T, Akech S, Agweyu A, Baker K, Bar-Zeev N, Campbell H, Checkley W, Chisti MJ, ColbournT, Cunningham S, Duke T, English M, Falade AG, Fancourt NSS, Ginsburg AS, Graham HR, Gray DM, Gupta M, Hammitt L, Hesseling AC, Hooli S, Johnson AWBR, King C, Kirby MA, Lanata CF, Lufesi N, Mackenzie GA, McCracken JP, Moschovis PP, Nair H, Oviawe O, Pomat WS, Santosham M, Seddon JA, Thahane LK, Wahl B, Van der Zalm M, Verwey C, Yoshida LM, Zar HJ, Howie SRC, McCollum ED. Protecting children in low-income and middle-income countries from COVID-19. BMJ Global Health 2020;5:1-3.
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11. Kattenberg JH, Gumal DL, Ome-Kaius M, Kiniboro B, Philip M, Jally S, Kasian B, Sambale N, Siba PM, Karl S, Barry AE, Felger I, Kazura JW, Mueller I, Robinson LJ. The epidemiology of Plasmodium facliparum and Plasmodium vivax in East Sepik Province, Papua New Guinea, pre- and post-implementation of national malaria control efforts. Malar J 2020;19:118. 12. Idoko OT, Smolen KK, Wariri O, Imam A, Shannon CP, Dibassey T, Diray-Arce J, Darboe A, Strandmark J, Ben-Othman R, Odumade OA, McEnaney K, Amenyogbe N, Pomat WS, van Haren S, Sanchez-Schmitz G, Brinkman RR, Steen H, Hancock REW, Tebbutt SJ, Richmond PC, van den Biggelaar AHJ, Kollmann TR, Levy O, Ozonoff A, Kampmann B and on behalf of The EPIC Consortium. Clinical protocol for a longitudinal cohort study employing systems biology to identify markers of vaccine immunogenicity in newborn infants in the Gambi and Papua New Guinea. Frontiers in Pediatr 2020;8:1-13. 13. Dobano C, Bardaji A, Arevalo-Herrera M, Martinez-Espinosa FE, Botto-Menezes C, Padilla N, Menegon M, Kochar S, Kochar SK, Unger H, Ome-Kaius M, Rosanas-Urgell A, Malheiros A, Castellanos ME, Hans D, Desai M, Casellas A, Chitnis CE, Severini C, Mueller I, Rogerson S, Menendez C, Requena P. Cytokine signatures of Plasmodium vivax infection during pregnancy and delivery outcomes. PLOS Negl Trop Dis 2020;14:1-7. 14. Gupta M, Wahl B, Adhikari B, Bar-Zeev N, Bhandari S, Coria A, Erchick DJ, Gupta N, Hariyani S, Kagucia EW, Killewo J, Limaye RJ, McCollum ED, Pandey R, Pomat WS, Rao KD, Santosham M, Sauer M, Wanyenze RK, Peters DH. The need for COVID-19 research in low and middle-income countries. Global Health Research and Policy 2020;5:1-4. 15. Vinit R, Timinao L, Bubun N, Katusele M, Robinson LJ, Kaman P, Sakur M, Makita L, Reimer L, Schofield L, Pomat W, Mueller I, Laman M, Freeman T, Karl S. Decreased bioefficacy of long-lasting insecticidal nets and the resurgence of malaria in Papua New Guinea. Nature Comm 2020;11:1-7. 16. Jabbarzare M, Njie M, Jaworowski A , Umbers AJ, Ome-Kaius M, Hasang W, Randall LM, Kalionis B, Rogerson SJ. Innate immune responses to malaria-infected erythrocytes in pregnant women: Effects of gravidity, malaria infection, and geographic location. PLOS ONE 2020;15:1-15. 17. Fernandez-Becerra C, Bernabeu M, Castellanos A, Correa BR, Obadia T, Ramirez M, Rui E, Hentzschel F, López-Montañés M, Ayllon-Hermida A, Martin-Jaular L, Elizalde-Torrent A, Siba P, Vêncio RZ, Arevalo-Herrera M, Herrera S, Alonso PL, Mueller I, del Portilloa HA. Plasmodium vivax spleen-dependent genes encode antigens associated with cytoadhesion and clinical protection. PNAS 2020;117:13056-13065. 18. Noviyanti R, Miotto O, Barry A, Marfurt J, Siegel S, Thuy‑Nhien N, Quang HH, Anggraeni ND, Laihad F, Liu Y, Sumiwi ME, Trimarsanto H, Coutrier F, Fadila N, Ghanchi N, Johora FT, Puspitasari AM, Tavul L, Trianty L, Retno Ayu Setya Utami RAS, Wang D, Wangchuck K, Price RN, Auburn S. Implementing parasite genotyping into national surveillance frameworks: feedback from control programmes and researchers in the Asia–Pacific region. Malar J 2020;19:1-20. 19. Rogerson SJ , Beeson JG, Laman M, Poespoprodjo JR, William T, Simpson JA, Price RN, The ACREME Investigators. Identifying and combating the impacts of COVID-19 on malaria. BMC Medicine 2020;18:1-7. 20. Angela Kelly-Hanku , H. Worth, M. Redman-MacLaren, S. Nosi, R. Boli-Neo, S. Ase, P. Hou, H. Aeno, M. Kupul, A. Amos, S. G. Badman, A. J. Vallely and A. J. Hakim on behalf of the Kauntim mi tu Study Team. Perpetration Of Violence By Female Sex Workers In Papua New Guinea: ‘We Will Crush Their Bones’. Brit J Criminol 2020;1-19. 21. Pedro N, Brucato N, Fernandes V, André M, Saag L, Pomat W, Besse C, Boland A, Deleuze JF, Clarkson C, Sudoyo H, Metspalu M, Stoneking M, Cox MP, Leavesley M, Pereira L, Ricaut FX. Papuan mitochondrial genomes and the settlement of Sahul. Journal of Human Genetics 2020;65:875–887. 22. Gupta S, Bernays S, Black KI, Ramsay P, Bolnga J, Kelly-Hanku A. Community attitudes and gendered influences on decision making around contraceptive implant use in rural Papua New Guinea. Reproductive Health 2020;17:1-13. 23. Pham BN, Appo J, Gende G , Rao C, Okely AD, Pomat W. Leprosy-tuberculosis Co-infection: A case report in Papua New Guinea. J Med Clin Res & Rev 2020;4:1-3. 24. Abdad MY, Soli KW, Pham B, Bande G, Maure T, Jonduo M, Kisa D, Rai G, Phuanukoonnon S, Siba PM, Horwood PF, Greenhill AR. Diarrhoeal disease surveillance in Papua New Guinea: findings and challenges. WPSAR 2020;11:1-7. 25. Fola AA, Kattenberg E, Razook Z, Lautu‑Gumal D, Lee S, Mehra S, Bahlo M, Kazura J, Robinson LJ, Laman M, Mueller I, Barry AE. SNP barcodes provide higher resolution than microsatellite markers to measure Plasmodium vivax population
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genetics. Malar J 2020; 19:1-15. 26. Molnár P, Orbán A, Izrael R, Babai R, Marton L, Butykai A, Karl S, Beáta G.Vértessy BG, István K. Rapid and quantitative antimalarial drug efcacy testing via the magneto‑optical detection of hemozoin. Scientific Report 2020;10:1-11. 27. Orami T, Ford R, Kirkham LA, Thornton R, Corscadden K, Richmond PC, Pomat WS, van den Biggelaar AHJ, Lehmann D, for the Neonatal Pneumococcal Conjugate Vaccine Trial team 1. Pneumococcal conjugate vaccine primes mucosal immune responses to pneumococcal polysaccharide vaccine booster in Papua New Guinean children. Vaccine 2020;30:1-12. 28. Pham NB, Silas V, Jorry R, Okely AD, Pomat W. Marijuana-use related Homicide: A case study in Papua New Guinea. Annals of Case Reports 2020;14:1-6. 29. Pham NB, Okely AD, Whittaker M, Siba P, Pomat W. Millennium development goals in Papua New Guinea: towards universal education. Educational Research for Policy and Practice 2020;19:181-209. 30. Laman M, Tavul LW, Robinson LJ. Editorial. Four decades of malaria research in Papua New Guinea. PNG Med J 2018;61:1-2. 31. Robinson LJ. Responding to change – current perspectives on four decades of malaria research at the Papua New Guinea Institute of Medical Research. PNG Med J 2018;61:15-20. 32. Gumal DL, Tavul L, Wong RPM, Michon P, Siba PM, Davis TME, Mueller I. Invitro susceptibility of Plasmodium isolates from East New Britain Province to antimalarial drugs using a colorimetric lactate dehydrogenase assay. PNG Med J 2018;61:21-27. 33. Malau E, Laman M, Manning L, Davis TME, Siba P, Barry A, Mueller I, Barnadas C. Investigation of polymorphisms in Plasmodium falciparum hrp2, hrp3, aldolase and pldh genes and their impact on the performance of malaria rapid diagnostic tests in Papua New Guinea. PNG Med J 2018;61:33-45. 34. Emori R, Pulford J, Alawaki A, Manup W, Yaku K, Andaken H, Lavuvur M, Timaus J, Siba PM, Phuanukoonnon S. Tuberculosis knowledge in Hiri (Central Province), Asaro (Eastern Highlands Province) and Karkar Island (Madang Province of Papua New Guinea. PNG Med J 2019;62:38-45. 35. Rarau P, Guo S, Baptista SN, Pulford J, McPake B, Oldenburg B. Prevalence of non-communicable diseases and heir risk factors in Papua New Guinea: a systematic review. SAGE and Open Medicine 2020;8:1-14. 36. Kattenberg JH, Razook Z, Keo R, Koepfli C, Jennison C, Lautu-Ninda D, Fola AA, Ome-Kaius M, Barnadas C, Siba P, Felger I, Kazura J, Mueller I, Robinson LJ, Barry AE. Monitoring of Plasmodium falciparum and Plasmodium vivax using microsatellite markers indicates limited changes in population structure after substantial transmission decline in Papua New Guinea. doi: https://doi.org/10.1101/817320. 37. Gruendberg M, Moniz CA, Hofmann NE, Koepfli C, Robinson LJ, Nate E, Monteiro WM, de Melo GC, Kuehn A, Siqueira AM, Nguitragool W, Bassat Q, Lacerda M, Sattabongkot J, Mueller I, Felger I. Utility of ultra-sensitive qPCR to detect Plasmodium falciparum and Plasmodium vivax infections under diferent transmission intensities. Malar J 2020;19:1-10. 38. Mazhari R, Brewster J, Fong R, Bourke C, Liu ZSJ, Takashima E, Tsuboi T, Tham WH, Harbers M, Chitnis C, Healer J, Ome-Kaius M, Sattabongkot J, Kazura J, Robinson LJ, King C, Mueller I, Longley RJ. A comparison of non-magnetic and magnetic beads for measuring IgG antibodies against Plasmodium vivax antigens in a multiplexed bead-based assay using Luminex technology (Bio-Plex 200 or MAGPIX). PLOS ONE 2020;1-14. 39. Hossain MS, Commons RJ, Douglas NM, Thriemer K, Alemayehu BH, Amaratunga C, Anvikar AR, Ashley EA,10, Asih PBS, Carrara VI, Lon C, D’Alessandro U, Davis TME, Dondorp AM, Edstein MD, Fairhurst RM, Ferreira MU, Hwang J, Janssens B, Karunajeewa H, Kiechel JR, Ladeia-Andrade S, Laman M, Mayxay M, McGready R, Moore BR, Mueller I, Newton PN, Thuy-Nhien NT, Noedl H, Nosten F, Phyo AP, Poespoprodjo JR, Saunders DL, Smithuis F, Spring MD, Stepniewska K, Suon S, Suputtamongkol Y, Syafruddin D, Tran HT, Valecha N, Herp MV, Vugt MV, White NJ, Guerin PJ, Simpson JA, Price RN. The risk of Plasmodium vivax parasitaemia after P. falciparum malaria: An individual patient data meta-analysis from the WorldWide Antimalarial Resistance Network. PLOS MEDICINE 2020;17:1-26.
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40. Middleton J, Abdad MY, Beauchamp E, Colthart G, Cooper MJF, Dem F, Fairhead J, Grundy CL, Head MG, Inacio J, Jimbudo M, Jones CL, Konecna M, Laman M, MacGregor H, Novotny V, Peck M, Paliau J, Philip J, Pomat W, Roberts CH,Sui S,8 Stewart AJ, Walker SL, Cassell JA. Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases. BMJ Open 2020;10:1-11. 41. Middleton J, Cassell JA, Colthart G, Dem F, Fairhead J, Head MG, Inacio J, Jimbudo M, Laman M, Novotny V, Peck M, Philip J, Pomat W, Sui S, West‑Oram P, Stewart A. Rationale, experience and ethical considerations underpinning integrated actions to further global goals for health and land biodiversity in Papua New Guinea. Sustainability Science 2020;15:1653–1664. 42. Miotto O, Sekihara M, Tachibana SI , Yamauchi M , Pearson RD, Amato R, Goncalves S, Mehra S, Noviyanti R, Marfurt J, Auburn S, Price RN, Mueller I, Ikeda M, Mori T, Hirai M, Tavul L, Hetzel MW, Laman M, Barry AE, Ringwal P, Ohashi J, Hombhanje F, Kwiatkowski DP, Mita T. Emergence of artemisinin-resistant Plasmodium falciparum with kelch13 C580Y mutations on the island of New Guinea. PLOS PATHOGENS 2020;16:1-21. 43. Mohamed Y, Kupul M, Gare J, Badman SG, Silim S, Vallely AJ, Luchters S, Kelly- Hanku A, AAMI Study Group. Feasibility and acceptability of implementing early infant diagnosis of HIV in Papua New Guinea at the point of care: a qualitative exploration of health worker and key informant perspectives. BMJ Open 2020;10:1-10. 44. Yee WL, Than KK, Mohamed Y,Htay H, Tin HH, Thein W, Kyaw LL, Yee WW, Aye MM, Badman SG, Vallely AJ, Luchters S, Kelly-Hanku A, on behalf of the AAMI study group. Caregiver experience and perceived acceptability of a novel near point-of-care early infant HIV diagnostic test among caregivers enrolled in the PMTCT program, Myanmar: A qualitative study. PLoS ONE 2020;15:1-16. 45. Kelly-Hanku A, Weikum D, Badman SG, Willie B, Boli-Neo R, Kupul M, Hou P, Gabuzzi J, Ase S, Amos A, Narokobi R, Aeno H, Pekon S, Coy K, Wapling J, Gare J, Dala N, Kaldor JM, Vallely AJ, Hakim AJ on behalf of the Kauntim mi tu Study Team. Factors associated with HIV and syphilis infection among female sex workers in three cities in Papua New Guinea: findings from Kauntim mi tu, a biobehavioral survey. Sexual Health 2020;17:311–320. 46. Grant JS, Chico RM, Lee Anne CC, Low N, Medina-Marino A, Molina RL, Morroni C, Ramogola-Masire D, Stafylis C, Tang W, Vallely AJ, Wynn A, Yeganeh N, Klausner JD. Sexually transmitted infections in pregnancy: a narrative review of the global research gaps, challenges and opportunities. Sexually Transmitted Diseases 2020;47:779-789. 47. Javati S, Masiria G, Elizah A, Matlam JP, Ford R, Richmond PC, Lehmann D, Pomat WS, van den Biggelaar AHJ. An observational study of the reactogenicity and immunogenicity of 13-valent pneumococcal conjugate vaccine in women of childbearing age in Papua New Guinea. BMC 2020;12:1-8. 48. Evesa R, Kelly-Hanku A. Medical pluralism, Pentecostal healing and contests over healing power in Papua New Guinea. Social Science & Medicine 2020;266:1-7. 49. Pham BN, Whittaker M, Okely AD, Pomat W. Measuring unmet need for contraception among women in rural areas of Papua New Guinea. SRHM 2020;28:1-17.
REPORTS 50. Pham BN, Aga T, Jorry R, Abori N, Jauka J, Silas V, Gende G, Kopol M, Maraga S, Degemba B, Gabe V, Kue L, Ainui N, Bola R, Manong Pomat W. Comprehensive health and epidemiological surveillance system technical report: mortality surveillance in communities. Reporting period. January – June 2020. Goroka: Papua New Guinea Institute of Medical Research 2020:1-74. 51. Pham BN, Aga T, Jorry R, Abori N, Jaukae J, Silas V, Gende G, Kopol M, Maraga S, Degemba B, Gabe V, Kue L, Ainui N, Bola R, Manong D, Pomat W. Comprehensive health and epidemiological surveillance system technical report: Morbidity surveillance at primary health facilities. Reporting period: July – December 2019. Goroka: Papua New Guinea Institute of Medical Research, 2020:1-158.
Annual Report 2020
31
2019 and 2020 Financial report PNGIMR’s total revenue for 2020 was K32,678,420. Total expenditure was K24,018,316. This generated a net surplus of K8,660,104. Much of the surplus is committed to future expenditures on research grants and infrastructure projects.
REVENUE Over 70 per cent of revenue in 2020 came from the operating account from the Government of PNG and research grants. An additional K4 million was given by the GoPNG to cover expenses related to laboratory testing for the virus that causes COVID-19.
PNGIMR Revenue in 2020 COVID-19 GoPNG Other sources Buttressing Coalition Fund CHESS GoPNG grant Madang Lab GoPNG grant
3%
Operational grant GoPNG
12%
4% 3%
42%
6%
Research grants
30%
Revenue in 2020 was 17 per cent higher than in 2019. This was due to an increase in revenue from research grants totalling K1 million, the GoPNG grant for managing COVID-19 and K1.2 million from the Buttressing Coalition Fund. These increases were off set by a decrease in other GoPNG grants of K1.4 million. Revenue in Operational grant GoPNG CHESS GoPNG grant Madang Lab construction GoPNG grant COVID 19 GoPNG grants Research grants Buttressing Coalition Fund Other sources TOTAL
32
2019 K 11,047,739 K 2,000,000 K 5,000,000
2020 K 13,631,076 K 1,000,000 K 2,000,000
-
K 4,000,000
K 8,966,374 K 798,469 K 27,812,582
K 9,984,346 K 1,195,594 K 867,404 K 32,678,420
PNG Institute of Medical Research
EXPENDITURE PNGIMR’s expenditure from all revenue sources in 2020 was K24 million; only 4 per cent lower than 2019 expenditures. Personnel costs comprised 54 per cent of expenditures, with another 9 per cent for rates and rentals for offices and staff houses. PNGIMR invested in the future in 2020, by spending nearly 11 per cent on repairs and maintenance and capital.
Detailed expenditure for 2020 Personnel costs Rates and rental Travel Laboratory consumables Repairs and maintenance Capital expenditures Council expenses Other administrative and general expenses Total
K 12,928,923 K 2,144,552 K 1,124,559 K 2,170,472 K 1,177,501 K 1,352,896 K 39,871 K 3,079,542 K 24,018,316
OUR CONTRIBUTORS PNGIMR is grateful for direct and indirect financial support in 2020 from: • Government of Papua New Guinea • Australian Department of Foreign Affairs and Trade • World Health Organization • Global Fund to Fight AIDS, Tuberculosis and Malaria • US National Institutes of Health • Wellcome Trust • Bill and Melinda Gates Foundation
• National Medical and Health Research Council (Australia) • Institutional and individual members of the Buttress Coalition • Menzies School of Health Research • Newcrest Mining Limited & Medicine for Malaria Venture (LMEP) • London School of Hygiene and Tropical Medicine • CSIRO Australia Centre for Disease Preparedness
OTHER FINANCIAL FACTS • PNGIMR-owned buildings and property have been independently valued at K16.7 million. • At the end of 2020 PNGIMR employed 326 staff. • PNGIMR expects to receive an unqualified (clear) audit from the Auditor General’s Office for 2019.
Annual Report 2020
33
PNG Institute of MedicalResearch
Homate Street P.O Box 60. Goroka Eastern Highlands Province, 441 Papua New Guinea Phone: (+675) 532 2800 | E-mail: info@pngimr.org.pg
www.pngimr.org.pg
