After battling illness for years, Nancy Karipa tested positive for HIV in 1999. She had just given birth to her first child. “It was a crossroads moment for me, with the fear of denial, but I chose action,” Karipa, who is now in her 50s, said at an Aids awareness event in Papua New Guinea’s capital Port Moresby in December. She and the baby received treatment, and her child remains healthy.
Karipa, from East Sepik in northern PNG, is unusual in sharing her story. The 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 UN agency that fights HIV/Aids globally, says the epidemic in PNG is among the fastest growing 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 rise of infections in women and children is particularly alarming, UNAids says.
“The transmission of [the virus from] mother to child is very high in Papua New Guinea, one of the highest globally,” says Manoela Manova, UNAids country director for PNG.
Changes to funding for HIV support and prevention have hit PNG hard. The suspension of US foreign aid by the Trump administration this year has affected hundreds of clinics. Sharp global reductions in funding for UNAids is also worrying health providers, and calls for the PNG government to do more are growing.
Manova says HIV awareness has declined over time and now, “it’s like the feeling that the epidemic does not exist”.
“That’s the perception in both the public and in the political class.”
The crisis in the country of about 10 million people is compounded by a combination of factors, including inadequate testing and lack of awareness. UNAids says PNG recorded an estimated 11,000 new cases in 2024, with nearly half of all new infections among children and people aged 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 didn’t receive the necessary antiretroviral therapy (ART) which could have prevented transmission to their child.
“A lot of people do not know their status and that’s the first step to addressing the epidemic [and] to be put on treatment,” Manova says.
US aid freeze hits clinics
The government declared HIV a national crisis in June and put in place an emergency response plan including more testing, treatment and support.
Deputy secretary of health, Ken Wai, says while the government is responsible for drug supplies, other support services and community outreach has depended heavily on US aid. In January, the Trump administration cut foreign aid, which was distributed through the United States Agency for International Development (USAID), although Wai says some funding has been restored to specific programs.
“USAID finances an organisation called FHI360; they help us with data recording, and one laboratory coordinator assists at the central public health laboratory,” Wai says.
Chair of the national Aids council, Wep Kanawi, says the government must do more to address the crisis. The council works to prevent HIV transmission and provide treatment across the country. Kanawi says the government does not receive direct funding from USAID for HIV medicines, but PNG does seek funding from global not-for-profit organisations which receive contributions from USAID. That then supports some HIV programs in PNG, including paying staff salaries, he says.
Kanawi says more than 200 clinics run by the government or churches that provide HIV services have lost funding after the US suspended foreign aid earlier this year, without providing further details about the services the clinics provide. Kanawi wants the government to do more, and says about K45-K50m (US$10m) annually is needed to deal with the epidemic.
“Many of our centres are operating but scaling down on their operations,” Kanawi says.
Kaugere Clinic in Port Moresby, which provides HIV and other health services, is one of the centres affected by the funding freeze. Rose Marai, a social worker at the clinic, says when aid was suspended by the Trump administration, salaries at the clinic were withheld because there was no funding.
“There was no second plan given to us and we were told to close down the clinic, which had affected the communities,” Marai says. “I used to receive K1,000 (US$235) to run a day awareness program in communities but since the stop of funding I now receive K240 monthly.
“I started doing voluntary counselling of referral patients who were already tested 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 Department of State and other US agencies, includes robust programs in security cooperation, disaster preparedness, and health.”
At the same time, UNAids has this year seen what it describes as a “historic funding crisis” because of cuts in the US foreign aid budget and reductions from other donor countries. A December report from UNAids said abrupt funding reductions and persistent funding shortfalls “are having profound, lasting effects on the health” of millions of people, although it noted funding for some HIV programs has restarted.
UNAids in PNG say the country has so far been shielded from the hit as Australia stepped in with additional funding. In October, the Australian government said it would “increase its annual HIV development funding to almost A$10m this financial year”.
Manova says additional funding from Australia will help maintain the UNAids office in PNG “for another two years”.
Still, concerns are rising in PNG that the epidemic highlights the fragility of the health sector and the heavy reliance on foreign aid, amid a surge in infections.
Foreign minister Justin Tkatchenko says the country needs a “fallback position”.
“The longterm strategy is doing it ourselves. We can’t continually rely on other donor partners to help us,” he says.
Rebecca Bush contributed to this report
