Report - Office of Development Effectiveness (ODE)

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Report - Office of Development Effectiveness (ODE)of,ODE

     ANNEX 26





    JANUARY 2011

     ANNEX 26





    JANUARY 2011

    Emily Rudland


    Purpose 1 Key findings 2 International practice 2 The LNG project and its risks 2 Services already available 3 What is being planned? 4 Conclusion 10 References 12

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    The purpose of this paper is to supplement the analysis of the Australian Agency for International Development’s (AusAID) contribution to the National Strategic Plan on HIV

    and AIDS between 2006 and 2010 with a forward looking analysis of AusAID’s potential

    contribution to social risk mitigation of the liquefied natural gas (LNG) project. The paper considers the relevance of the role of AusAID being involved in the social risk mitigation, and the appropriateness of activities and plans made to date.

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    International practice

    It is clearly established from international experience that mining projects bring with them increased risk of human immunodeficiency virus (HIV) transmission. On top of the dynamics around HIV transmission common to all development environments (such as unequal power relations between men and women), mining projects tend to produce a working environment that creates a risk-taking mentality and exaggerated forms of masculine identity among workers, combined within a recreational environment in the surrounding communities conducive to risky behaviour through transactional sex and intravenous drug


    The ethical responsibility of mining companies to develop HIV prevention, treatment and care programs for their workforce and the surrounding communities is also clearly established. It is common for mining companies to provide HIV awareness programs, condom distribution, testing and treatment services, as well as health services for the surrounding communities. Guidelines from the International Council on Mining and Metals suggests that it is important to focus on communities as well as the workforce, and to treat the three diseases (HIV, malaria and tuberculosis [TB]) in an integrated manner to address


    The international literature suggests that, while HIV interventions around mining projects may be well resourced and extensive, many seem to focus on prevention approaches that are known to have little effectiveness when they are not part of a comprehensive prevention approach. Some studies of HIV interventions in South Africa by mining companies suggest that prevention programs have had little impact, as they do not address the social and

    3developmental dimensions of HIV transmission.

    No literature was identified that focuses on government or donor approaches to mitigating the impact of HIV transmission around mining projects, although it is recognised that mining companies will normally work with external partners in setting up and delivering their programs.

    The LNG project and its risks

    The LNG project, currently at the start of its construction phase, will be a major influence in the Papua New Guinea (PNG) economy and society over the next 30 years. It will involve a large workforce of international and national workers.

     1 Governance and Social Development Resource Centre, Helpdesk Research Report: HIV Transmission and National

    Resource Extraction Projects, 2010. 2 International Council on Mining and Metals, ICMM Good Practice Guidance on HIV/AIDS, Tuberculosis and Malaria,

    2008. 3 AusAID Thematic Knowledge Services literature search: ‘’Mines and HIV risk prevention, Establishing mining

    projects’, conducted July 2010.

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    Its main impact will be in the Southern Highland Province (SHP) and Gulf Province (extraction facilities), Western Highland Province (business centre and regional service hub) and National Capital District (processing plant and port). However, it will also involve major transport operations on the Highlands Highway, which extends its influence throughout the

    4 highlands provinces and Morobe.With a mobile workforce likely to come from around the

    country, the potential impact of increased HIV transmission related to the LNG project could be widespread.

    The main project impact areas include the poorest and most under-serviced in the country. The LNG Project’s Social Impact Assessment identified HIV as a key risk of the project, in a context where social networking and gender-based violence are common and surveys have

    5identified high caseloads of untreated sexually transmitted infections (STIs).

    Local service providers estimate HIV prevalence in the Southern Highlands Province at around four per cent, and report increasing deaths from acquired immune deficiency syndrome (AIDS). Local service providers and government officials have expressed serious

    6concerns to an AusAID scoping team about the impact of the LNG project on HIV.

    In meetings with government and non-state stakeholders, the evaluation team heard widespread concern about the possible impact of the LNG project. A government official said: ‘LNG will be a big problem for me’.

    The evaluation team’s visit to Western Highlands Province in October 2010 revealed that the

    LNG project is expected to substantially impact on HIV risk and transmission, and on demand for services. Stakeholders are already seeing an impact from the LNG project in terms of increased activity in Mt Hagen, and increasing demand for services. Stakeholders do not know how they are going to respond given they are already struggling to meet existing needs.

    We will just see what happens. We’re not ready.

    We talked about it at the highlands bishop’s meeting, we don’t know how to prepare.

    Services already available

    Oil Search Limited (OSL), one of the LNG project partners, is already providing community health services in the project impact areas. Funded by AusAID and the Asian Development Bank (ADB) through the Rural Enclaves Project, OSL provides support and supervision for community health facilities run by government or faith-based providers, and operates five of its own clinics providing testing, counselling and treatment for its workforce. Other services in the area are provided by the government (Tari Hospital, Tari HIV/STI clinic), Médecins Sans Frontières (hospital level management and nursing care and family

     4 See LNG Project website: . 5 Goldman, L. PNG Liquefied Natural Gas Social Impact Assessment 2008, 2009. 6 HIV Program, Report on Scoping Mission to the Southern Highlands Province and a follow-up visit to the Western Highlands Province including Jiwaka February 8-11 2010, 2010.

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    and sexual violence clinics), Clinton Foundation (providing support for government

    7facilities), Catholic Diocese and the Evangelical Church of PNG.

    The Southern Highlands Province and Western Highlands Provinces are priority provinces for the PNG Australia HIV and AIDS Program (HIV Program).

    What is being planned?

    The most advanced plans to mitigate the HIV impact of the LNG project are those of the LNG partners. Based on information available to the evaluation team it appears planning by AusAID, the Government of PNG and other development partners are still in the early stages.

    Government of Papua New Guinea

    Specific mitigation plans by the PNG Government (national and provincial) have not yet been identified.

    The evaluation team heard reports that the LNG project is being widely discussed within the Government of PNG. This does not appear to have translated into action. Following its assessment visit in April 2010 the Independent Review Group (IRG) on HIV and AIDS wrote:

    Nationally and locally, there generally continues to be a poor understanding by leadership that business as usual will not suffice given the severity and impact of HIV, especially within the

    8context of major development activities such as the LNG project.

    The need to focus on mitigation of the LNG project risks is reflected in the National HIV and AIDS Strategy 20112015 (NHS). The NHS includes strategic objective 3.2.3:

    ‘Economic enclaves and resource developments include HIV prevention and primary health care interventions’, and the related target of ‘100% of large-scale projects have HIV

    prevention and primary health care interventions by 2015’.

    The NHS says:

    The significant health impact of large resource developments and economic projects (such as the LNG Project, mines, special economic zones and agricultural plantations) must be planned for and addressed comprehensively. Specific commitments on HIV and STI prevention and gender equality must be included in contracts relating to resource extraction, the transport sector, infrastructure construction and economic enclave development. Existing work to reduce HIV vulnerability in economic enclaves and in economic corridors such as the Highlands Highway will

    9 be sustained and expanded.

    The specific actions the NHS identifies in relation to achieving strategic objective 3.2.3 are:

     7 HIV Program, Report on Scoping Mission to the Southern Highlands Province and a follow-up visit to the Western Highlands Province including Jiwaka February 8-11 2010. 8 P Aggleton et. al., Independent Review Group on HIV/AIDS report from an assessment visit 22 April 5 May 2010, 2010,

    p. 16. 9 NACS, Papua New Guinea National HIV and AIDS Strategy 20112015, 2010, p. 34.

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    > Amend Mining, Forestry and other relevant Acts, policy and agreements to ensure future economic developments meaningfully address HIV and AIDS.

    > Ensure all current and future economic developments (for example, LNG, mines, plantations, fisheries and so on) undertake HIV impact assessments and develop and

    10implement appropriate interventions for their workforce and surrounding communities.

    LNG impact mitigation is also indirectly covered by strategic objective 3.2.4: ‘Expand and improve public private partnerships for the delivery of HIV prevention, care, support and treatment services’.

    However, in a strategy that has many objectives, the NHS’s focus on economic enclaves is relatively minor. LNG impact mitigation is not reflected in the NHS’s top ten interventions, headline targets or monitoring indicators.

    Some provincial level governments are starting to plan for the LNG project. The Western Highlands Government health department is hoping to set up a ‘one-stop’ centre to meet

    demand for health services, and at the time of the evaluation fieldwork was waiting to hear if its proposal to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund)

    11 Round 10 would be successful.

    LNG partners

    The evaluation team had feedback from a number of stakeholders that OSL is well respected for its corporate responsibility. The respect for the commitment and capabilities of OSL is reflected in its nomination as a principle recipient of the Global Fund Round 10 grant. Some stakeholders expressed scepticism about Exxon Mobile’s commitment to social impact mitigation.

    The LNG partners are developing community health plans and activities. The Project Health Safety and Security Plan states a commitment to focusing on surrounding communities: Specifically focuses on the mitigation of potential community health impacts that may be attributed to the Project and its workforce, and are considered to be the responsibility of the


    13Activities in process include:

    > a partnership for health with the Institute of Medical Research (IMR). IMR has developed detailed technical approach/protocols for the evaluation of STI rapid diagnostic testing kits across key project areas with an emphasis on the Highlands Highway > working with non-government organisations (NGOs) and faith-based organisations to enhance and develop Voluntary Counselling and Treatment capability at key locations to serve communities in the project impact area

     10 NACS, Papua New Guinea National HIV and AIDS Strategy 20112015 Implementation Framework, 2010. 11 Key informant interview. 12 LNG Partners, PNG LNG Quarterly Environmental and Social Report First Quarter 2010, 2010, p. 28,

    _8_pages.pdf>. 13 LNG Partners, PNG LNG Project HIV/AIDS Factsheet, (undated).

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    > working with partners to develop a detailed plan to significantly improve the diagnostic laboratory capability at key clinics in the project impact area

    > information, education, communication and behavioural change activities in key communities through existing clinics and community health organisations > outreach and education about the risks of HIV and AIDS, as well as voluntary testing, for employees and contractors

    > submitting the project policy on STIs and HIV/AIDS to the Business Coalition Against HIV and AIDS

    > developing scopes of work for NGOs regarding general project worker education and transportation of workers

    > coordinating meetings with project teams to define ‘closed camp’ policies and enforcement procedures

    > under the Strategic Community Investment Program, collaborating with AusAID to deliver primary school textbooks and capacity building booklets (including HIV/AIDS prevention, problem solving and violence prevention booklets) to the Hiri District and remote areas of the Southern Highlands

    > planning to manage STIs as a separate but inter-linked program.

    In addition, contractors are required to have specific STI and blood borne pathogen management plans which include: education and prevention activities, supportive programs encouraging early diagnosis and counselling at camp clinics, referral processes to local health services for viral STIs, on-site treatment for non-viral STIs, provision of barrier contraception on-site, control of camp access to limit inappropriate interaction, identification of at-risk workers (for example, first aid and clinical staff) and provision for appropriate personal protective equipment and response procedure (for example, for needle stick injury). An independent environmental and social assessment states:

    From the information provided in the field, the overall Project health program is considered

    appropriate for a Project like this, has significant budget resources allocated, and has the

    opportunity to deliver long term benefits to the PNG health system. An aggressive program for

    TB, HIV/AIDS has been established throughout all Project locations including the partnership

    14with several carefully selected national partners as well as NGOs.

    It is possible that this assessment is referring to OSL programs that pre-dated the LNG project, as other activities by the LNG partners appear to be still being set up. The evaluation team notes that current activities by OSL, and activities being planned by the LNG partners, only cover the immediate impact areas from the LNG project. The evaluation team does not have details on the types of prevention programs being planned by the LNG partners, and what geographical areas they will target.

     14 D’Appolonia S.p.A., Final report of the Independent Environmental and Social Consultant Environmental and Social Compliance Monitoring, PNG LNG Project, Site Visit: May 2010, 2010, p. 12.

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