PNGIMR 40th Anniversary and Colloquium

CONTENTS
Thank you to sponsors Colloquium Organizing committee Invited guests PNGIMR Council Members Welcome address Governor of EHP - Mr Mal Smith Kela Message from the Patron of the 40th Anniversary & Colloquium - Sir Peter Barter Message from the Butteressing Coalition Chairperson - Professor Fiona Stanley Welcome remarks from the PNGIMR Director - Professor Peter Siba (2006-2008) Foreword - PNGIMR Colloquium and 40th Anniversary Celebration Co-Chairs - Mr Samson Akunaii and Mr Livingstone Tavul PNGIMR Directors report - Professor Peter Siba PNGIMR Past Directors reports - Dr Dick Hornabrook - Professor Michael Alpers - Professor John Reeder Finance Managers report Administration Managers report PNGIMR branch reports - Madang Branch - Maprik Branch PNGIMR Unit reports Operational Research Unit - Public health, social and behavioural research - Strengthening HIV social research capacity in PNG Infections and Immunity - Immunology - Molecular Microbiology - Virology - HIV/STI - Bacteriology Vector Borne Diseases - Research in PNGIMR Vector Borne Diseases Unit - Molecular Parasitology - Immunology - Entomology - Microscopy - Data Entry and IT Support 1 2 3 5 7 8 9 11 12 13 16 17 22 25 27 29 31
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PNGIMR Colloquium and 40th Anniversary Magazine
Kuru Computing and Statistics Information and Communications Laboratories Training - Global infectious diseases research training program A reflection of life in PNGIMR - Stories from long serving staff - Pioto Namugui - Professor Peter Siba - Gerald Saleu - Cynthea Leahy - Livingstone Tavul - David Kotale - Gol Dadok - Joe Paino - Walaf Sakel - Nasi Sinup - Mannaseh Baea - Lubus Kaukesa - Daina Lai - William Pomat - Johannes Haay - Long serving staff in Maprik PNGIMR in pictures In memorium Map of Papua New Guinea
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Thank you to our sponsors:

The Papua New Guinea Institute of Medical Research thanks the following Organisations, Institutions and Business Houses for their contribution in cash or kind towards sponsoring the 2008 PNGIMR 40th Anniversary and Colloquium:
Air Niugini Belltek Chemicals Bird of Paradise Hotel Brian Bell & Co Case Western Reserve University EBOS PNG Limited Ela Motors Goroka Coffee Roasters Goroka Didiman Hardware Intelink Kooka Gas Supplies Laikos Architects Laisans Autoparts LTD Madang Lodge Mendikwae Group Limited Moibamo Constructions MRDC Nambawan Super Niugini Electrical Ok Tedi Mining Limited Pacific Gardens Hotel RAM Building Constructions Welcome Stationary
Colloquium Organizing Committee

Executive Committee
Samson Akunai Chairman (Goroka) P.O. Box 60 Goroka EHP 441 Papua New Guinea PH: (675) 732 2800 (ext 210) Fax: 732 1998 Email: samson.akunai@pngimr.org.pg Livingstone Tavul Co Chairman (Madang) P.O. Box 387 Madang Madang Province Papua New Guinea PH: (675) 852 2909 Fax: (675) 852 3289 Email: livingstone.tavul@pngimr.org.pg William Pomat P.O. Box 60 Goroka EHP 441 Papua New Guinea PH: (675) 732 2800 (ext 214) Fax: 732 1998 Email: william.pomat@pngimr.org.pg Martina Yambun P.O. Box 60 Goroka EHP 441 Papua New Guinea PH: (675) 732 2800 (ext 205) Fax: 732 1998 Email: martina.yambun@pngimr.org.pg John Taime P.O.Box 387 Madang Madang Province Papua New Guinea PH: (675) 852 2909 Fax: (675) 852 3289 Email: john.taime@pngimr.org.pg
Accommodation Committee
Martina Yambun David Kotale Daphne Sepe
Sports/Venue Committee
Morris Andy Kim Papaso Daniel Mondurafa
Food and Social Committee

June Hamena
Open Day Committee

John Taime Pamela Toliman
Special Recognition Committee

Peter Siba Manasseh Baea Thomas Adiguma
Scientific Committee
Livingstone Tavul William Pomat Ivo Mueller Pascal Michon
Sightseeing Committee
Gerald Saleu
Media and Information Committee

Llane Munau Douglas Diave Susan Gandi Kukzahe Iva Sunnry Talipe Magazine Design and Editorial Committee Llane Munau Albert Serra Pou Cynthea Leahy Susan Gandi
Fundraising Committee
Samson Akunaii Livingstone Tavul Jack Taraika Melinda Susapu Roslyn Maiya Llane Munau
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Invited Guests
Aaron Jenkins Adolf Saweri Alan Cowman Ali Kevin Alice Bais Allan Saul Allan W Cripps Alois Tama Alyssa Barry Amallasa Pallar Amuk Turlua Peter Andrew Collins Andrew Vallely Angie Sabumei Anis Kuri Anita Groos Anita van den Biggelaar Anne Kelso Anne Sehonae Arammov Anatoly Asavi Kendua Asibo Wahasoka Bale Pakalu Barbara Andersen Barbara Joyce Barbra Holt Barry Combs Bart Currie Beatrice Marjen Ben Alpers Benetty Kadavaion Joseph Bernard Brabin Bertha Kenneth Beverley Biggs Blaise Genton Bob Ginbey Boni Oveyara Brendan Crabb Brian Kay Bruce Robinson Bryant Allen & Fadwa Al-Yaman Buka Goli Malai Candy & Julie Lombange Carolyne Taime Cathy Tiru Charles Mgone Charles Watson Cherlyl Johansen Chetan Chitnis Chris King Chris Moraitis Chris Morgan Clara Menendez Clement Malau Colin Masters Daniel Champion Daniel Tisch David Burgner David Dunn David Forbes David Ikabala David Isaacs David Kemp David Smith Debbie Chapman Deborah Lehmann Denise Deolan Dimitri Prybylski Dr Braum Edwards Eigel Sorensen Esther K. Simon Esther Kulbob Fadwa Al Yaman Fiona Stanley Francis Tuwaio Frank Cooper Frank Shann Gabriel Kapris Gairo & Violet Gerega Gary Fagon Geoff Shellam George & Dawn Parsons George Anian Gibson Winston Gideon Philip Gilbert Hiawalyer Graham Brown Guim Kagl Guy Barnish Harin Karunajeewa Heather Worth Helen Bashir Henry Siwi Herrick Aeno Hilliary Petau Hiru Olabe Ian Maddock Ian Riley Ingrid Felger Ingrid Laing Ipi Hailaevila Isi Kevau Jacqueline Cattani James & Miriam Korarome James Beeson James Kazura James Kila James Marabe, MP James Topo Jane Barker Jane Thomason Jeffrey Warner Jennifer Blackwell Jerome Whitfield Jerry Adams Jim Tullock Joachim Pantumari Joanne Liciandro Joe Nale John Collinge John Finlay-Jones John Mackenzie John Matthews John Milan John Reeder John Richens Veronica Spooner John Vail John Vince John Leedom Josephine Aho Kanji Hanagata Karen Day Kasure Karigifa Kathleen Pilny Kathrine Trenholme Kazuhiro Suda Kazumi Natsuhara Kelly Lovuru Ken Boon Ken Ilett Kuldeep & Saroj Bhatia Lara Herrero Lawrence Hammer Leanne Tilley Lee Hall Leonard Harrrison Lisenia Boletu Louis Schofield Lysaght Griffin Madline Lemeki Malai Malcolm Smith Kela Malcom Avusi Malla Rao Marcel Tanner Margaret Mogish Margaret Sali Maria Etai Maria Yazdanbakhsh Mark Menz
Martha Mellombo Mary Yohogu Masahiro Umezaki Mathias Sapuri Maxine Whittaker Megan Passey Meroly Lengo Mexy Kakazo Michael Alpers Michael Foley Michael Good Michael Mohe Mike Toole Monica Noah Monica Sungu Moses Bockarie Keith & Chris Coakley Nakapi Tefuarani Nana Yapea Nancy Erdey Nayer Kaviani Neal Alexander Nellie Hazame Nevile Bruce Nicholas Kuringi Nivia Weti Ohtsuka Patrick Holt Paul Constable & Jenny Rush Paul Garner Paul Torzillo Paulus Matane Pedro Alonso Peter Barter Peter Beck Peter Deutschmann Peter Heywood Peter McMinn Peter Richmond Peter Sapak Peter Tagayu Peter Zimmerman Peter Jacoby Pibi Auyana John Bride Rachel Hinton & Daniel Cowley Ray Sanders Ray Spark & Helen Spark Robert Attenborough Robert Clancy Robert Graham Robert Palme Robin Anders Robin Hide
Ruth Kirarock Sarah Yarsley Sasa Zibe Shingo Odani Shirley Lindenbaum Simon Mead Sir Isi Kevau Sir Peter Barter Sivon Makeso Stephen Rogerson Steven Collins Steven Tiwara Steven Wesseling Steven Yoifa Sue Serjeantson Suzanne Cory
Suzanne Crowe Suzanne Garland Tachi Yamada Tania Timi Thomson Harokaqve Tim Davis Tom Riley Tony Aimo Tony Steward Trevor Duke Tsukasa Inaoka Wayne Melrose Wendy Alpers Wilfred Peter Zachery Dimber Zachery Per
PNGIMR Council Members from 1968-2008

Sir Macfarlane Burnet Professor R. J. Walsh Professor F. J. Fenner Professor K. P. Lamb Mr N. I. Uroe Mr O. Tammur Dr R. F. R. Scragg Dr I. Maddocks Dr F. A. Rhodes Professor B. S. Hetzel Mr Z. M. Zurecnuoc Professor H. M. Whyte Dr R. W. Hornabrook Dr W. D. Symes Dr A. J. Radford Professor R. N. H. Bulmer Professor P. F. Sinnet Dr J. C. Rooney Dr J. O. Tuvi Mr Raphael Bele Mr John Pokia Mr Paul Langro Mr Anthony Ila Dr J. Onno Dr A. Toua Dr J. R. A. Biddulph Dr A. Saweri Professor A. Strathern Dr D. Amato Dr C. Bowie Dr J. Foote Dr J. Igo Mr P. Kakorya Mr K. Kale Mr A. Miakwe Mr R. Safitoa Dr J. Christie Dr J. Igo Mr S. Krokie Dr R. A. Latukefu Professor Sirus Naraqi Dr A. Tarutia Dr B. Taukuro Professor Michael Alpers Dr Issac Ake Dr Timothy Pyakalyia Dr Wari Iamo Professor John Reeder Dr Kilagi Vanuga Dr Nicholas Mann Dr Mathias Sapuri Mrs Dauga Anakapu Dr Tukutau Taufa Dr Isi Kevau Dr Clement Malau
Welcome address from the Governor of Eastern Highlands

Distinguished guests, friends, ladies and gentlemen. The Eastern Highlands Province, the home of the everlasting spring, hosts the head quarters of one of PNGs finest Institutions the PNG Institute of Medical Research. The Institute which enjoys a high level of reputation both on the local and international scene for its excellent work in its mandated field of delivering Health Research Services into major health problems affecting the people of PNG and providing evidenced based findings and research outcomes to influence and assist in the development of health policies in PNG as well as contributing to the global knowledge in tropical diseases and patterns. It is my great pleasure as the Governor of the host province to welcome you all both former and current staff of the PNGIMR, members of the IMR Council, partners, stake holders, members of the buttressing coalition and scientists to this 40th anniversary celebrations and Colloquium. I invite you to join me in celebrating the IMR and the Eastern Highlands Governor: many achievements of its research work since it was established 40 years ago. The Papua New Guinea Institute of Medical Research has, since 1968, been recognized as a premier institution, a jewel of biomedical and social science research in the Pacific and, indeed, the world. I have always admired the work of the Institute and the high accolades it receives and visitations to their office and laboratory facilities from highly esteemed people and dignitaries is an expression of the excellent work that is produced by the Institute. These excellent accolades cannot be expressed without the dynamic leadership at the helm and the untiring efforts of its hard working staff, its collaborating partners and many of its key stakeholders at large. Despite the growth of the Institute and increase in the scope and activities of its work, I am pleased to note that the Institute continues to be focused on the relevance of its work towards the health priorities of PNG and this is something we all can be proud of. Over the 40 years of its existence, the work of the Institute has made some direct impact on the lives of people and contributed towards successful interventions and management of diseases including contributing significantly towards assisting the National Health Department with its planning and policy developments. The 40th Anniversary celebrations and colloquium should be a time of reflection on the work of the Institute over the years, take stock of its achievements and shortcomings and re-strategize for the next 40 years. The next 40 years will not be as easy as the last 40 years because of significant changes in the life style of Papua New Guineans and the challenges this will pose. HIV/AIDS for instance has already taken a strong foothold in all sectors of the PNG community and modern diseases like heart, liver and kidney problems are on the rise. Let us not forget the re-emerging diseases like TB, typhoid and many others. This important occasion should also be a time for the Government to reflect and rethink its priority on health and push for stronger core funding and support to maintain the core administration and infrastructure and boost the efforts of important Institutions like the PNGIMR in pursuing their mandate which has and continues to have a positive impact on the lives of Papua New Guineans now and in the future. 40 years is a long time and I believe that our friends and visitors from overseas including those from within PNG will take time to reminisce on old times, recall your experiences at the PNGIMR, the ups and downs you may have encountered and use these invaluable experiences and encounters to chart the next 40 years. I wish PNGIMR happy 40th anniversary and wish you all the best and trust you will all enjoy the hospitality of the people of Goroka and the Eastern Highlands Province. Mr Malcom Smith Kela Governor of Eastern Highlands
PNGIMR Colloquium and 40th Anniversary Magazine 7
Mr Malcom Smith Kela, CMG, MBE, DFC, MP
Message from the Colloquium Patron

Distinguished guests, ladies and gentlemen. It is my great pleasure and privilege to welcome you all -- former and current staff of the PNGIMR, members of the IMR Council, partners, stake holders, members of the buttressing coalition and colleagues -- to this Colloquium. I invite you to join me in celebrating the IMR and the many achievements of its research work since it was established 40 years ago. A special mention to Dr Bill Hornabrook, the former Director of the Institute of Human Biology, the forerunner to IMR who unfortunately cannot be here with us today but deserves recognition as a pioneer of medical research and indeed one of the founders of IMR. In 1967/68 I was the pilot who carried blood samples from Wonenara to Madang that was sent to Australia and am fully aware of the work done by Dr Hornabrook and the researchers and staff of IMR when it was established in 1968. Over these years since 1968, the Papua New Guinea Institute of Medical Research has become recognized as a premier institution, a shining jewel of biomedical and PNGIMR Colloquium & 40th social science research in the Pacific and, indeed, the whole developing world. Anniversary Celebration These well-deserved accolades were achieved through creative leadership and the Patron: Sir Peter Barter sheer hard work of you all, in keeping with the goal of IMR to conduct research into the health problems faced by Papua New Guineans. This research has been organized primarily around the core diseases of pneumonia, malaria, malnutrition, enteric diseases and sexual health. The IMR has not only studied these diseases but has also aimed to pursue its research studies until they make a difference to peoples lives. There are many successful research programs conducted by and through IMR over the last 40 years, many of which you will hear about in the scientific sessions in the days to come. These researches have led to successful interventions and management of diseases and also near eradication of some diseases in the country. Pigbel and kuru are two that come to mind as success stories from the diligent and fruitful efforts of PNG IMR staff. Certification of PNG as polio free was also achieved through the work at the IMR and plans to eliminate filariasis are based on the IMRs intervention research. In the use of insecticide-treated bed nets and the development of a blood-stage vaccine to prevent malaria IMR has led the way. The IMRs work has helped the Health Department with policy changes to combat pneumonia, malaria, measles and sexually transmitted infections. There are many more examples, as your contributions here will attest to. Let us take the time at the colloquium to reflect upon and re-live our past successes. Let us also take the time to learn from these experiences, as plans are made to continue the hard work and raise the bar to face up to the challenges in the next 40 years. A concern that is shared by many is the deterioration of the rural health services in most parts of PNG resulting in some of the worst indicators in infant and child mortality, women dying in childbirth access to potable water and a means of disseminating awareness to promote better health by eating local, quit smoking and chewing of buai. Already new and emerging diseases have taken a foothold in Papua New Guinea as our health system struggles to cope with the burden of existing infectious diseases. Taking on the complexities of HIV/AIDS and the diseases associated with a modern lifestyle while continuing work on existing diseases will be challenging for the IMR. Finding innovative ways to make health systems more effective will be an essential part of the plan to improve the health and well-being of our people. I take this opportunity to congratulate the IMR on its work over the last 40 years and wish you good fortune as you continue to contribute to lessening the burden of disease faced by our people. As the motto on the IMR logo says, Save tambuim sik: the new knowledge and understanding that you create serves to prevent sickness and harm and to improve the quality of all our lives. Thank you ladies and gentlemen. Sir Peter Barter, (Hon. D.Univ ACU), Kt, OBE
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Message from the Buttressing Coalition Chairperson Professor Fiona Stanley

Two years ago I attended an annual symposium of the Medical Society of Papua New Guinea (PNG) which was organised by members of the PNG Institute of Medical Research (PNGIMR) in Goroka, Eastern Highlands Province, where their headquarters are located. The scientific program was rich, varied, excellent and relevant to the major health problems facing the country. Presentations from international researchers were interspersed with those by indigenous PNG scientists, most of whom had been brought up in a village and now were performing at an international level of excellence. After being scientifically exhilarated during the day, we were entertained superbly in the evening by local students and staff from the Institute and from the University of Goroka in traditional costumes with dancing, music and theatre from different groups from many parts of PNG. And the food was great too! This is the way to run a conference and keep collaborators engaged as well showcasing both the science and the rich culture of PNG. I am looking forward to the 40th Anniversary Colloquium of the PNGIMR to be held in Goroka at the end of June this year.
In the meantime I have learned a lot about the PNGIMR, what it has achieved and what it aspires to achieve. A recent visit of Peter Siba and Ivo Mueller to Perth helped considerably to inform us all here. The PNGIMR is the national institute for health and medical research in PNG and one of the leading biomedical research institutes in the developing world. Over the last 40 years it has conducted research to serve the local health problems in PNG and to enhance the capacity of PNG nationals to participate in this research and its application. Professor Peter Siba, the Director, is a product of this capacity building and is continuing its traditions of relevant research to underpin successful management of the range of diseases and problems which challenge the health and wellbeing of the Papua New Guinean population. While its administrative headquarters and main laboratories for microbiology, immunology and genetics are in Goroka, the Institute also has major branches in Madang and Maprik and smaller bases in Waisa (for field studies on kuru), Wewak and Port Moresby. The main laboratories for malaria research are in Madang and include microscopy, molecular parasitology, immunology and entomology. The Operational Research Unit, which is engaged principally in behavioural research on HIV/AIDS, is based in Goroka. Laboratory studies on sexually transmitted infections are conducted in Goroka. The epidemiological, immunological and microbiological studies on acute respiratory infection, for which the Institute has long been a WHO Collaborating Centre, are based in Goroka, though new studies have also begun at Modilon Hospital in Madang. The involvement of the Telethon Institute for Child Health Research (TICHR) resulted from the retirement to Perth of a former Director of the PNGIMR, Michael Alpers (Director from 1977 to 2000). We were lucky to recruit his partner Deborah Lehmann into our Institute to head up our infectious disease epidemiology. Deborah brought a huge experience and international network around acute lower respiratory infections in children (particularly pneumococcal disease), with a proven track record in capacity building and epidemiological fieldwork in difficult conditions. Her research now includes surveillance, epidemiology, a longitudinal study of otitis media in Aboriginal and non-Aboriginal children in a rural city in WA, evaluation of preventive strategies (vaccines, swimming pools in remote communities) and creating an environment of research excellence, generally and amongst our Indigenous researchers (Deborah is the lead applicant on our Indigenous Capacity Building grant). TICHR now has a major research project (with many sub-studies) with PNGIMR funded by the Wellcome Trust and the NHMRC. This is a neonatal pneumococcal vaccine trial that not only focuses on the safety of vaccination at this early age and immune responses to conjugate vaccine but also on morbidity (since pneumonia is the leading cause of sickness and death in these children) and bacterial carriage (which is a major risk factor for early disease).
Professor Fiona Stanley Chair, Buttressing Coalition Director, Telethon Institute for Child Health Research
The PNGIMR has a long history of successful international collaboration, from which Michael Alpers created the concept of a Buttressing Coalition. This has been in place since 1999, aiming to support all the research and training activities of the PNGIMR and to maintain its institutional strength without jeopardising its independence. The Buttressing Coalition was previously chaired by Professor Steve Wesselingh from the Burnet Institute in Melbourne whom has now left the Institute to become Dean of Medicine at Monash University. I would like to acknowledge his leadership in heading up the Coalition from 2005 to 2007. Previously the Coalition was led, in a more informal way, by Michael Alpers and his immediate successor as PNGIMR Director, John Reeder. Whilst there are already benefits flowing both ways between collaborating institutions such as those which PNGIMR has with all its individual collaborators, we believe that there are added advantages of having a Buttressing Coalition. These were referred to by Alpers in 2003 (Alpers MP Trends in Parasitology 19 no 6 p278 -280) and included two-way exchange and training expanding into many way opportunities across all of the institutions to enrich the local work and research; greater buttressing power from a greater number of joined-up forces, including funding and capacity building opportunities; an effective network for recruiting new members for research or training (becoming urgent and important for PNGIMR see below); and placing good science in a wider context in the various ways in which we all communicate. With the involvement of the Health Department and the Medical School in PNG, there is the chance to review and inform policy, and the strategic, ethical and practical issues facing the nation. Understanding the challenges facing PNG means that the individual and collective Coalition partners can use all their skills, capacities and networks in novel ways to serve PNGIMRs agenda. A major issue currently challenging the PNGIMR is the problem of attracting highly trained researchers to live and work in PNG. Salaries are lower than in the developed world and scientists also risk losing their track record status in their own peer groups and institutions, which may jeopardise their future careers. There is a program of training at PNGIMR with excellent young scientists undertaking Honours (through the Fogarty scheme) and masters (eg, Jacinta Francis who is currently in Perth) but there is only one Papua New Guinean with a PhD at the Institute, with another not far off. It will take time and good mentors to train the upcoming generation of PNG scientists. How can we attract trained researchers and these much-needed mentors to work at PNGIMR? One solution that has been suggested by a group of us associated with the PNGIMR is to create a funded mechanism whereby postdoctoral scientists can embark on a career path within an Australian institution on an Australian salary and work in PNG under the direction of the PNGIMR Director through a collaborative arrangement between the two institutions. Such arrangements have worked well in the past, even when the norm was for young scientists to join the PNGIMR directly and work there on a PNG salary (which is now, it seems, no longer so attractive an option). A white paper has been prepared to support this idea and AusAID is seriously considering how this mechanism can best be developed and funded. If such a scheme were funded, the Buttressing Coalition would have an important role in helping to make it work. The next meeting of the Buttressing Coalition will be in Goroka in early July as part of the Institutes 40th Anniversary Colloquium. We are expecting a good attendance by members from all over the world and by the important partner agencies in PNG. I am looking forward to this opportunity to renew contact with old friends and colleagues, to meet the members whom I do not know and to strengthen the links that bind the Coalition together so that it can become an even more powerful force in support of the PNGIMR. Acknowledgements: Professor Michael Alpers and Dr Deborah Lehmann
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Welcoming remarks from the PNGIMR Director

It gives me great pleasure to invite former staff, past and current collaborators and friends of the Papua New Guinea Institute of Medical Research (IMR) to attend the Institutes 40th Anniversary Colloquium, to be held in Goroka, Papua New Guinea from 30 June-4 July, 2008. The Institute has come a long way from its humble beginnings in 1968 to being recognized today, as a prestigious biomedical and social sciences research institution within Papua New Guinea and overseas. The IMR is a statutory body of the Papua New Guinea Government, and is tasked with conducting research into health problems with the ultimate goal of providing effective interventions which will lead to improvements in health and in the control and prevention of disease. The Institute has been organized principally around its disease-based research programs, which are aligned to the disease priorities of the National Health Department - pneumonia, malaria, enteric diseases, sexually transmitted diseases including HIV/AIDS, womens health, filariasis, TB, and dengue .
There have been many successful research programs conducted at IMR over the last forty years that have led to the intervention for the control of diseases in the country, and the contribution of scientific information to the global knowledge. Success stories from IMR include the pigbel vaccine; prevention and eradication of kuru; mapping of the epidemiology of malaria in PNG; contributing to the national policy on the treatment of malaria; usage of treated bed nets to prevent malaria; treatment and control of filariasis; introduction of the Hib vaccine in PNG; mapping of sexually transmitted diseases including HIV; providing information for intervention and policy on controlling HIV/AIDS; monitoring of antimicrobial resistance patterns to generic drugs in treating pneumonia; gonorrhoea and other bacterial diseases; evaluation of the typhoid diagnosis; evaluation of the measles vaccine; and, contribution to global eradication of poliomyelitis. I trust that every attendee at this Colloquium will take time to reflect that, whilst we have all come a great way in the forty years, we still have a great deal of work to do. The future of the IMR looks very bright and this is evident from the threefold-increase in the number of research programs that are currently being conducted along with the expectancy of more to come. With excellent in-house financial and administrative support, and good support from the National government and the international collaborating partners, I see the IMR embarking on many new and interesting scientific research programs in the future. To the visitors, welcome back to PNG, and we look forward to sharing your experiences. Your contributions have helped make the IMR a household name in biomedical and social science research within PNG and internationally. Come and enjoy.
PNGIMR Director: Professor Peter Max Siba 2006-2008
Professor Peter Siba Director
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Foreword from the Colloquium Co-Chairmen

The 40th Anniversary and Colloquium of the Papua New Guinea Institute of Medical Research (PNGIMR) marks an historical moment in the life of the Institute, offering an opportunity to reflect on PNGIMRs past and to consider its future. It is an opportunity to celebrate the achievements of the Institute and to build upon its strengths, as well as a time to acknowledge any flaws and learn from its failures. With these thoughts in mind, 2008 marks a significant moment in the life of the Institute. The Organizing Committee is very proud of PNGIMRs long-term association with our friends, wantoks, collaborators and donors, who have seen the Institute grow from its humble beginnings and then go from strength to strength over the last 40 years.
PNGIMR Colloquium & 40th Anniversary Celebration Co-Chairman - Mr Samson Akunaii
We acknowledge all the invaluable efforts and contributions given over the years towards research into health related issues to improve the quality of health for ALL Papua New Guineans and contribute to global knowledge. To our distinguished guests, visitors, friends and former staff we thank you for making time available to celebrate this historical and memorable event with us. We also take this opportunity to acknowledge the support given by the business houses, donor agencies, the PNGIMR staff and friends which has enabled us to host a successful anniversary celebration. On behalf of the Organizing Committee we heartily welcome you to this memorable occasion and wish you a happy 40th anniversary celebration and a pleasant stay in Goroka, Papua New Guinea. Samson Akunaii & Livingstone Tavul Co-Chairpersons (40th Anniversary and Colloquium Organizing Committee)
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PNGIMR Directors Report
Professor
Peter Siba
This is a very important chapter in the history of the Institute of Medical Research.
ver the last forty years, numerous research activities have been successfully implemented with excellent progress being made in all areas of the Institutes program. The program has continued to closely reflect the needs of the National Health Plan and the HIV/AIDS Medium Term Plan. Furthermore, the work has been conducted at the high levels of quality and ethical standards that the Institute is acclaimed for. Scientific highlights over the years have included: studies on falciparum and vivax malaria in children; the reporting of important findings of malaria drug resistance in PNG; major trials of artemesinin combination therapy for malaria; trials of artemesinin suppositories in very sick children; studies on control and treatment of filariasis, studies on aetiological agents of pneumonia; the neonatal immunisation for pneumococci; studies on the epidemiology of drug resistant TB; and, studies on the epidemiology of HIV/STIs. Development of the organisational infrastructure to support activities continues to
progress well. Financial and administrative systems have adopted best practice models and internal restructuring, training, and recruitment have raised the skill-base and efficiency of the Institutes administration. Strong focus has been put on strengthening the scientific depth of the Institute and graduate recruitment and post-graduate scientific training have become IMR priorities. The IMR continues to expand its strong national and international networks and is developing the funding opportunities afforded by these collaborative links. Scientific Programs The malaria research program has continued to produce research of international quality and acclaim. Scientific studies have spanned the basic biology of malaria pathogenesis, parasite immunology, host genetics and vector biology. The program has expanded its work on vivax malaria which has gained a high international reputation, while providing
vital information for PNG on a significant public health problem. The malaria mapping of the highlands has provided Government malaria control units with a very valuable intervention and planning tool. Drug resistance studies in Maprik and Madang are closely monitoring the impact of the Government combination malaria therapy policy on the emergence of drug resistance, which is a problem emerging with frightening speed. An alternative antimalarial therapy for very sick children, artemether suppositories, was trialled in the Sepik with great success. Major trials of alternate artemesenin combination therapy are well underway in Madang and will be a critical factor in formulating policy for the next generation of antimalarial treatment, as resistance to current drugs takes effect. The IMR also continues to support a very productive vector biology/entomology section, which is a critical component in allowing an ecological disease perspective to be brought to malaria control. Finally, the basic laboratory work on malaria genetics and parasite biology continues to be published in the highest rating scientific journals. Thus enhancing the
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IMRs reputation and credibility with external competitive scientific funders. The IMR has maintained its world-class malaria vaccine testing facility in the East Sepik and there is still much interest in future trials being conducted there The IMR filariasis sub-program, though relatively small, has achieved world renown acknowledgement. Data from its studies is informing not only the PNG campaign for the mass eradication of lymphatic filariasis, but the regional and global efforts too. There is a strong program in respiratory disease research, in acknowledgement of the preeminence of pneumonia as a killer of children in PNG. This has led to a major Wellcome Trust funded project on pneumococcal vaccines for neonates. The background work to the trial is also providing extremely useful information on antibiotic resistance patterns in respiratory bacteria and on the distribution and carriage of pneumococci in the community. The study into the epidemiology of tuberculosis, a major issue for PNG health services, is progressing very well, with funding support from AusAID and WHO. The study has found high incidence of multi drug resistant TB in communities in the country. The program on sexual health is conducting a major project supported by NHASP to map HIV and sexually transmitted infections across the nation, in a variety of geographic locations with different socio-cultural groups. Studies have now been completed in Daru, Lae, Porgera, Kikori, Moro, Tabubil, Banz, NCD, Goroka, Wewak, Vanimo and Kimbe combining HIV sero-surveillance, molecular epidemiology of HIV, STI surveys and social and
anthropological research, to better define the PNG epidemic. Site by site reporting of the survey to NACS is providing data that directly supports the national response. A new project has commenced, with the support of PASHIP, to provide baseline data to non-government organisations in Australia and PNG who are implementing interventions to control the spread of HIV and other STIs. The disease surveillance program has maintained its prominent role in maintaining PNGs polio free certification. It is now developing its activities in viral diseases, particularly dengue, measles/rubella, influenza, rotavirus and Japanese encephalitis. This program is liaising closely with the Australian biosecurity initiative, for monitoring emerging diseases in the region. The major studies of infectious diseases were in typhoid, kuru and paediatric meningitis. The series on meningitis has now recruited over 3000 patients and it is providing important information on antibiotic resistance patterns in meningitis, that allow better empirical treatment in health facilities without laboratory facilities. The ongoing study of kuru is bringing the work of the IMR into high international profile, as studies on the genetics of this disease have profound implications for the course of the European variant CreutzfeldJacob disease epidemic. This year marked 50 years of Kuru research, which also contributed to two Nobel prizes. Another important initiative developed under the support program was the formation of an Operational Research Unit to address questions closer to the implementation and evaluation of health services. Activity in this unit has expanded enormously
over the last two years and the heavy demand for its services has clearly justified the need for such a capacity at IMR. Projects have encompassed health systems research on antimalarial drug delivery, and formative research on TB treatment and antenatal care. Studies have been done on womens perceptions of their sexual health. Administrative Infrastructure The IMR has continued to give high priority to creating and maintaining an efficient and transparent organisational structure. The move towards de-centralisation of routine administrative duties and the delegation of responsibilities out from the management team has continued. A detailed welldefined line management structure has now been developed and reviewed. The IMR has put in considerable effort to adopt bestpractices across the whole of the Institutes administrative load. To accommodate this, a number of jobs have been re-structured and re-defined and where necessary, people with specific skills brought in to fill gaps in the skill base. Human Resource Management There has been a continuation of the effort to upgrade human resource management systems. A detailed organisational structure has been documented and clearly written job descriptions have been developed for every staff member. Based on the job descriptions, a performance based appraisal system for increments and promotion has been instigated. Standard 3-year performance based contracts have now been introduced for all new employees and job promotions and short fixed-term contracts
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have been introduced to replace the casual employment practice. The recruitment and training strategy has continued to be directed towards increasing the skill-base of IMR. Recruitment has been focussed on getting more high quality young science graduates into the Institutes programs and identifying specific skill gaps in the administrative and support services and filling them with appropriately well-qualified employees. The training plan has two main strategies. The first is the building of scientific depth through post-graduate training and exposure to international science for the graduate scientific staff. The
second is the use of short training courses to upgrade specific skills that will help staff better perform their function for IMR. The gaining of a major Fogarty International (USA) grant, to establish a Global Infectious Disease Research Training Program has greatly enhanced the potential of the IMR for scientific training. Networking and Expansion of Funding Base The IMR has worked hard in strengthening its networks with key national institutions, such as UPNG, NDoH and NACS and Institute staff now contribute to
many committees supporting these organisations. Its international networks, based around the buttressing coalition of supportive institutions, remain extremely strong. Already, most of the scientific activity of the malaria and respiratory disease programs are funded through external competitive sources and in many cases with collaborators from the coalition. New funding sources added to the IMR portfolio include the renewal of the AusAid Core Support Program from 2007-2011. We are constantly and actively seeking new opportunities for overseas funding and collaboration.
PNGIMR Past Directors Reports
Dr
Dick Hornabrook
Written by Annette Beasley
(1968-1975)
Following an earlier period of two years based in Okapa as clinical director of the kuru investigation, Dr Richard (Dick) Hornabrook was appointed as director of the newly founded Papua and New Guinea Institute of Human Biology in February 1968.
ick took up the appointment in late 1968 and was based in Madang for almost two years while waiting for suitable premises and accommodation to became available in Goroka. Dicks time at the Institute was marked by a great deal of scientific activity, and an accompanying constant flow of visiting scientists, research workers and students. In addition to the day to day running of the Institute, Dick was actively engaged in and co-ordinated a wide range of collaborative research on diseases affecting the people of Papua New Guinea. He recalls this period as a challenging time involving tremendous problem[s] in building the right resources to be able to follow through [research] at
the right depth and reliability. Among these projects was the ongoing research on kuru, and into local diseases such as pigbel, cretinism and an epidemic of syphilis in the highlands and so on. Dick was also involved in coordinating research arrangements for the International Biological Programmes Human Adaptability Section in Papua New Guinea. This program attracted many overseas scientists and included the establishment of a research base on the island of Kar Kar. Dick recalls being tested by the enormous administrative
task in establishing a small residual camp for the visiting scientists laboratoriesand transportation. On a personal note, Dick was accompanied to New Guinea by his wife, Fay and their three children. He was well known for his passion as an amateur naturalist who spent much of his spare time - sometimes in the company of his two young sons - on excursions to add to his extensive beetle and butterfly collection. He returned to New Zealand in late 1975 to resume his former position as a neurologist at Wellington Hospital.
expert Cobb an EEG Dick with Bill - late 1960s
Old Council members: (L-R back row) Biell, Nick Day, Van der Kaa, Tomlinson, Sprent, Kelly, Stan Hope, Hornabrook (L-R front row) Lawrence, Malcom, Durdin, Walsh, Symes, Cotes
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PNGIMR
Professor
Michael Alpers
(1977-2000)
The Papua New Guinea Institute of Medical Research is very special, both to the people of Papua New Guinea and to all the staff, national and expatriate, who have ever been part of it. It is not just an institution, but has a place in all our hearts.
t is remarkable that a scientific research institute with such a strong national and international profile should be so connected with people and so heart-warming. The light of knowledge it generates shields us from disease and harm (save tambuim sik). The work of many people over 40 years has made the vision of PNGIMR, as expressed in its logo, a reality. In the celebrations of the 40th anniversary we will acknowledge their achievements. We also know that many problems remain and the PNGIMR still faces many challenging research tasks. However, as an established and reputable research institution with a formidable group of scientific collaborators from all over the world it should be able to confront these challenges with confidence. I was the Director of IMR for 23 years, from January 1977 to April 2000. The PNGIMR is therefore part of my bones. In fact, I first came to Papua New Guinea before that, long before Independence: I started my research work on kuru in the Okapa area in 1961. I am still working on kuru, 47 years later.
In 1964 these studies took me to the National Institutes of Health in the United States, where I stayed for 4 years. In the year the PNGIMR was founded I moved to the University of Western Australia in Perth, and was there for 9 years. My connections to PNG were maintained and indeed strengthened throughout my time in Perth by working visits to Goroka and the Okapa communities for 6 weeks each year. My links with the Institute were established and my relationship with Waisa and other Fore villages grew. When I came to live in Goroka in 1977 I innocently thought that I would then be able to spend more time in the village, but it was not to be: the task of rebuilding the Institute fully absorbed my time and energy. The Institute started in 1968 as the Institute of Human Biology, essentially an Australian arm of the International Biological Programme. However, many things were changing in Papua New Guinea at that time and it was only a few years before the members of the Institute Council were appointed from within Papua New Guinea and the name was
changed to the Institute of Medical Research. In 1975 it became the Papua New Guinea Institute of Medical Research. There was a common belief at this time of transition that sophisticated institutions like PNGIMR would go into decline after Independence and disappear. Indeed this almost happened to the Institute. Both its inaugural Director, Richard Hornabrook, and Deputy Director, Greg Crane, were medical doctors. They acted as hosts for overseas biological colleagues brought in by the Australian Council of the Institute, but in their own work they conducted diseaserelated medical research from the very beginning. Their leadership therefore set the course that the Institute has followed throughout its life. However, regrettably, at the time of Independence they both left. Greg Lawrence was appointed Deputy Director and carried out his studies on pigbel, but other activities ceased. When I arrived at the beginning of 1977 we had about 5 expatriate and 5 national staff. Over the years many new research programs were initiated and many new staff employed, from overseas and from within PNG. For several
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reasons the number of expatriate staff at the IMR declined in my last years as Director and when I left in 2000 we had about 5 expatriate staff and 250 national staff. That was a major contrast: by then the Institute had become Papua New Guinean in much more than name only. The principles that guided the Institute as its research programs were being rebuilt were important and have continued to inspire the Institutes mode of operation. The first related to the perceived outcomes of our research. Research of any kind is a scientific activity which requires intellectual input and meticulous attention to detail. Medical research involves people and has the ultimate purpose of improving the quality of peoples lives. A necessary part of undertaking research is to write scientific papers and reports but, however important,
they are not the ultimate purpose of the IMRs work. As soon as we could spot a useful intervention we set about evaluating it. If it was shown to be successful we set about promoting it to ensure that it was implemented. Sadly, since the matter was then largely beyond our control, we were often unsuccessful in this. There are some interventions that we and committed colleagues are still trying to get implemented, decades after the studies were completed. No research without service: no service without research. The ultimate benefit for the people and communities participating in research studies may be in the distant future or not at all, since research by its very nature deals with the unknown, which may turn out to be not what you expect. Therefore it is important for some kind of immediate
service or benefit to be provided for participating communities, of potential value to everyone in the community, whether they are taking part in the research study or not. This is a message understood by all our research staff that has also to be made clear to administrators and funding agencies. On the service side, research (that is, a spirit of enquiry) needs to be encouraged at all levels. Research should be welcomed and embraced, not distrusted, as it often is by service practitioners. Among the staff of the health services a questioning attitude to established practices, always seeking ways to improve them, should be part of the culture. These questions may be big or small. One of the Institutes functions is to engage with the health services in order to help identify and solve these questions. The big questions will have to be tackled by
the Institute and its collaborating international colleagues. The small questions may be answered by health staff themselves, with assistance from the IMR to design a proper study and analyze it. In such ways we may put into practice the two parts of this balanced aphorism. Research may be highly complex or quite simple. However, in every case it must be appropriately designed, carried out meticulously, correctly
analyzed and written up. If it is not done properly it is not worth doing at all. There are no partial benefits to be obtained from a poorly conducted scientific study. The Institutes major research projects were designed to be embedded in the community and to use the most sophisticated, state-of-the-art tools available to answer the research questions, calling upon the expertise of international colleagues but wherever possible carrying out the laboratory or computational work in PNG. We have been remarkably successful in achieving this aim. The IMRs work has always been applied, problemdriven research, not basic (or pure) research conducted to satisfy scientific curiosity. Research is the art of the soluble if no solution can be seen and no research study formulated then there is no point in undertaking research on that problem. It is true that basic research characteristically leads to unanticipated benefits of great value in the future but it is not possible to do everything and the IMRs priority is to address health problems that PNG faces now and to evaluate foreseeable solutions. Because research is problemdriven rather than curiosity-driven does not mean that it is intellectually less demanding. Moreover, since it is conducted in the real world
applied research is more difficult to carry out than pure research. The Institute has always ensured that its research is conducted to the highest scientific and ethical standards. The involvement of the community at various stages of the research is essential to achieve this. The other essential factor is a strong and independent Medical Research Advisory Committee, which the IMR has always fully supported; however, this has been a constant struggle to achieve because of apathy in some quarters and opposition from others. The relationship between the PNGIMR and the Department of Health is a vital one. In my time as Director I had good personal interactions with every Secretary for Health and other senior members of the Department. This allowed for occasional consultation and useful exchange of information. However, it was not possible to forge more formal links, and I think that these are necessary, provided that the independence of the two institutions is not jeopardized. Firstly, building a creative interaction between research and policy requires ongoing and regular dialogue and sustained collaboration within a joint body of senior staff. Secondly, IMR representation may provide a useful voice when matters other than medical research are being discussed. The involvement of the Medical School in these activities would also make sense. I am delighted that the Institutes direct relationship with the Medical School is now flourishing and that formal links between the two institutions have been firmly established. This gives me especial pleasure as I reflect on the difficulties and jealousies we had to deal with in the past.
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The new research programs established by the IMR in the late 1970s and early 1980s were directed to the disease problems of greatest importance to Papua New Guineans: pneumonia, malaria, enteric diseases, filariasis and malnutrition. Funding was also secured for a new building for the Institute in Goroka. A branch was established in Yagaum for the malaria research program. Pneumonia research was undertaken in the Asaro Valley and in Tari, where the IMR took over the Tari Research Unit. Later, major programs were established in womens health and sexually transmitted infections, including HIV (human immunodeficiency virus). New branches were created in Maprik and Wewak, Port Moresby and Lae. We did so much else we studied kuru, asthma, diabetes, hypertension, rural water supplieswe even drafted the anti-smoking legislation for PNG (very good legislation it was too, and was passed even if it has hardly been implemented). Details of these research activities and achievements may be found in articles in the Papua New Guinea Medical Journal (1-3, among others), the 1976-1978 Annual Report of the Institute (4) and the Silver Jubilee Magazine (5), as well as all the papers and reports in the Institutes Publication List and Unpublished Reports, which are held in the Michael Alpers Library. To describe them here would require a book. Every competent medical research institute in the world has similar aspirations to those of the PNGIMR and the same exacting standards. What makes the PNGIMR special is its degree of excellence and international standing as a national research institute of the third world (6),
its focus on the community (7), its buttressing coalition (8) and the multidisciplinary nature of its research programs. Epidemiologists, clinicians, social scientists, statisticians, microbiologists/parasitologists, immunologists, molecular biologists, geneticists and, for some diseases, entomologists all worked together within integrated multidisciplinary disease-based programs, driven by the Director. This led to exciting and innovative collaborations. Jointly we worked out what we thought should be done, what we had the capacity to do, and what we could get funded. However, creative thinking must also be tempered by a knowledge of what has already been done, and informed by new technologies. Trying to keep abreast of the relevant bits of all these disciplines was a nightmare. The only way I could even dream of achieving this was by reducing sleep to the bare minimum, read all the journals in our wonderful library and study the piles of reprints I ordered through Current Contents (another world to look back on!). When I was last in Goroka those reprints were being entered into the Library collection. The other effective strategy I adopted was to minimize the time spent on attending meetings (which in both the academic and bureaucratic worlds can become a full-time self-fulfilling occupation). Of course it was the staff who did the work the research staff, the administrative staff and the support staff. The research staff whenever possible were sent to scientific meetings to present our research findings, take the credit for their work and build their own network of international colleagues; the administrative staff as well as the research staff each had their own academic career path; and the support staff were
treated as equals when it came to entitlements and access to the open door of the Directors office. I knew all the staff of the Institute at our many branches. Though I cannot name them all here, I take this opportunity of thanking them all especially my deputies. When Greg Lawrence left, Peter Heywood was appointed as Deputy Director. Peter was followed, in due course, by Charles Mgone, who supported me to the end. Well before I left, Peter Siba was made Assistant Director, not only an appropriate promotion but also a good omen for the future. Peter made the most of his opportunity and, when my successor John Reeders term was over, took his rightful place as Director of the Institute. I acknowledge also the only two senior staff from the time of the Silver Jubilee in 1993 who are still in their same positions Martina Yambun and Samson Akunaii. I thank Cynthea Leahy, and others before her, for their editorial work on the Papua New Guinea Medical Journal the Journal proved to be another happy way of helping to fill my day (and still does). I would not have survived without a secretary, and I had many fine ones over the years; I mention only the last two, Norries Pomat and Clare Mile, both of whom were trained by Deborah Lehmann and then stolen by me; they are still working at IMR. Norries, I remember, had the dubious privilege of handing me, one cheery morning, a fax with the text of an act of parliament to abolish the Institute. We survived that crisis, as we did many others. I thank all my colleagues in the Department of Health, at all levels, across the country, my close friends in the Medical School (I have to say that in the past not
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everyone in the Medical School was a friend of the IMR!) and the members of the PNGIMR Council over my period as Director. For most of that period the Chairman of the Council was Adolf Saweri, a true friend and untiring supporter of the IMR, whose name appropriately adorns the IMRs new lecture theatre. I thank my long-suffering family Wendy and our 4 children, Kirsten, James, Deryn and Ben (who had the privilege of growing up, for at least part of their lives, in Goroka and Waisa) for their support. My final debt of gratitude goes to Deborah for her many roles and responsibilities at the Institute (some of which she still pursues) and for her care in sustaining me personally and keeping me sane. I have not mentioned altruism putting others first though this has been fundamental to the philosophy of PNGIMR; and most unusually so, it has to be acknowledged, for a scientific institution in this cut-throat world. Nor have I mentioned love, trust or loyalty, though they
have been everywhere implied. They pervade the years we are celebrating at this Colloquium and every place we have worked in. They apply to everyone I have acknowledged, each in their own individual way. These qualities show in subtle ways: certainly, the fact that many children of staff want to work at IMR is a sign of the strong family allegiance it engenders. The senior staff who return to collaborate with IMR after they leave demonstrate their attachment to PNGIMR and to PNG. Love, trust and loyalty rightly come at the end of my personal reflections since they sum up my feelings for the IMR and the people among whom I have worked. Such virtues are sadly often regarded as old-fashioned and out of place among the harsh realities of the contemporary world. I disagree strongly with that and not, I think, because I am out of touch with the world around me. I hope that love, trust and loyalty and altruism will continue to be integral to the life and work of the PNGIMR into a long and successful future.
References 1. Alpers MP, Al-Yaman F, Beck HP, Bhatia KK, Hii J, Lewis DJ, Paru R, Smith TA. The Malaria Vaccine Epidemiology and Evaluation Project: rationale and baseline studies. PNG Med J 1992;35:285-297. 2. Alpers MP. Past and present research activities of the Papua New Guinea Institute of Medical Research. PNG Med J 1999;42:32-51. 3. Alpers MP. A history of kuru. PNG Med J 2007;50:10-19. 4. Papua New Guinea Institute of Medical Research. Seventh Annual Report 1976-1978. Goroka: Papua New Guinea Institute of Medical Research, 1981:102p. 5. Wani J, Jenkins T, Alpers MP, eds. Silver Jubilee Magazine, Jubilee International Colloquium, Madang, 17-20 Aug 1993. Goroka: Papua New Guinea Institute of Medical Research:105p. 6. Reeder JC. Health research in Papua New Guinea. Trends Parasitol 2003;19:241-245. 7. Reeder JC, Taime J. Engaging the community in research: lessons learned from the malaria vaccine trial. Trends Parasitol 2003;19:281-282. 8. Alpers MP. The buttressing coalition of the PNGIMR: an example of international collaborative research. Trends Parasitol 2003;19:278-280.
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Professor
John Reeder
(2000-2006)
Congratulations PNG on the 40th anniversary of the PNGIMR! It is an event that can be looked upon with pride by all Papua New Guineans, not just for the longevity of a national institution, but for the international reputation for excellence that it has built over this time.
he PNGIMR shines on the global stage, and celebrates four decades of bringing rigorous science to bear on the major health problems of PNG, providing evidence that has shaped health policy not only in PNG but all around the world. Importantly, it has done this not as a field-station of an overseas academic institution, but as an independent PNG statutory body, with the agenda being set by its PNG council. One of the keys the PNGIMR success has been to realise the importance of an international outlook in setting its scientific standards, and to realise the potential of international collaboration and recruitment to develop national capacity. It was in this spirit that after an international search for a successor to the eminent and long-standing Director, Professor Michael Alpers, I was appointed Director of the Institute in 2000. I was no stranger to PNG or the PNGIMR, but my previous stay in PNG had been under very different circumstances. Coming from a background in hospital laboratories in the UK, I was posted to PNG as a VSO volunteer laboratory trainer in
1990-92, with an office right behind the PNGIMR. I clearly remember my shock at being refused the loan of a book from the IMR library, by a very strict librarian, on the grounds that volunteers were too unreliable! I later received the book, borrowed on the personal ticket of Michael Alpers, who obviously had a little more faith in me! After leaving PNG and working for several years on malaria research at the Walter and Eliza Hall Institute in Melbourne, collaborating closely with the PNGIMR program, it was an exciting challenge to return as Director and claim my own library ticket. When I commenced as Director two things were obvious; the first was that there was the great legacy of an incredibly strong scientific culture and many exceptional, experienced staff members; but sadly the second was that the tight economy of the times had left the Institute struggling financially and increased funding had to be urgently secured before we could move forward. Strategically, the short-term fix to this would be to lobby Government and aid donors for support. But in an age of many competing demands for this type
of support this was clearly not a long-term sustainable plan and the money gained would somehow have to be used in a focussed way to lever external competitive international research funding. On consulting stakeholders I was surprised to find out how little knowledge there was of the PNGIMR and its contribution within PNG. It seemed to be much better known outside the country than it was inside it! A campaign of newspaper articles, written by PNGIMR staff, had great impact on redressing this gap in public knowledge and showed the value of close engagement with the media. However, the real potential of the PNGIMR for influencing health policy through scientific evidence only became clear to Government and donors with the writing of a 5-year strategic plan for the Institute, to articulate its role in the 2001-2010 National Health Plan. This actually represented no major departure of activity, as the PNGIMR had always worked to contribute to the health of the nation, but it did give focus and make the specifics of this contribution transparent and obvious. The plan soon led to a generous offer of support through
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the Government and AusAID, which kick-started the PNGIMR back on the road toward fulfilling its potential. It would have been easy at this stage to breathe a sigh of relief and rest a while on this financial reprieve, but the will was there not just to get our head above water, but to set off swimming forward. So with targeted recruitment to support the science programs, including the first of what has become dozens of new PNG graduate students, the IMR threw itself back into a busy and active research program. At the same time, conscious of the rigorous requirements of international scientific funders, a review was carried out of the Institutes management structures and best practise management systems introduced. It was to the very great credit of the staff that this period of great change was accomplished very smoothly, as people bought into the vision for the future of the Institute. The strategy clearly paid off with external scientific funding doubling each consecutive year, including major multi-million kina projects in important areas such as malaria, HIV and pneumonia, giving the PNGIMR a much more sustainable mix of government, donor and scientific funding to support its now much expanded activities. The growth also brought the benefit of a generous PNG Incentive Fund grant to re-develop the Goroka headquarters, including a long sought after library and lecture theatre complex. Funding and management though is only a means to an end, and for the PNGIMR that end was to perform essential research to a high international standard and to develop local scientific capacity. At the end of the day, the Institute must be judged upon
performance, not balance sheets. The real success of the new look Institute could be measured in its phenomenal contribution to the international scientific literature through a torrent of publications in the top international scientific literature. Groundbreaking work in malaria and filariasis, to name just two areas, firmly maintained the PNGIMRs scientific credentials. Just as importantly, this information was translated into PNG health policy ranging through malaria control and treatment, immunisation schedules, harm reduction and sexual health, and many other areas. PNG has become the envy of many other countries for its ability to use locally generated scientific evidence to drive more effective health intervention. One of the great pleasures of the PNGIMR scientific program is its engagement with top-flight scientists around the world. Many of these scientists have demonstrated a deep commitment to PNG, based on long-term association with the country. These researchers have also formed a buttressing coalition to help to support the IMR from the outside, using their considerable collective influence to advocate for the Institute and provide assistance when requested. A critical element of the future development of the PNGIMR will be the nurturing and maintenance of this precious resource of international, goodwill. It is, of course, very important to develop a strong national identity, but science is a global pursuit and is in the
international arena that the PNGIMR must continue to excel. The other great pleasure of working with the PNGIMR was to see the dramatic expansion of the student training program. Through closer union with the University of PNG, the PNGIMR now offers training opportunities to scores of the brightest and best PNG graduates. It is an immensely satisfying experience to see these young people develop towards being the scientists of the future, indeed the future PNGIMR Directors. A dream now brought closer, of course, by the appointment, after an international search, of the first Papua New Guinean Director of the PNGIMR, Professor Peter Siba. Being Director of the PNGIMR was a challenging but ultimately tremendously rewarding experience. The job of Director is however not to be the boss of the staff, but to work for them and enable an environment where they can perform at their best. The great successes achieved during my time at PNGIMR were thus those of the hundreds of dedicated and hardworking members of the PNGIMR staff who made things happen day by day. I thank them for making my time working with them so satisfying and wish them the very best of future success in the next 40 years!
Finance Managers Report
Mr Samson Akunaii
Finance Manager
t gives me great pleasure to report on the activities of the Finance Unit of PNGIMR during this important occasion of commemorating its 40th Anniversary. As I reflect on my years at the Institute, I can say with some degree of satisfaction that the Finance Unit has come along way. In 1989 there was only Ms Roslyn Rees and myself in the unit, but today the unit has increased to 10 staff and this is remarkable progress. Some staff in the unit are highly trained and skilled in managing multiple project fundings and are always ready to adopt the specific requirements of the varied project sponsors and to meet different reporting deadlines. The Finance Unit at present consists of the following people: Samson Akunaii Finance Manager & Unit Head June Hamena - Senior Accountant Ulo Jasipa - Accountant (currently pursuing post graduate studies) Morris Andy - Finance Officer projects Deborah Bob - Data Entry & Management Tume Goso - Payroll Officer Danny Saho - Accounts Officer Norman Taru - Accounts Officer Kim Papaso - Fixed Assets & Inventory Officer Neal ONeal - Accounts Clerk Previously we did not have the major projects that we
have today, but instead there were ongoing activities with traditional partners like WHO, ACIAR, MacArthur Foundation, National Geographic Society etc. Over the years the level of funding to the Institute from the Government, through there budget support and from project funding has grown steadily. In 2005 the Finance Unit was allocated new office space and it is now equipped with modern, high speed computers and office equipment not like in the past. These improvements have resulted in an increase in staff performance and a better work flow. The annual accounts of the Institute are up-to-date and the effort put in by the staff to achieve this has received high commendation from the Ministry of Finance & Treasury. These positive improvements and progress have also brought new opportunities and challenges. It has provided the platform for the unit to continually reassess its role by analysing the strengths and weaknesses and for it to look at ways to improve and create opportunities for now and the future. The unit manages the computerised payroll for the Institute, which caters for over 300 employees at any given time, whilst the human resource function is under the Administration. The unit currently manages a total of 27 different project accounts all of which are integrated into the Accpacc
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accounting software system and there are now plans to gradually adopt the accrual concept of accounting, which will greatly alleviate a lot of short comings we currently face with the cash accounting concept. In line with the efforts of the Institutes management, the unit sees its role as being one of promoting good business practises across the board. These efforts are regularly reinforced with positive inputs from independent audits and reviews from professional firms like Deloittes, KPMG, Auditor Generals Office and more recently BDO Kendalls of Australia. In order to keep up with changes taking place globally in the field of finance and technology, I was given the opportunity to pursue post graduate training at the James Cook University in Townsville and I graduated with a Masters of Business Administration. One of our accountants, Mr Ulo Jasipa, is currently
pursuing a Masters Degree in Professional Accounting at the University of Queensland, and he should complete his course at the end of 2008. Other staff have been encouraged to attend short term courses to update their skills. The unit with its knowledge, skills and experience is in a good position to assist the efforts of the Institute as it pursues its mandated tasks to a higher level over the next 40 years. In commemorating this 40th Anniversary, special mention should also be made of former staff who have contributed towards making the unit what it is today. Thank you very much to: Roslyn Rees, Moniti Polin, Sandra Moon, Aluken Omena, Francis Tuwaio, Lisha Hunter, Arnold Teka, Alice Bais, Esther Keompa Simon, Anna Arthur, Kay Scott, Betty Lloyd, Gima Waiin, Neil ONeal, Roselyn Amakua and Anna Bakou.
2008 Finance team: (L-R standing) Norman Taru, Neal ONeal, Danny Saho, Morris Andy, Samson Akunaii, (L-R seated) Deborah Bob, Tume Goso, Kim Papaso and June Hamena.
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Administration Managers Report
Ms Martina Yambun
Administration Manageress
ince accepting the role of Administration Manager at the PNG Institute of Medical Research (PNGIMR) in 1989, I have been responsible for all aspects of the Institutes administration and human resource management. With over 300 staff at 4 locations across Papua New Guinea, it was necessary to develop and implement specific systems, in line with legislative requirements. A major project commenced in 2003 with the building of a new Library, Lecture Theatre, Operational Research Unit wing, Finance office and various renovations and refurbishment of all PNGIMR owned properties in Goroka and Madang. A successful Institute is not just about smart new buildings; the most important thing is the commitment and ability of the people who use them. Other areas of the infrastructure development included improving the central administration, computing and statistics, training and education, information, education and communication. Maintenance and capital expenditure were also a part of the major project that was completed in 2004. Between 2000 and 2003, PNGIMR underwent some big changes with the employment of a new Director, formation of the Management team and the development of the PNGIMRs new policies and procedures.
These new systems have included the development of the staff appraisal system. Employees now have an opportunity to have a say in what affects them and the work tasks allocated to them during their appraisals. The style of management has changed from directional to motivational. Previously PNGIMR did not have a Human Resource Section. All such matters were dealt with by the Administration Manager. With the expansion of the Institute and the need to recruit more staff to participate in existing and new research projects, it was felt that a human resource section should be set up to handle all staff matters. My extensive experience and knowledge of both the organisation and the staff employed within, enables me to ensure that not only are the Institutes human resource requirements met but that the staff employed are also supported within, and through their working environment. The statutory function of the Institute is to carry out medical research and this remains its first priority. In the course of undertaking research and as part of the function of each contract staff member there are many opportunities for providing training for national members of staff and also for students assigned to the Institute for limited periods of instructional training. The atmosphere and the working environment at the Institute is very challenging and very exciting as well, as one gets to learn new things and meet new and
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exciting people from all walks of life both within Papua New Guinea and abroad. This year marks an historic event in the life of this
growing institution. The fruits of the hard work of collaborators and staff of this Institute, both past and present, over 40 years is now visible throughout Papua New Guinea and abroad.
2008 Administration team: (L-R standing) Robert Kuplinga, Martha Kana, Mary Amos, Sasah Tangabo, (L-R seated) Louise Tony, Norries Pomat, Martina Yambun
2008 Building team: (L-R) Morgan, Wiba Ribu, Samuel Anakapu, Bill Mathal, Saul Vilabat
2008 transport team: (L-R) Johannes Haay, Bill Kotuno, Bill Gomeno, Mathias Ulka, Daniel Mondorufa
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PNGIMR Branch Reports
Madang Branch
Manager Mr John Taime

he Papua New Guinea Institute of Medical Research, Madang branch, mainly works on malaria related diseases, under the Vector Borne Disease Research Unit. Office and laboratory buildings are in Yagaum which is about thirty minutes drive out of the Madang township. There are five scientific disciplines organized for the Malaria Research programs in Madang; immunoparasitology, molecular parasitology, entomology, epidemiology/demography and microscopy. The support units include computing, data management and administration. The field work for malaria related studies are carried out in Alexisahafan, Mugil, Modilon Hospital and in Maprik, Wosera, Dreikikier, Ihalaita and Sumun areas of the East Sepik Province. We have a fleet of 12 vehicles to help carry out our projects in Madang. There are 5 ten seaters, 5 hilux double cabins, 1 hilux single cabin and a Hiace 15 seater bus. More than 80 staff are currently working for IMR Madang, 90% of staff are nationals and 10% expatriates. Most staff live in town and come to work at Yagaum, and so pickups and drop offs are done at 7:30 am and 4:06 pm each working day. One third of the staff live in Yagaum, including the site administrator Some years ago accommodation was not a problem for staff at IMR Madang, however, today it is a major concern. Recently we have not been able to cope with the increase in activities and staff numbers due to lack of space in the laboratories, offices and accommodation. Negotiations for moving the IMR office and laboratory complex to town was
done years ago, however we received a favorable response from the Lands Board meeting only recently. The building of a new office and laboratory complex in town is likely to happen depending on the official release of documents from authorities and the availability of funds. To move staff out of Yagaum and relocate them closer to the town area is a problem because of land and housing availability. However, negotiation with land owners in and around Madang town is progressing. A lot of changes have taken place at Yagaum in three main areas there has been an increase of staff numbers, logistics and research operations which has caused over crowding of office space. Offices have been modified and renovated to make extra office space available to accommodate the increase in staff. Centralizing different projects that have similar tasks like the IT and microscopy sections now come under one unit head for easy communication, coordination and management. Memorandums of understandings have been signed with the Modilon Hospital, Divine Word University, Mugil and Alexsisaphen health centers so as to integrate our research units with their establishments and to conduct research together. Communities can see that IMRs work is widely supported by other institutions and in return they support and participate in our studies but only after much awareness work is done with them. One of my main tasks is to keep an eye on the Maprik administration as they are a part of the Vector Borne Disease Research Unit.
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We acknowledge past achievements but also look forward to the future and to new office and laboratory buildings in town and to new research projects that may come up. It is a real milestone for the Papua New Guinea Institute of Medical Research to survive and to achieve such enormous research developments which impact on the national health policies. In conclusion I wish to congratulate past DirectorsProfessors Michael Alpers and Professor John Reeder for a job well done and the current Director, Professor Peter Siba and the Executive Management, Senior Scientists like Dr Ivo Mueller, Researchers and staff for doing excellent work in managing and running the Institute so that it can celebrate its 40th Anniversary.
John Taime giving an awareness talk to mothers about the Lastly but not the least I acknowledge the broader community for their support and participation in IMRs IPTi project research projects as their involvement has impacted on the growth and development of IMR.
The IMR Madang laboratory and office complex in Yagaum is now getting too over crowed
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East Sepik Branch

he work of PNGIMR in East Sepik Province started in 1986 with a nutritional survey that was carried out in and around the Kaugia area of the North Wosera census division followed by a Pregnancy Outcome study which was a study in relation to the Nutritional Survey from 19881990. In 1991 demography work started in 10 villages within both North and South Wosera areas. This was in preparation for the Epidemiology and Vaccine Evaluation Project which was carried out in 1997 to 1998. From then onwards the field site was continuously maintained for further research projects related to vector bourne diseases and other studies. The Institute later extended its study area to include the Wosera, Drekikier, Maprik and Wewak districts. Many projects have been conducted in these areas including the malaria vaccine trial, Vitamin A, Entomological work, drug resistant, pregnancy study, Fillariasis, Enhancing Pregnancy Outcomes, the Cohort study in Ilahita, anthropological studies, operational research and other vector bourne related diseases. Current Projects We are currently running 5 active studies and they are, the Intermittent Preventive Treatment in Infant study (IPTi), Cost Effectiveness study, the ICIDER study, the Demography study and the Vivax study. Sections There are seven sections operating in Maprik with their own supervisor or coordinator, though most of
Manager Mr Lawrence Rare
the unit heads or Principle Investigators are based in either Goroka or Madang. The following is a list of staff: Administration IPTi Demography - Lawrence Rare - Dr Patricia Rarau - Elias Namosha / Seri Maraga (both overseas) Vivax - Benson Kiniboro ICIDER - Steven Paniu Operational Research - Olive Oa Immunology - Sarah / Danga (on Rotation basis) Microscopy - Moses Lagog
Vehicles In order to actively run these projects we require good running vehicles on site and so currently we have a total of 10 Toyota land cruisers which includes one in Wewak. Staff Maprik, Wosera and Drekikier - 102 Wewak 6 All staff are nationals. Unit heads and Principal Investigators are a mixture of expatriates and nationals who are based outside of the Province or country and do regular visit to the site. These includes: Dr Ivo Mueller Dr Moses Bokare - Scientific Unit Head Vector Bourne Diseases - ICIDER
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2008 - some of IMR Mapriks staff
Dr Inoni Betuela - Vivax Mr Will Casten - ICIDER Dr Danielle Stanisic - Immunologist Dr Nicolas Senn - IPTi Dr Jim Kasura and Dr Pits Jimamen Case Western Infrastructure PNGIMR occupies a total of 16 houses at the four locations Maprik, Wewak, Wosera and Drekikier. Out of the 16 houses, 4 are rented houses while 12 belong to the Institute.Two buildings are under construction in Maprik.
Comments From my observation over the past 16 years that Ive been working for the Institute in the East Sepik, the sites have developed significantly . When I began it operated from a rented house in Kunjigini which is now the field house, and from there it extended its operations both scientifically and administratively. I, therefore, commend the PNG Institute of Medical Research and the Management team for the initiatives and the great efforts placed into developing the site to where it is now.
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PNGIMR Unit Reports

OPERATIONAL RESEARCH
Public Health, Social and Behavioural Research Section
Ms Geraldine Maibani
Senior Scientific Officer
he Operational Research Unit plays a pivotal role in population based research. It links laboratory based studies with population/ community based studies and also conducts quick short studies and health systems research (HSR) to provide information on the operations and delivery of health care. Public Health, Social and Behavioural Research Section The role and functions of the Operational Research Unit determines the specific functions of the Public Health, Social and Behavioural Research (PHSB) Section. In most cases collaborative research is with local and international organizations. Within PNG these include the National Department of Health (NDOH), National AIDS Council Secretariat (NACS) and NGOs. International collaborators include Family Health International (FHI), UNICEF, Churches Medical Council (CMC) and Medical Ambassadors International. The sections main focus is on public health and social and behavioural research, as well as monitoring and evaluation and health impact assessments (HIA) closely linked to intervention programs. Projects The Operational Research Units Public Health, Social and Behavioural Research Section was
established in 2003. Past, present and future projects include: Womens Health: perceptions of women in the highlands of PNG. Commenced 2003 and is ongoing; in collaboration with the National Department of Health (NDOH) TB and Stigma Study in a hospital setting in EHP. Commenced in 2003 and completed in 2005; in collaboration with NDOH STI and HIV prevention in the Porgera Valley. Commenced in 2002 and completed in 2004; in collaboration with Pogera Joint Ventures (PJV), Pogera Gold Mining Company. Advocacy for HIV prevention amongst youth in PNG and the Pacific. Commenced in 2003 and completed in 2004; in collaboration with ADCOM and UNIFPA Introduction of Hib Vaccine into the health system and community acceptability study. Commenced in 2003 and completed in 2004; in collaboration with NDOH Health seeking behaviour in PNG. Commenced in 2004 and completed in 2004; in collaboration with the World Bank Capacity strengthening of studies in molecular epidemiology, STI/HIV prevalence and surveillance. Commenced in 2003 and completed in March 2008; in collaboration with NDOH and NHASP/NACS Evaluation of Health Services Support Program
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(HSSIP). Commenced in 2005 and completed in 2005; in collaboration with NDOH Evaluation of Community Based Health Promotion Program in Eastern Highlands. Commenced in 2005 and is ongoing; in collaboration with CMC, NDOH and Eastern Highlands Provincial Health Evaluation of the Poro Sapot Project: Baseline & Post Intervention Studies. (HIV & STI prevention amongst Men who have sex with men (MSM) and FSW in Port Moresby and Goroka. Commenced in 2004 and completed in 2007; in collaboration with FHI and SCiPNG Evaluation of Integrated Management of Childhood Illnesses (IMCI). Commenced in 2006 and completed in 2007; in collaboration with NDOH and WHO Womens Health. Commenced in 2003 and is still ongoing; in collaboration with NDOH. Capacity strengthening of HIV research and molecular epidemiology. Commenced in 2003 and completed in April 2008; in collaboration with NDOH and NHASP/NACS Evaluation of Health Promotion in EHP. Commenced in 2005 and is ongoing; in
collaboration with CMC/EHP Health and NDOH Behavioural Studies in TB in the five pilot provinces under the Global Fund. Planned in 2007 and just starting in 2008; in collaboration with NDOH and WHO Male circumcision and vaginal microbicides in men and women at high-risk for HIV infection in PNG : Acceptability, epidemiological impact, cost-effectiveness and options for implementation. Planned in 2007 but just starting in 2008; in collaboration with the Queensland Medical School, & UNSW National Centre in HIV Epidemiology & Clinical Research Evaluation of PNG Australia Sexual Health Improvement Program (Research Support). Planned in 2007 but started in April/May 2008; in collaboration with AUSAID & 5 NGO partners in Australia and PNG A new project that has been designed but is awaiting funding is the: Male circumcision and vaginal microbicides in men and women at high-risk for HIV infection in PNG: acceptability, epidemiological impact, cost-effectiveness and options for implementation project.
2008 ORU staff: (L-R) Pioto Namugui, Dorothy Kavanamur, Geraldine Maibani, Claire Mile, Hannah Nivia, Janet Totave
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Training and Research Our Section provides on-the-job training for young researchers and offers supervision for Masters of Public Health students from the University of Papua New Guinea and other institutions within PNG and overseas. Some of the staff in this section are also heavily involved in community service, one of which is a program on cancer awareness to communities in and around Goroka. The following studies were/are student research projects conducted in close collaboration with PNGIMR: Challenges to Scaling up of Antiretroviral therapy in PNG. Commenced in 2004 and completed in 2004; in collaboration with Masters Program London School of HTM A Study of the Christian Churches Response to the HIV/AIDS Epidemic in Papua New Guinea: the views of the clergies and the Churches Leaders. Started in 2005 and completed in 2006; in collaboration with Masters Program UPNG, NACS & EHP Health
Role of Health Promotion & Community Participation in Supporting TB and HIV Prevention and Care in EHP. Commenced in 2007 and is still ongoing; in collaboration with PhD Program Curtin University We also help with research protocol and instrument (questionnaire) development for students from the UPNGs School of Medicine and Health Sciences and other NGOs. The Social Research Cadetship Program trains young social researchers as part of the capacity strengthening in social research in Papua New Guinea with the understanding that these cadets will then be employed anywhere in PNG at the completion of the 18 month program. During their program they do practical research in the communities. Three of them had the opportunity to join the IMR team when they did fieldwork in West New Britain in OctoberNovember 2007.
OPERATIONAL RESEARCH
Strengthening HIV social research capacity in PNG
Dr Angela Kelly
HIV/STI Research Cadets Team Leader
trengthening HIV Social Research is a two year project which trains Papua New Guinean graduates to undertake HIV social research. The project is funded by the National Centre in HIV Social Research (NCHSR) but is a partnership with the PNG Institute for Medical Research (PNGIMR) and is based in Goroka at the PNGIMR. The philosophy of learning by doing underpinns the cadetship program. At the completion of the two-year cadetship the trainees will have skills in: understanding the HIV pandemic in PNG and worldwide; a wide range of HIV social research techniques; critical and scholarly thinking, carrying out real life research projects (external and internal); writing for academic publications; oral presentations and applying for research funding. We argued that medical models had dominated the national, provincial, and local-level responses to the epidemic in PNG, and that there was little in the way of an indigenous social research tradition. This had led to a deficiency in demographic and social data on which to base HIV prevention and education activities. There was also a dearth of trained, indigenous social researchers. This situation had decreased the ability of national and local level authorities to respond to the HIV epidemic with evidence-based social research. The increasingly serious challenges posed by HIV in PNG required a social research response that is: a) indigenous in its meanings and activities and
sustainable in its applications; and b) grounded in PNGs social-structural realities. Building capacity means creating a pool of well-trained researchers and local collaborating partners who understand the process and value of HIV-related social research. The national centre in HIV social research NCHSR and IMR were committed to overseeing the development and submission of applications to local and international funding bodies on HIV-related social research projects. Enhanced research capacity support multi-sectoral approaches and leverages new resources to inform interventions. The cadets have undergone rigorous HIV social research methods training and their outcomes and achievements are testament to the success of the pilot. Having developed a theoretical understanding of the underpinnings of social research, the cadets have become learned in a vast variety of qualitative research methods including action research, interview techniques, types of interview questions, focus group discussions, ethnography and rapid rural appraisal. In quantitative research methods the cadets have learned how to develop surveys, and use SPSS. The cadets have also been trained in monitoring and evaluation, have learned how to code and analyse qualitative data and develop research proposals. The cadets have under gone training in abstract, journal and conference presentation writing. More recently the cadets have learned how to set up a research field site and how to work collaboratively with people living with HIV/AIDS (PLWHA) on research
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2008 Social Research Cadets and Team Leader: (L-R standing) Barbara Kepa, Agnes Mek, Angela Kelly (Team Leader), Martha Kupul, Lucy Walizopa, Brenda Peter, Lawrencia Pirpir, (L-R seated) Frances Akuani, Somu Nosi, Rebecca Emori
projects (in support of the greater involvement of people living with HIV and AIDS (GIPA) principle). Further to the formal structure of the cadet program the cadets have been involved in a number of conferences, training courses and research projects throughout the project. Conferences Two Research Cadets were granted scholarships to attend the International AIDS Society Conference in Sydney, Australia in July 2007 and were guest presenters at a special one day symposium on HIV in Papua and PNG. All ten Research Cadets were awarded scholarships to attend the VIII International Congress on AIDS in the Asia Pacific held in Sri Lanka in August 2007. Three Research Cadets gave oral presentations including married womens vulnerability to HIV, the challenges of abstinence as a prevention method in PNG and the cultural and language issues that arise when translating behavioural surveillance systems (BSS) questions into Tok Pisin. The remaining seven cadets gave poster presentations on topics including sorcery and HIV, the role of the Catholic Church in PNGs response to HIV, orphans, the availability of condoms in Goroka and an overview of the Research Cadet program, rural enclaves and HIV and male circumcision, HIV and PNG. Six of the Research Cadets had their work accepted to be presented at the PNG Medical Symposium, Port
Moreby, in September 2007. More recently, one of the cadets had a paper accepted and presented it at the Everyday Lives Conference: 10th HIV, Hepatitis C and Related Diseases Conference, Sydney, University of New South Wales (UNSW) in March 2008. Further Training All ten Research Cadets attended the International HIV and AIDS Monitoring and Evaluation Training Course conducted by The Centre for International Health, Curtin University in conjunction with the National Centre in HIV Social Research, University of New South Wales in August 2007. Two cadets were selected to complete a week-long UNSW graduate course Health, Development and Human Rights run by the Institute of Health and Human Rights at the UNSW in July 2007. One of the Research Cadets has been actively involved in the Community Conversations Training provided by PNG Sustainable Development. Three cadets were invited to attend a national workshop in Port Moresby on developing PNG specific United Nations general assembly special session on HIV/AIDS (UNGASS) indicators. Research Projects Within PNGIMR there have been three research projects which the cadets have been involved in. All of the cadets were involved in a focus group study of young peoples attitudes towards HIV and sex in
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the Eastern Highlands. Three Research Cadets were involved in five weeks field work in Kimbe for the National Mapping and HIV Project which was lead by Mr Tony Lupiwa and Ms Geraldine Mainbani. Of most significance has been the social impacts of antiretroviral study which the team is involved in. The team decided on the topic, wrote the proposal to the National AIDS Council Secretariat (NACS) and was funded to carry out this study. This study is a large mixed method study which requires the cadets to use both qualitative and quantitative research skills. Throughout this process they have learned how to establish a field site and engage with PLWHA using the GIPA principle. There have been numerous occasions when the involvement of the cadets have been requested. The cadets have been engaged in three projects
in this manner. The first was for the evaluation of the voluntary service overseas (VSO)/Tokout AIDS program in Jimi Valley and Raikos. For the PNG country evaluation in the AusAID commissioned Best practices in addressing violence against women and girls in Melanesia and East Timor, four of the Research cadets were contracted. Most recently, six cadets have been involved in a study with the NCHSR (UNSW) on condom access and availability in Tonga and Vanuatu for the South Pacific Commission. Conclusion The research cadets are beginning to create a tradition of Papua New Guinean HIV Social Research which will have an impact on the inequalities which both spread HIV and which are experienced by those with HIV.
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INFECTIONS AND IMMUNITY
IMMUNOLOGY
Mr William Pomat
Senior Scientific Officer Immunology Unit
he Neonatal PCV study began in 2004 and recruitment of study participants is now complete. More than 100 children have completed the study and received certificates of participation. To September 2007 the following samples were processed through the immunology laboratory: Saliva: n =1524 Serum: n = 1296 Cord and peripheral mononuclear cells: n = 912 Antibody concentrations for 81 children up to 4 months after PCV vaccination have been completed and more work is underway to complete the remaining samples. Preliminary antibody data and laboratory procedures were presented at the annual Medical Symposium in September and at the Australian Indigenous Immunization Research Workshop in Darwin, Australia from August 20-21st. Antibody data to date shows that neonatal and infant schedule of PCV is safe and immunogenic in PNG infants. While antibody in children in the control arm of the study declined from 4 months of age, antibody in PCV vaccinated children did not. Antibody to serotypes that are common in PNG but are not included in the vaccine formulation declined in all children. This preliminary data is exciting but more analysis is needed to elucidate the impact of PPV booster at 9 months of age.
Analyses we are looking forward to performing include: 1. Salivary antibody assay 2. Avidity assays Work in the immunology laboratory has progressed well thanks largely to the staff, students and collaborators highlighted below. Research Staff Mr William Pomat Ms Jacinta Francis (Currently on study leave) Ms Tilda Orami Mr Martin Michaels (joined the Unit in July 2006, and left in September 2007) Ms Hennah Aole Post graduate student Ms Annemarie Laumaea (BSc Honors candidate) Fogarty internship 2007 Ms Cecily Kaira Visitors Dr Peter Richmond Dr Anita van den Biggelaar
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Presentation: 1. Immunogenicity of the pneumococcal conjugate vaccine (Prevenar) in Papua New Guinean children: Preliminary results from the Neonatal Pneumococcal Conjugate Vaccine (NPCV) Trial in the Asaro Valley, Eastern Highland Province Annemarie Laumaea, William Pomat, Suparat Phuanukoonon, Tilda Orami, Anita van den Biggelaar, Deborah Lehmann, Peter Richmond and Peter Siba. 2. Pneumococcal conjugate vaccine trial in PNG: collecting blood samples to isolate mononuclear cells from umbilical cord blood and young children Michaells M , Pomat W, Orami T , Phuanukoonnon S, Siba PM, Francis J, Van den Biggelaar A 2, Richmond P, Holt Pand Lehmann D 3. Neonatal Immunization with PCV in PNG
(presented in Darwin August 20th 2007) W Pomat and Neonatal PCV Team 4. Neonatal immunization with pneumococcal conjugate vaccine in Papua New Guinea Biggelaar, Avd, Pomat W, and NPCV team Presented in Beijing, China, at the Wellcome Trust Asia Pacific Networking Workshop held from October 27-29th 2007. The poster presentation took out 2nd prize at the meeting. Studies conducted through our laboratory 1. Differences in neonatal immune regulation in the developing and developed world: implication for neonatal vaccinations? Avd Biggelaar, D Stanisic, S Phuanukoonon 2. Genetic influences on causal pathways of pneumonia in infants from PNG. I Laing, P Siba, D Lehmann
2008 Immunology unit staff: (L-R) Milred Lai, William Pomat, Tilda Orami and Hannah Aole
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MOLECULAR MICROBIOLOGY
Mr Dagwin Suarkia
Senior Scientific Officer Molecular Microbiology Unit
he Molecular Microbiology Unit comprises of 4 staff members:
1. Dagwin Luang-Suarkia - Unit and Laboratory Head 2. George Koki - Senior Technical Officer 3. Lisol Luke - Scientific Officer (resigned 2008) 4. Jacinta Kono - Technical Officer (resigned 2008)
studied include 21 bp gene deletions in agnoprotein of JC virus and markers related to haemoglobin gene polymorphisms. Some noteworthy collaborators in these studies are Professors Jonathan Friedlander and Mark Stoneking, respectively, currently or formerly based with Temple University, Florida. Lisol is a graduate scientist with a Bachelors degree in Science. She was involved with tuberculosis epidemiology and anti-tuberculosis drug-resistance work, which was undertaken in collaboration with Dr Suparat Phunookoonon and our collaborators, Drs. Chris Gilpin and Dr James MCarthy of the Brisbane TB Reference Laboratory and Queensland Institute of Medical Research respectively. Apart from entering and keeping data, Jacinta gained in-house training over the years to do preliminary work in blood separations and DNA/RNA extractions. She assisted with polymerase chain reaction-based work. 2007 Projects Epidemiology of tuberculosis in PNG Tuberculosis is caused by members of Mycobacteruim tuberculosis complex. The epidemiology and true extent of TB in PNG is not known, though increasing admission records in hospitals and anecdotal observations suggest that TB incidence could be well above the current yearly estimate of 104/100,000 population. In addition to this,
Dagwin holds a Masters Degree in Science from the University of Queensland, specializing in Molecular Biology/Virology. In 2002 he was involved with the development of a Taq-Man assay for the detection of a Sepik arthropod-borne virus while he was attached with Arthropod-borne Reference Laboratory at the Queensland Health Scientific Services (QHSS). This test is now being used at QHSS with a panel of tests used in differential diagnosis of infecting arthropodborne viruses. George is a graduate nurse. He has made invaluable contributions over the years in studies of HLA disease associations, including that of type II diabetes in Papua New Guinea. He has also been involved extensively with population migration and genetics studies with external collaborators with respect to the people of island Melanesia, looking mostly at several haplotypes, including deletions in mitochondrial DNA and mutations in several loci on Y chromosome. Other markers that have also been
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TB disease spectrum has changed dramatically over the years: as high as 30% of HIV cases are now reported to be co-infected with TB; extrapulmonary TB is on the rise with up to 63% reported at Goroka Hospital in 2006; and although not confirmed, anti-TB drug resistance has been suspected on clinical grounds. Since 2006, we have been investigating the epidemiology of tuberculosis (TB) among patients who were presenting to Mugil Health Centre and Modilon Hospital in Madang Province, to estimate the burden of TB disease as well as to determine and establish an anti-TB drug resistance profile. In light of the changing spectrum of TB disease, and its implication on diagnosis, in particular, given that the laboratory capacity for culture is lacking in the country and that sensitivity of smear microscopy is further reduced with ETB cases, an additional objective of this study was to assess the potential of polymerase chain reaction (PCR) to diagnosis TB in our setting. Of more than 340 patients seen so far, 53% of them have been confirmed to be positive for TB by smear microscopy. Combined results of BACTEC culture that was done in collaboration with collaborators in Brisbane, Australia, and a IS6110-based PCR we employed at PNGIMR suggest that the true positives could be in the vicinity of 30%. In this study, 17% of 69 samples that were successfully tested for drug susceptibly were found to show primary resistance to commonly used anti-TB drugs namely, rifampicin and isoniazid or both. Resistance to ethambutol and second-line drugs ethionamide and PAS were also observed. Using clinical diagnosis and pooled results of smear microscopy and BACTEC culture as gold standards, the sensitivity and specificity of IS6110 based PCR used in the study were found to be 90% and 100% respectively. PCR performed better than culture, considering observed contamination and high rates of unviable growths observed with the latter method. It was applied successfully to investigate TB from a range of extrapulmonary specimens, including pericardial, pleural, knee and aspirates from cerebrospinal fluid (CSF). The preliminary findings of this study were presented at the 2006 and 2007 PNG Annual Medical Symposiums in Madang and Port Moresby. Laboratory capacity building is essential for further studies. It is made all the more necessary in the light of established anti-TB drug resistance. Our future direction is to increase sensitivity of readily available smear microscopy as well as to put in place a system
for quality assurance. We also intend to establish culture and standardized PCR for all specimen types to cater for imposing challenges, including determination of TB drug-resistance. A major funding support is required to successfully achieve the objectives of this study. Completed Projects - 2005-2006 Molecular and epidemiological studies of measles and subacute sclerosing panencephalitis in PNG Measles epidemics occur every 3-4 years in PNG, with a case fatality rate of 14%. Every year between 56-98/million population in PNG are said to be infected it being the highest incidence rate reported anywhere in the world. Studies into measles epidemiology started in 1993 and continued in 1999 under the leadership of Dr Charles Mgone, the head of Molecular Microbiology, in collaboration with Nihon University School of Medicine and the Kitasato Institute in Tokyo, Japan. Findings of this study have been published in several peer reviewed journals (1-3). One of the major challenges to the study of measles is the complications of subacute sclerosing panencephalitis (SSPE). SSPE can be fatal. Clinical presentation may be characterized initially by persisting fever and some form of disability, followed by myoclonic jerks, falling attacks, difficulty with gait and movements, speech impairment and inability to walk or stand. The exact mechanisms contributing to its development is not known, though early history of measles, persisting CSF infection, viral and host genetics factors are considered to play a role. These studies as well as insights into immunopathological bases are expected to provide some insights. An increasing body of evidence is now suggesting certain serum and CSF cytokines to be associated with SSPE. Our recent findings in 2005, involving a large number of SSPE patients, has shown that serum levels of IL-6 and IL-10 are greatly elevated in SSPE patients with fever. Similarly, more than half of the patients showing myoclonic jerks were shown to have elevated levels of CSF IL-6 (Cytokine, 2006:33;17-20). We also studied the influence of matrix metalloproteinase-9, an enzyme promoter responsible for degradation of myelin layer leading to breach in blood-brain-barrier and the potential role of its inhibitor TIMP-1 in a related study. Our study results showed elevated levels of serum MMP-9/TIMP1 corresponding with clinical severity of SSPE, thereby suggesting a role of this matrix enzyme and
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its inhibitor in modulation of inflammatory cascade across blood-brain barrier in SSPE patients. A paper on this has been submitted for publication in the Journal of Neurological Science. Genetic Origins and history of human populations of Island Melanesia and their diseases People of island Melanesia have received much attention from anthropologists and other scientists to understand human evolution and early migrations. Also of interest, associated with such migration over time is the evolution and, from the modernday perspective, the determination of genes or genetic polymorphisms that are protective or expose population groups to diseases. It is estimated that the original settlers arrived in PNG about 45,000 years ago, followed by a more recent wave of migration 3,500 years ago. Because of admixtures over time with implied heterogeneity in population and cultures, the traditional use of cultures, pottery and language groups are not able to sufficiently delineate questions surrounding evolution and migration in these population groups. Genetic markers, especially those of mitochondrial DNA (matrilineal) and Y chromosome haplotypes (patrilineal) that may have co-evolved with these early migrations are expected to provide more insights. This study was conducted in mid 2005 in collaboration with Professors Manfred Kayser, Mark Stoneking and Wulf Schiefenhvel from the Max Plank Institute of Evolutionary Biology, Leipzig, Germany, and Professor Bill Foley from the University of Sydney, Australia. The study aimed to establish clear genetic bases and associations in an effort to delineate origins among mainland and off-shore island populations along the north and north-east coast of PNG, including Manus. Subpopulation groups in these regions represent both early (Austronesian/Papuan speaking groups) and
latter (Non-Austronesian speaking groups) settlers. Heterogeneity among the two main groups, with influences, from one or the other or both groups are wide-spread, hence, they provide an ideal setting for associated findings to be of significance. The study results are yet to be published. Future directions Aetiology of many diseases that are seen at hospitals or health centres in PNG are not known due mostly to lack of diagnostic facilities. Recent observations made by Mueller, et al (PNGIMR, unpublished) among febrile patients presenting to coastal hospitals suggest that malaria may be responsible for 50-60% of the cases. In view of previous reports of dengue endemicity, one of the groups interest is to study the contribution of this and other related viruses, including Japanese encephalitis, Influenzae virus and measles, to the overall burden of diseases that are being seen in the country. It is expected that the initial work will be supported by a small research grant from the World Health Organization. References 1. Mgone CS, Mgone JM, Takasu T, Miki K, Kwanishi R, Asuo PG, Kono J, Komase K, Alpers MP. Clinincal presentation of subacute sclerosing panencephalitis in Papua New Guinea. Trop Med Int Health 2003;8:219-227. 2. Mgone JM, Mgone CS, Duke T, Frank D, Yeka W. Control measures and the outcome of measles epidemic of 1999 in the Eastern Highlands Province. PNG Med J 2000;43:91-97 3. Miki K, Komase K, Mgone CS, Kawanishi R, Iijima M, Mgone JM, Asuo PG, Alpers MP, Takasu T, Mizutani T. Molecular analysis of measles virus genome derived from SSPE and acute measles patients in Papua New Guinea. J Med Virol 2002;68:105-112
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VIROLOGY
Professor Peter Siba

PNGIMR Director Head of Virology Unit
irology investigations have been a regular activity of the the IMR for more than 30 years. The activities of the unit remained primarily focussed on determining the epidemiology of viral diseases in PNG. The Institute has been involved in investigating viruses and viral diseases such as measles/rubella, influenza, respiratory syncytial virus, cytomegalovirus, influenza, adenovirus, rotavirus, Epstein-Barr virus,
hepatitis B virus, human T-cell lymphotropic virus type 1, dengue, Japanese encephalitis and polio virus The data generated from the Virology Unit has made and continues to make significant contributions to the formulation of the national immunization policy. Currently the Virology Unit is designated and also functions as the National Polio Laboratory and the National Influenza Centre.
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HIV/STI
Mr Tony Lupiwa
Senior Scientific Officer HIV/STI Unit
he HIV/STI section has been involved in sexual health and HIV/STI research for over 17 years. The current work by the section has been the biological research for the IMR capacity building project: Molecular Epidemiology of HIV-1 in PNG. The study has just been completed with the last site being Kimbe in West New Britain Province. The data is now being analysed for the final report. The section has new projects that are going to keep it very busy for the next five years. The biggest project will be the Papua New Guinea Australia Sexual Health Improvement Program (PASHIP) funded by AusAID. The goal of PASHIP is to reduce the burden of STIs in the project sites as a strategy apart from behaviour change to reduce the incidence of HIV. IMR as the research partner in the program has been given K8 million for the next five years to collect data to inform implementing NGOs intervention project planning and policy planning at the national level. The HIV/STI section will conduct the biological research at all project sites that will include baseline surveys in the project sites, mid-term surveys if required and impact surveys at the end of the term. Comparison of baseline data with mid-term or end line surveys will determine if there is any change or decrease in prevalence of STIs and HIV in the NGO project sites that is directly related to the intervention programs.
The section will also be working with the National Department of Health in the National STI surveillance programs which will be an annual event that starts this year. We will conduct STI clinic based biological surveys to determine the prevalence of common STIs in PNG. The surveys will also include drug resistance of gonorrhoea to standard treatment and other possible antibiotics now available in PNG. Study on the prevalence of human papillomaviruses (HPV) is ongoing and we believe this project will provide data that will provide valuable information on HPVs role in women developing cervical cancer in PNG. Staff The HIV/STI section currently has 6 staff members who are all based in Goroka. They are: Tony Lupiwa - Senior Scientific Officer, Section Head Janet Gare - Scientific Officer Pamela Toliman - Graduate Scientific Officer George Koki - Principal Technical Officer Bangan John - Graduate Scientific Officer Krufinta Bun - Graduate Scientific Officer Staff Training Janet Gare has just returned from Switzerland where
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2008 HIV/STI staff: (L-R) Bangan John, Tony Lupiwa, Krufinta Bun, Janet Gare, George Koki.
she completed her Masters Degree. She will be a lead researcher in some of the new projects that the section is now undertaking over the next five years. Pamela Toliman and Krufinta Bun have just completed their post-graduate honours, while Bangan John is enrolled in the Forgarty Honours Program. He is now working on his essays and a research project for his thesis. The HIV/STI section team looks forward to another three to five years of busy schedules both in collecting specimens in the field and analysis in the laboratory.
INFECTIONS AND IMMUNITY INFECTIONS AND IMMUNITY
BACTERIOLOGY
Dr Andrew Greenhill
Head of Bacteriology Unit
acteriology has been integral to the research conducted at the IMR since its inception. The bacteriology section is based at Goroka, and currently has six staff members: Audrey Michael (senior medical technologist), Mition Yoannes (medical laboratory technician), Celestine Aho and Valentine Siba (graduate scientific officers) and Philip Ove (laboratory assistant). Andrew Greenhill has recently joined the team as the head of the unit. Although there are no bacteriology staff outside Goroka, some bacterial culturing is conducted by Dr Laurens Manning and Chris Taput in Madang and sent to Goroka for identification. Research conducted in the Bacteriology Unit has contributed significantly to a number of the IMRs proud achievements over the years. Foci of research has typically concentrated on the major causes of morbidity and mortality in this country, including acute respiratory infections, diarrhoeal diseases, meningitis, typhoid fever and sexually transmitted infections. In conducting such studies the Bacteriology Unit closely monitors antibacterial resistance in many of the important pathogens. Currently, the Bacteriology Unit is playing a major role in the pneumococcal conjugate vaccine (PCV) trial being conducted in the nearby Asaro Valley and Goroka urban areas. This study is being conducted in collaboration with the Telethon Institute for
Child Health Research in Western Australia. The bacteriological component of the study includes the isolation of Streptococcus pneumoniae and other potential respiratory pathogens from the nasal passage of infants to determine what effect the various trial vaccination regimes have on the carriage of such organisms. This important study could pave the way for improved vaccination schedules throughout the country. For over 10 years now, the Bacteriology Unit has been monitoring the incidence of bacterial meningitis cases at the Goroka base Hospital. Results obtained over the course of the study have contributed to the decision making process of the National Department of Health, resulting in the forthcoming introduction of the Haemophilus influenzae Type b (Hib) vaccine. Additionally, surveillance is conducted of antibiotic resistance in the clinical isolates obtained in this study. In the near future a number of new studies will be conducted by staff of the Bacteriology Unit. One study will look at the effect of adverse in utero conditions on the immune response of infants. One indicator used in the study will be intestinal infections in pregnant women, which will be analysed in the bacteriology laboratory. The data collected by the bacteriology staff will be collated with other data collected both within the IMR and by international collaborating institutes to help determine what role microbial exposure during pregnancy has on the development of the infant immune system.
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Later in the year it is hoped an evaluation of typhoid fever diagnostics will commence. The currently used Widal test is of limited diagnostic value in typhoid endemic regions, and it needs to be interpreted differently around the country depending on the level of typhoid endemicity. A rapid, user-friendly, highly sensitive and specific test could greatly improve the current diagnosis of febrile patients. Other studies in the early stages of planning include a detailed investigation of the aetiology of pneumonia in children and adults, and a molecular epidemiological study of Streptococcus pneumoniae. It is also hoped that the Bacteriology Unit can contribute to future tuberculosis studies. Despite the many great projects that have been conducted by the Bacteriology Unit in the past, there remains much to be done. Infectious diseases
continue to be the greatest burden on the health of Papua New Guineans, and bacterial infections are a significant contributor. Many of these infections are currently preventable or easily treatable. However, with the likelihood of increasing antimicrobial resistance due to the widespread availability of some antibiotics and the empirical treatment of many illnesses, bacterial diseases will become harder to adequately treat. Infant mortality rates remain unacceptably high, with infection being a leading cause of death. The Bacteriology Unit is committed to meeting the challenges that lie ahead by working cooperatively with other sections within the IMR to ensure cohesion in our research. We strive to conduct nationally relevant research, and where appropriate will engage in international collaborations to ensure that our staff continue to be highly skilled and our science continues to be highly regarded.
2008 Bacteriology Unit: (L-R) Audrey Michael, Andrew Greenhill, Mition Yoannes, Valentine Siba and Celestine Aho.
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VECTOR BORNE DISEASES
Research in PNGIMR Vector Borne Diseases Unit
Dr Ivo Mueller
Scientific Head Vector Borne Diseases Unit
he research in the Vector Borne Disease Unit (VBDU) spans all areas from basic biomedical research over clinical research to research in intervention and control of the disease. The integration of the entire program allows for discoveries in the field of basic research to follow through to clinical research and control, while in reverse observation in intervention and clinical research projects raise new questions for 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, culture of P. falciparum and P. vivax in-vitro and studies in the natural acquisition of immunity and immunopathology. Currently there are 3 basic epidemiology studies ongoing and in different stages of completion. The Mugil treatment re-infection study was conducted to measure risk of malaria infections and disease in children 5-14 years and determine correlates of naturally acquired immunity. The study was conducted in collaboration with the Walter & Eliza Hall Institute (WEHI), the Case Western Reserve University (CASE), and the International Center for Genetic Engineering & Biotechnology Delhi (ICGEB) and included 206 children. Following an initial treatment they were followed-up actively for 6 months for malaria infections and disease. Field work was completed in 2005 and host genotyping in 2007. The immunological assays, data analyses
and writing up are however still ongoing. To date 2 papers have been published on this study. This studies showed that in PNG children immunity to P. vivax is acquired much faster than that to P. falciparum (Michon et al, 2007 AJTMH) and that antibodies that block the interaction between the human Duffy antigen and the P. vivax duffy binding protein protect children against P. vivax infections (King et al, in press, PNAS) A second cohort in children 1-3 years of age is the Ilaita (Maprk district) RO3 study. This study followed a cohort of 250 children over a period of 16 months. Children were monitored for malaria infections every 8 weeks and actively checked for morbidity ever 2 weeks to describe risk and dynamics of malaria infections and disease and determine interaction between malaria species. Besides these epidemiological objectives, the study also aims at studying acquisition of malarial infection and determine correlates for clinical immunity to P. falciparum and P. vivax. The field work came to an end in July 2007 and the molecular parasite typing work (conducted in CASE and at the Swiss Tropical Institute (STI)) should be completed by the end of this year. While immunological assays (done at IMR, ICGEB and WEHI) have been progressing well, they will continue for a considerable time before all aspects have been studied. The initial funding for the study was received as an NIH grant directly to the IMR. Additional funding for in-depth laboratory studies were procured from the NHMRC (Australia):
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The most recent cohort study is the P. vivax Vaccine Baseline Cohort. This study is part of a recently funded international consortium on P. vivax research in which the PNGIMR participated. The study aims to determine the epidemiology of P. vivax preparation for vaccine trials, provide evidence for the contribution of P. vivax relapses to the burden of infection and disease and continue our studies on correlates of immunity. The study has started in January 2008 and involves 500 children 1-5 years of age that have been randomized to receive either artesunate, artesunate plus primaquine or no drug treatment at the beginning of follow-up. Following the baseline assessment scheduled for mid May, the
malarial infections and followed up to delivery to study the impact of malaria in pregnancy on the mothers and their offspring. The study was designed to serve as a basic burden of disease study producing basic information on malaria in pregnancy that would allow the IMR to compete successfully for project testing interventions to reduce the burden of malaria in pregnancy. This approach has proven successful with the recently successful proposal to conduct an IPTp trial in PNG (see below). The field work of the study was completed in January 2008. With lab work still ongoing, it is expected that the final results will be available by late 2008 early 2009. In 2006 the IMR was invited by the University of Oxford to join the Gates Grand Challenges project for a Malaria Genetic Epidemiology Network (MalariaGEN. As a full member of the network, the VBDU received network funding to participate in two consortium studies: the larger study is the Million Genotyp Study of Severe Malaria. This study aims at screening the whole human genome for traits associated with an increase or decrease in risk of severe malaria using samples from case-control studies in Africa, Asia and the Pacific. As a consequence, in late 2006 the IMR established a unit for studying severe paediatric illness at Modilon Hospital in Madang together with the University of Western Australia. There we now conduct a case-control study of severe malaria cases, uncomplicated malaria and health community controls. To dated the study has collected >160 cases and a similar number of controls and hopes to collect >300 cases by June 2009. In addition, the IMR has given MalariaGEN access to archival samples from two earlier studies of severe malaria at Modilon by Allen et al. and Karunajeewa et al. The VBDU also participates in the Malaria Gen Diversity Study. This study will determine haplotypes for over 500 candidate genes putatively involved in malaria resistance or immune responses in order to determine global diversity in these genes. For this study the VBDU is collecting 30 mother-fatherchild triplets in 4 PNG populations (Madang, Maprik, Alotau and Rabaul). The last population was sampled in April 2008. Initial DNA samples from both study have been transferred to the University of Oxford for genotyping and initial results are expected in 2009. Besides the MalariaGEN studies the VBDU conducts
2008 IPTi and IPTp project staff in Madang
children will be followed up actively for 9 month for incidence of infection and disease. The field work is thus scheduled to finish in February 2009 with the lab work continuing until at least early 2010. The study is conducted in collaborations with the Barcelona Centre for International Health Research (CRESIB), ICGEB, WEHI, CASE and STI, with funding provided by the Cellex Foundation (Spain) for field and some lab work, the Veterans Association (USA) and NHMRC(Australia) for additional laboratory studies. Last but not least, over the last 3 years the VBDU (in collaboration with the University of Melbourne and CASE) has conducted a Pregnancy cohort study at Alexishafen health centre. As part of this study over 400 pregnant women were screened for risk of
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a number of additional host genetic research projects. they can be used for parasite genomics and basic First and foremost, we continue our traditional biology studies. Of particular interest is the evolution focus on the study of the effect of common red cell of antimalarial drug resistance in P. falciparum, polymorphism on the risk of malaria. In collaboration where a number of studies are being conducted with CASE we continue to study the effect of the in collaboration with CASE and STI. Results from locally arisen mutation in the Duffy receptor on that work have revealed that only the sulphadoxine risk of risk in P. vivax infection and disease. Large component of the current standard treatment of community based studies in the Wosera have shown chloroquine and SP is not compromised. In addition, that people heterozygote for the trait have a reduced in collaboration with CASE we have recently started to risk of P. vivax infections (Kasehagen et al 2007, set up culturing procedures for P. vivax, where we are PLoS One). The first round of research has recently currently working on the collection of field isolates and come to an end and while finishing laboratory work purification of reticulocytes from cord blood in order to and writing up is on-going, a continuation project to look at the effect of the mutation on risk of clinical disease and acquisition of immunity has recently been submitted to the NIH (USA). In our epidemiological cohort study as well as the severe malaria casecontrol study we also continue to study the effect of alpha-thalassaemia, the Gerbich blood group, South East Asian Ovalocytosis and G-6-PD deficiency on risk of malaria infections and disease. In addition to genetic epidemiology studies, we are also restarting work on the effect of these mutations on basic parasite biology such as invasion or adhesion. Part of this later work is part of Livingstone Tavuls PhD proposal, other parts are conducted in collaboration with WEHI. Additional ongoing host genetic projects deal with i) the effect of mutation in the HLA and KIR genes on innate and intermediate immune responses using samples from 2008 Malaria team in Goroka: (L-R) Jonah Iga, Ore Toporua, Dr Ivo Mueller epidemiological cohort study as well as the severe malaria case-control study. This study is in collaboration with WEHI and Royal Perth Hospital improve short term cultures of field isolates. (funded by NHMRC) and started in early 2008; and ii) study the presence of mutations in the cytochrome P With the establishment of several longitudinal (CYP) family of genes and their effect on absorption cohort and clinical studies and the presence of and metabolism of different antimalarial drugs and a full time immunologist at the VBDU, the recent their effect on drug efficacy. Studies in collaboration years have seen a resurgence of research in the with STI, UWA and CASE are well advanced and natural acquisition of immunity and determination of initial results should be available before the end of correlated protective immunity. In collaboration with 2008. WEHI, CASE, ICGEB and CRESIB we are currently conducting a wide ranging array of immunological In recent years, the VBDU has only maintained a studies. These included studies on humeral and small program of research in the area of basic parasite cellular immune responses to merozoite surface biology. We continue to maintain P. falciparum in-vitro protein related to invasion (Pf and Pv) including culturing to study parasite invasion into red blood cells a number of vaccine candidates and or to variant and to investigates patterns of in-vitro drug resistance. surface antigens (eg, PfEMP-1). In addition, we have The later work has already assisted in informing the started an intensive program of studies into innate and new national antimalarial treatment guidelines and intermediated responses to malarial parasites in order initial results should be published shortly. In addition, to determine immune factors that contribute to severe we continue to adapt field isolates for culture so disease and anaemia. The studies in samples from
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the Mugil treatment reinfection cohort have advanced to the stage that initial publication will be submitted in the coming months. In-depth immunological studies on other samples are ongoing. The major changes in the research activities of the VBDU has been the (re-) establishment of a strong clinical research program that included clinical studies, drug efficacy and pharmacokinetic studies as well as a number of intervention trials. To support this, dedicated clinical research units have been established at Modilon Provincial Hospital and
accurate diagnosis and assist the paediatric ward with treatment, a small clinical diagnostics lab including basic microbiology, haematology and dry chemistry has been established at Modilon. The study is funded by MalariaGEN and NHMRC and with the current funding it will be able to continue until at least late 2009. At the Alexishafen site we have the infrastructure for conducting drug trials of uncomplicated malaria in children as well as pharmacokinetic study according to ICH GCP guidelines. Between August 2005 and July 2007 randomized trials of the efficacy of 4 antimalarial drug treatments in children was conducted at Alexishafen and Kunjigini (ESK) health centres with funding from Rotary against Malaria, WHO and NHMRC. Over 750 children 6-60 months were randomized to receive either chloroquine and SP, artesunate and SP, Coartem, or DHApiperaquine. The study revealed high level of failure of chloroquine and SP, moderate levels of failure in artesunate and SP and DHA-piperaquine, while Coartem was the most effective drug for treating P. falciparum. DHA-piperaquine was however significant better for the treatment of P. vivax. These data were presented to a national meeting on the future PNG national antimalarial standard antimalarial treatments on March 4th and 5th and were instrumental for the decision to select Coartem as the new standard treatment for PNG. In support of the efficacy study a series of pharmacokinetic (PK) studies with chloroquine, piperaquine, SP, Coartem and naphtoquine in children 5-10 years of age were conducted concurrently. The data on choloroquine and piperaquine, that showed a fast volume distribution in piperaquine compared to chloroquine has been published (Karunajeewa et al. 2007, AAC). The assays and pharmacological modelling of the other studies is currently being finalised. Treatment of malaria in pregnancy is hampered by very limited knowledge of drug levels and metabolism of even very old antimalarial drugs. In order to examine the currently recommended dosing for chloroquine and SP, a PK studies with both drugs was conducted in pregnant women presented to ANC at Alexishafen health centre in 2007. A preliminary data analyses revealed that drug levels for both drugs are significant lower in pregnant women compared to non pregnant controls. A second PK study with Azithromycin and SP and Azithromycin and chloroquine in pregnant women was conducted between December 2007 and April 2008 to determine the ideal dosing regimen for the upcoming IPTp trial (see
2008 IPTi team in Maprik
Alexishafen health centre in collaboration with UWA. These units now employ 2 expatriate and 2 national clinicians as well as >15 nursing officers. With the upcoming IPTp study (see below), these numbers will increase through employment of another 2 clinicians and at least another dozen nursing officers. The unit at Modilon is mainly conducting studies in severe pediatric illness with the objective to study clinical patterns of severe disease (both of malaria and non-malaria severe illness) in PNG children and improve diagnostic algorithms for malaria. For that purpose a surveillance of all admitted cases is conducted and a case-controls study of severe malaria, severe non-malaria, uncomplicated malaria and health community control was established in late 2006. To date over 1000 admissions have been assessed and >150 severe malaria and similar number of severe non-malaria and other controls have been enrolled into the case-control study. In order to provide
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below). The results of the later study should be available by September 2008. All PK studies were conducted in collaboration with UWA and with funding from NHRMC and the Malaria in Pregnancy consortium. The largest study currently conducted by the VBDU is the a randomized placebo-controlled trial of intermittent preventative treatment for the prevention of malaria and anaemia in infants (IPTi). The study is aiming to test if giving a course of amodiaquine and SP or artesunate and SP given during routine EPI clinics at 3, 6, 9, 12 months of age will reduce the incidence of malaria and anaemia in the first year of life. The study, which is funded by the Bill & Melinda Gates Foundation and conducted in collaboration with UoM, WEHI and CASE, started in both Madang North Coast and Wosera in June 2006 has so far enrolled 1100 of 1800 children. Of these, over 400 have completed the follow-up to the primary end point at 15 months of age. As part of the study all samples collected will be typed for presence using a PCR-based assay. A sub-sample of positive blood samples will also be tested for markers of drug resistance. For these molecular assays a high throughput PCR laboratory has recently been built in Goroka. Once fully operational by mid 2008, it should be able to handle up to 400 PCR reactions per day. The study will also test the effect of IPTi on acquisition of immune responses to malaria. In 2007 a flow-assisted cell counter (FACS) machine was installed in the laboratory in Yagaum and is currently being used for immunology studies on both samples from IPTi and the different longitudinal cohort studies. In order to assist the policy process towards and eventual implementation of IPTi in PNG, both the cost effectiveness and acceptability of the IPTi intervention are assessed in a health economics and a social science study conducted in collaboration with the IPTi consortium and CRESIB Barcelona. Following intensive preparation and 3 years of negotiation the IMR and the University finally received the funding to conduct a randomized placebocontrolled trial of Azithromycin and SP for the prevention of malaria and STIs in pregnant women (IPTp) in December 2007 from Gates Foundation through the Malaria in Pregnancy consortium and the European Union. The study will included 2800 women attending ANC at Modilon Hospital (and associated town clinics), Alexishafen and Mugil health centres. They will be randomized to receive either 3 doses of azithromycin and SP or PNG standard preventative treatment during the course of their pregnancy. All women will be followed-up until delivery where the impact of this intervention on maternal and child health
will be assessed. The study will also included in-depth laboratory studies on placental pathology, the risk of P. vivax infection in pregnancy and the effect of IPTp on the acquisition of immunity. Contract negotiations between IMR and UoM are currently ongoing with the start of the study scheduled for the second half of the year and it will run for 4 years. Since 2004, the PNG health authorities have been carrying out a national insecticide treated bednet (ITN) distribution program with funding from the Global Fund for Aids, TB and Malaria. The VBDU is conducting two studies to determine the effect of this distribution program on malaria and filarial transmission. The ecology of malaria and filarial vector study aims at studying the micro-ecology of PNG vector mosquito and assess the impact of bednet distribution on transmission levels using spatial modelling. The study, funded by the NIH (USA), is conducted in collaboration with CASE and will take place in Drikikir (ESK) and Wosera (ESK) or Madang North Coast. Work in Drikikir was started in early 2008, while work at the other site will start by mid 2008. In addition, the VBDU will conduct a formal evaluation of the national bednet program on behalf of the National Department of Health. The study will both evaluate the outcome of the distribution (ie. how many people are using nets and are they being used in high risk groups) and its impact on incidence of malaria illness and prevalence of infection in specific risk groups. This will be achieved through a mixture of sentinel site surveillance (at 6 sites) and rapid assessment surveys in all 20 provinces. Following the signing of the contract, we are awaiting funding so as to then staff recruitment and then the field work hopefully by late May or early June. Apart from these malaria research projects, the VBDU is continuing its research in the control of filariasis through mass drug administration (MDA). Together with Prof Jim Kazura from CASE the IMR was able to gain another NIH ICIDR grant to further evaluate MDA interventions in PNG. The aim of this project is to assess the long-term consequences of an interruption of transmission by MDA in the Drikikir area and conduct a trial to determine if the addition of ITNs will accelerate the eradication of filariasis through MDA. Long-term follow-up studies in Drikikir started late 2007, while the trial of MDA and ITN is still in planning. Last but not least, the VBDU (in collaboration with the virology section) has started a project to determining the contribution of dengue infections to the burden of febrile illness in Madang and in collaboration with the University of Sydney is continuing the effect of Parvovirus B19 infection on risk of severe malaria in PNG children.
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MOLECULAR PARASITOLOGY
Mr Pascal Michon
Head of Molecular Parasitoloy Section
he Molecular Parasitology Section, based at Yagaum, was established in 1994 when Dr Hans Peter Beck, with the assistance of Ingrid Felger, created it. The main goal at the time was to take advantage of recently discovered techniques in molecular biology: polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), Deoxyribose Nucleic Acid (DNA) cloning etc. These techniques aim at studying the genetic material (DNA) that contains precious information on the genetic makeup of an organism (including humans). Later on the section was under the direction of Dr Alfred Corts who continued to develop these types of molecular tools. He also added the Plasmodium falciparum in vitro cultures to the repertoire of techniques used in the Molecular Parasitology Section. Among other things, Alfred conducted some interesting in vitro assays that led to the discovery that only a few Plasmodium falciparum cell lines invaded (and developed in vitro in) red blood cells presenting a human genetic polymorphism frequently found on the North Coast of Madang: South East Asian ovalocytosis (SAO). These results and those of others have contributed to investigating the natural resistance conferred by some common human genetic polymorphism found in PNG against malaria severe disease. Now, the section is under the responsibility of Dr Pascal Michon and is still working towards the same goals, using and trying to perfect some of those early molecular tools as well as the in vitro cell culturing of P.
falciparum but also recently P. vivax, the second most important malaria species present in PNG. Directions of research currently conducted by the Molecular Parasitology Sections include: 1. PCR genotyping of human genetic polymorphisms including: a. +-thalassaemia (caused by 2 deletions in the -globin), b. SAO (caused by a deletion in the the band 3 gene), c. Gerbich negativity (caused by a deletions in the glycophorin C gene), d. single nucleotide polymorphisms (SNPs) in the Complement Receptor-1 (CR1) gene, e. single nucleotide polymorphisms (SNPs) in the Tumor Necrosis Factor- (TNF ) gene promoter f. single nucleotide polymorphisms (SNPs) in the Interleukin-6 (IL-6) gene promoter 2. PCR / RFLP genotyping of 3 P. falciparum genetic markers (namely: MSP2, MSP1 and GLURP) used to assess possible treatment failures in antimalarial in vivo drug resistance studies 3. PCR genotyping of the four malaria species found in PNG: P. falciparum, P. vivax, P. malariae and P. ovale 4. In vitro assessment of resistance to antimalarial molecules in P. falciparum isolates from various regions of PNG
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5. In vitro invasion assays of P. falciparum using red blood cells with common human polymorphisms 6. In vitro cultures of freshly collected P. vivax isolates using cord blood as a source of reticulocytes (these cells are a sub-population of immature red blood and are the target cells for the P. vivax parasite) The Molecular Parasitology Section has been recently involved in the preparation and purification of human DNA as part of 2 main projects of the MalariaGEN consortium (i) A case/control study on the Genetics of Severe Malaria aimed at identifying new genes conferring resistance against severe malaria and (ii) The Genetic Diversity of Severe Malaria project which aims at comparing the DNA from family trios (father/mother/ child) in various areas of PNG endemic for malaria. We are also starting collaborations with various overseas teams with the aim of collecting a large number of malaria parasite isolates from infected volunteers. These malaria-infected blood samples will provide a source of parasite DNA to study the genetic diversity of malaria parasites in PNG (including the use of whole genome sequencing). A main goal for the international collaborations is also to create a repository of malaria isolates of PNG origin (some of them to be propagated in vitro or in laboratory animals). Past and present staff who have been working at the Molecular Parasitology Section
Mata Mellombo (1999-2005 worked as a Laboratory Assistant: blood sample preparation, PCR, in vitro cell culture) Alfred Corts, (1999-2003 Section Head) Ariadna Benet (1999-2003 Research fellow) Alice Ura (2001-present Laboratory Assistant: blood sample preparation, PCR) Livingstone Tavul (1993-present Lab technician and then Scientific Officer; Completed his Medical Science Masters in 2007: Genotyping human genetic polymorphisms, P. falciparum in vitro cell culture, in vitro P. falciparum invasion assays, P. falciparum Drug resistant assays) Pascal Michon, (2004-present Section Head) Mak David (2005-present completed his Honors
2008 Molecular Parasitology Laboratory Scientist: (L-R) Livingstone Tavul, Dulcie Latu, Anna Rossanna and Mak David.
Hans Peter Beck, (1993-1996 Section Head) Ingrid Felger, (1993-1996 Research Fellow doing genotyping of P. falciparum, malaria vaccine trial studies) Simon Kabintik (1993-1996 Nursing Officer, Worked as a Laboratory assistant, later shifted to Lab Manager) Gerard Casey (1999-2001 Research fellow doing drug resistant genotyping) Mark Kia (2000-2001 student assisting in drug resistant genotyping)
Degree in 2008, currently working as Laboratory Assistant: In vitro culture of Plasmodium vivax and P. falciparum, PCR) Enmore Lin, (2005-2007 worked as a Post Doctoral Fellow responsible for the genetics lab in the section: PCR genotyping) Dulcie Lautu (2005-present Laboratory Assistant currently working on her Honors Degree: P. falciparum in vitro cell culture, in vitro assays on resistance of P. falciparum isolates to antimalarial drugs) Anna Rosanas, (2007-present Post Doctoral Fellow working in the genetics lab: PCR genotyping)
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IMMUNOLOGY
Dr Daniella Stanisic
Head of Immunology Section
he Immunology Section of the Vector Borne Diseases Unit has labs in both Madang and Maprik with a total of 7 staff between the 2 sites. Due to the increased number of malaria-focused studies now running in the Madang and Maprik areas, the activity in the immunology labs has greatly increased over the past 2 years. Sample processing for many of the projects is performed by the staff in these labs. The commencement of studies such as IPTi and the Ilahita study has also meant that all of the lab procedures have been adapted and implemented in keeping with the standards of good clinical practices (GCP). The recent addition of a flow cytometer to the labs in Madang as well as upgrading a number of key pieces of equipment has greatly increased our ability to perform many assays on site that previously had to be done in labs overseas. The overall scientific focus of the Immunology Section is examining natural acquisition of immunity to the malaria parasite. We are working with samples from a number of different studies to achieve this. IPTi Study This study is investigating whether preventing malaria in infancy by giving anti-malarial drug treatments as part of a routine immunization program will influence the development of immunity to the malaria parasite. If IPTi reduced the amount of malaria these children experience, this may have an
impact on childrens immunity. In order to study this we are comparing antibody responses to malaria antigens between the different drug arms of the study. Antibodies to merozoite antigens are examined by ELISA and antibodies to variant surface antigens (VSA) on the surface of parasitised red cells are examined by a flow cytometry based assay. Further analysis will also be performed to determine if these antibody responses are associated with protection from malaria, parasitemia and anemia. Alexishafen Pregnancy Study An observational study examining the burden of malaria in pregnancy in PNG has recently been completed on the North Coast of Madang. As part of this study we are studying antibody responses to different malaria antigens in this cohort to see if they are associated with protection from malaria in pregnancy. Longitudinal Cohort Studies Over recent years we have started to study acquisition of immunity and immunological correlates of protection in a series of longitudinal studies in Mugil (Madang North Coast) and Ilahita (East Sepik Province). Within these studies, we have been examining the acquisition of antibody-mediated immunity to a number of malaria antigens (both merozoite antigens and VSA) in cohorts of 1-3 year
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2008 Immunology Unit staff: (L-R) Heather Huaupe, Jack Taraika and Sarah Javati
olds (Ilahita) and 5-12 year olds (Mugil) to understand how acquisition of immunity to the different malaria parasites evolves with age and to determine if any of these responses are associated with protection from malaria. We have also been examining functionality of the antibodies to the P. vivax Duffy Binding Protein using a novel ELISA based assay and relating these responses to protection from P. vivax infection in the Ilahita cohort. In addition, both adaptive and innate cellular immune responses are being examined in these cohorts. In January a new cohort study commenced in children 1-5 years of age in the Ilahita area in the East Sepik Province. Besides providing baseline information for future P. vivax vaccine trials, this study will investigate differences in the acquisition of immune responses to the different malaria parasites and relate them to protection from parasitemia, anemia and symptomatic malaria episodes. Severe Malaria Study Since late 2006 the IMR has been conducting a study of severe pediatric malaria at Modilon Hospital in Madang. As part of this study we want to identify host immune responses associated with protection
from severe malaria and also those responses that may be involved with the pathogenesis of severe disease. To date very little experimental work has yet been performed with the blood samples collected. In addition, parasites are being collected from individuals with severe malaria and uncomplicated malaria to examine differences in expression of particular parasite virulence genes Much of the work in the Immunology Section is done in collaboration with a number of overseas institutions such as the Walter & Eliza Hall Institute (WEHI, Melbourne), University of Melbourne (UoM), Case Western Reserve University (CASE, Cleveland OH), the International Centre of Genetic Engineering & Biotechnology (ICGEB, India) and the Barcelona Centre for International Health and Research (CRESIB, Spain). The main collaborators are: Dr James Beeson (WEHI, humoral immune responses and VSA) Dr Louis Schofield (WEHI, cellular immune response and immunopathology), Dr Chris King (CASE, P. vivax immune responses), Dr Stephen Rogerson (UoM, VSAs and parasite virulence), Dr Chetan Chitnis (ICGEB, Immunity to PvDBP), Dr Hernando del Portillo and Dr Carmen Fernandez Becerra (CRESIB, immune responses to P. vivax).
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ENTOMOLOGY
Ms Melinda Susapu
Senior Scientific Officer Entomology Section
he Entomology Section is currently staffed by 13 members, making it one of the biggest sections in the Vector Borne Unit based in Madang. There are 3 graduate scientific officers (Melinda Susapu, Daphne Sepe and Steven Paniu), 2 senior technicians (Henry Dagoro and Erwin Ibam), 2 lab technicians (Absalom Mai and Muker Sakur), 5 lab assistants (Lemen Kilepak, Siub Yabu, Yule Eele, Wal Kuma and Lubus Kaukesa) and 1 cleaner (Walaf Melaid Sakel) who is also the Sections expert on mosquito rearing. Since the departure of senior research fellow Dr Moses Bockarie two years ago, there is the need to fill the position he has left behind. Over the years the Entomology Section has carried out various studies and produced many good publications. Studies like ecology and behavior of malaria vectors (Anopheles punctulatus group of mosquitoes), malaria transmission rates in endemic populations, entomological evaluation of permethrinimpregnated mosquito nets, and transmission dynamics of lymphatic filariasis, just to name a few. Also over the years, the Entomology Section, having some of the longest serving and highly experienced staff, has offered its services and expertise to many mining companies such as Lihir, Misima and Ok Tedi to conduct malaria and lymphatic filariasis baseline studies. Currently, there is one major research activity that
has been keeping the entomology lab busy for the last 10 months and that is the entomology component of the International Collaborations in Infectious Disease Research (ICIDR) lymphatic filariasis project. This is a collaborative research project between the Case Western Reserve University in Cleveland, Ohio, USA and the PNG Institute of Medical Research, with Professor James Kazura as the chief international Principal Investigator (PI) and Professor Peter Siba as the in-country PI. It is an observational study of the long term impact of mass drug administration (MDA) on the reduction of lymphatic filariasis morbidity and infection in Papua New Guinea and is funded by the National Institute of Allergy and Infectious Diseases (NIAID). It is a yearlong project and is expected to be completed before the end of 2008. Routine monthly mosquito samplings are being carried out in 4 of the previously treated Drekikier villages. Studies prior to treatment 10 years ago in the Drekikier area have shown the area to be highly endemic for lymphatic filariasis, with prevalence rates as high as 60-80% and the annual transmission potential to be in the thousands in the highly endemic areas. The entomology laboratory is equipped to carry out lab assays such as malaria sporozoite ELISAs,
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2007 Entomology Staff in Madang
efficacy of insecticide treated bednets, mosquito larva rearing, mosquito feeding experiments, mosquito dissection, microscopic slide reading and mosquito DNA extraction for molecular purposes. The traditional methods such as morphological identification of local malaria and filariasis vectors (Anopheles punctulatus group of mosquitoes) are
still maintained even though molecular techniques are readily available in the Institute for species identification. This makes it one of the few labs in the world that are still practicing traditional entomology, given the current trend where most labs are moving towards highly technical methods such as molecular techniques.
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MICROSCOPY
Mr Hector Morris
Microscopy Section Manager
he Microscopy Unit plays a major role in terms of making sure blood slides collected from different study sites are read in a timely manner, according to priorities and contain minimum discrepancies with quality results. Microscopy reading results are now stored in a database system of its own. This has made life easier for microscopy as the retrieval of basic information in regards to slide readings is efficient. Furthermore, microscopy has been liaising with the Data Management Unit in terms of managing basic data entered into the microscopy database as well as creating databases for other microscopy related activities such as chemical monitoring, slides tracking and basic inventory. The Section has 9 staff - 7 lab technicians, a data entry clerk and a section manager. Two lab technicians are well experienced - Nandao, is the Principle Microscopist and Sectional Head and Lina, who is the Assistant Principle Microscopist. All the other lab technicians were trained in-house by Nandao and Lina. The Section has also trained one clinical nurse from RD Tuna Canneries in parasitic diagnostics using a microscope. The Microscopy Section in Madang also facilitates three mini labs in the province, which do quick reads and are looked after by field nurses.
Studies The Microscopy Section is specifically concerned with studies that generate blood slides. The section has so far completed two studies (RO3 and XIAs) of which satisfactory results have been attained. Currently 4 studies are under the process of 2nd and 3rd readings while 2 (XIIs and XMKs) new studies are undergoing 1st reading for microscopy. Annually an estimate of 30 to 40 thousand slides are being generated from the different studies. With the settingup of a new database system by IMRs hardworking Data Management Unit, the section is able to do calculations for 3rd readings according to species and density. Studies undergoing microscopy readings include: RO3 (Completed) AXH Pregnancy Alexhishafen Pregnancy Study Severe Malaria Study Modilon Hospital IPTI Intermittent Preventive Treatment in Infants Drug Study Enhanced Pregnancy Outcomes Dengue Fever Flow of slides in brief When each of the studies generates slides, the slides are brought into the Microscopy lab for registering,
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2008 Microscopy staff: (L-R) Eddie Gini, Martin Imbans, Naomi Sambale (Front), Lina Lory and Letus Waranduo.
fixing, drying and staining. Then the slides are allocated into their definitive slide boxes and stored in the incoming slides storage area. According to priorities in place, the slides are taken on board for reading (1st reading). The complete reading result forms are given to the data management for entry into the microscopy database system. According to the first and second reading results, the database system calculates and selects slides for third readings while the data management allocates readers for the third reading using the database system and the readings are carried out according to weekly plans filled out by sectional head.
Challenges Microscopy has faced a lot of challenges. Since last year the section has seen a lot of workers leave to work with other organizations and so there has been new hands taking over from the old ones. However, these changes have never hindered the Microscopy Section from achieving its goals. With limited time frame and the start of new projects our schedule has been rather tight and managing it has also been a challenge for microscopy. In the coming years, we hope to have a coordinated system in place in terms of the flow of slides, reading of slides, storage of slides and retrieval of data in a timely manner. We will aim to produce quality results in an effective and efficient way.
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DATA ENTRY AND IT SUPPORT
Mr Thomas Adiguma
Data entry and IT Support Manager
he Data Management Section in Madang has two parts; the Data Management and the IT sections. In the Data Management area, data managers are assigned to take on projects to look after the studies data information, whilst data entry clerks enter the data taken from the field. We currently have 3 data managers and 1 assistant and 6 data entry clerks in this section. The data managers are; 1) 2) 3) 4) Thomas Adiguma (Unit head) Gordan Warvi Rose Sabub Yangta Ura (assistant)
did everything ourselves. In the past there wasnt much to do compared to the present day. Three years ago we moved on to use the DMSYS, built on Visual Fox Pro to enter our data. Because of the standards we have employed now, we can do second and third checks. Stuart Dobbie, who was a data manager from Australia, set up the data base premier for the IPTi project and helped us in setting up a more reliable date entry system. Apart from that he was also involved in the training and recruitment of data managers and data entry clerks. We are currently managing 11 projects between Madang and Maprik and the data is entered here in Yagaum. This year the ISIDAR project is using the Electronic Data Capture system, and is using the Personal Digital Assistant (PDA) to get their information. This is a new challenge for us but we are open to learning new things to keep up with the world of technology. We have a total of 8 PDAs and 6 are currently being used in the field.The PDA is good for short answer questions.
All the data managers share the work load together. The data entry clerks are; 1) 2) 3) 4) Fransica Adiguma Rhonda Clement Margaret Marem Vija Dali
In the IT section, we have only one system administrator: Stanley Aisi. Before he joined IMR we
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2008 Data entry and IT support staff: (L-R) Yangta Ura, Vija Dali, Stanley Aisi, Thomas Adiguma, Rhonda Clement, Gordan Warvi, Rose Sabub, Hector Morries, Margaret Marem, Fransica Adiguma, Martin Imbans
KURU
KURU
KURU
Mr Jerome Whitfield
Head of Kuru Unit 50 years of kuru research
n the 11-12 October 2007 the conference celebrating The end of kuru: 50 years of research into an extraordinary disease was held at the Royal Society in London. There were over 90 participants from around the world, including 15 from Papua New Guinea; these included Professor Peter Siba, the Director of the Papua New Guinea Institute of Medical Research; Dr Adolf Saweri, the Chairman of the Council of the Institute; Dr Ken Boone, who performed the last kuru autopsy; and 12 participants from the Fore linguistic group, who were the principal sufferers from kuru (Collinge and Alpers, 2007). This magazine celebrates the 40th anniversary of the Papua New Guinea Institute of Medical Research (PNGIMR). The relationship between kuru research and the establishment of the Papua New Guinea Institute of Medical Research is an important part of the history of the PNGIMR. The first Director of the PNGIMR, Dr Richard W. Hornabrook, was amongst the third wave of researchers to enter the kuru-affected region and assumed responsibility for epidemiological surveillance once appointed Director of the PNGIMR (Collinge and Alpers, 2007). This work continued under the second Director, Michael Alpers, who was an integral part of the early research team and later the kuru transmission studies team. Subsequent Directors of the PNGIMR have continued to oversee kuru investigations to the present day.
The scientific focus of kuru investigations has changed over the years from an exotic disease, to the first human transmissible spongiform encephalopathy, to a model for the transmission of Creutzfeldt-Jakob disease, to a model for multidisciplinary epidemiological enquiry, and to a model for bovine spongiform encephalopathy (BSE) and variant Creutzfeldt-Jakob disease (vCJD) in humans (Alpers, 2007; Collinge and Alpers, 2007). Kuru has played an important part in late 21st century scientific medical investigations leading to the establishment of a new field of enquiry, prion diseases, which has seen the pioneer of kuru research, Dr Carleton Gajdusek, and Professor Stanley Prusiner, who first characterized the prion agent, become Nobel laureates (Collinge and Alpers, 2007). It also played an important part in the establishment of the PNGIMR, which has contributed so much to the health and wellbeing of Papua New Guineans. Geography of the kuru affected region The kuru-affected region is located between the Kratke Mountains to the North, and the Lamari and Yani Rivers to the east and west creating a triangle (Lindenbaum, 1979). This area measures about 65 km by 40 km with 172 villages having a history of kuru, of which 145 have had recorded cases since 1957 (Alpers and Kuru Surveillance Team, 2005). Kuru is found amongst the Fore people and 9 contiguous linguistic groups (Alpers et al., 2007). There have
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been no cases of kuru amongst Barua and Simbari speakers of the Anga, who are a different cultural group separated from the kuru-affected region by the Lamari River (Gajdusek et al., 1972). History of kuru Oral histories collected by early kuru researchers suggest that the first case of kuru occurred in Uwami in the Keiagana linguistic group in about 1910. From there it spread into Awande in the North Fore and to Kasokana and then continued to spread across the kuru-affected region (Glasse, 1962; Mathews et al., 1968). Of the more than 2700 recorded cases of kuru, over 80% occurred in the Fore, most of which were in the South Fore. The epidemic peaked in 1958-1959 and kuru surveillance data showed a decline by 1960, which has a long tail stretching to the last case in 2005 (Alpers, 2007). Kuru is a neurological disease, which principally affects the cerebellum causing astasia, ataxia of gait, trunkal instability and shaking tremors. Kuru means shaking or shivering in the Fore language, and was the name given to this syndrome by the local people who believed it was caused by a powerful form of sorcery. The clinical course lasts an average of 12 months and has a range of 3 months to 2 years with a few cases extending to 3 years (Alpers, 2007; Collinge et al., 2006). In the late 1950s the age of patients ranged from 5 years to 70 years, with 60% occurring in adult females, 38% in children and adolescents of both sexes, and only 2% in adult males. By the 1960s it was noted that there was a disappearance in cases of kuru in children under 10 and then later in children under 14 years of age. It then became clear that children born since 1960 were growing up kuru free (Alpers, 2007). William Hadlow, a veterinary neuropathologist who saw an exhibition on kuru in London recognized that the neuropathology of kuru was the same as that of scrapie, an infectious, transmissible disease of sheep and goats that had long incubation periods. An experiment was then set up under D. Carleton Gajdusek, C. Joseph Gibbs Jr and Michael Alpers to test this hypothesis. Kuru material was inoculated into chimpanzees and after about two years, the animals started to exhibit signs of kuru, which Elisabeth Beck later confirmed pathologically. This led to the award of a Nobel Prize to Carleton Gajdusek in 1976 (Alpers, 2007). It then became clear that an infectious agent transmitted through the practice of transumption of the
dead, in which relatives were eaten and incorporated into the bodies of the living and which was a universal practice in the kuru-affected region at that time. Transumption has been defined as: .the mortuary practice of consumption of the dead and incorporation of the body of the dead person into the bodies of living relatives, thus helping to free the spirit of the dead; this practice had deep significance for the Fore people and their neighbours. (Alpers, 2007). It was the women and children of both sexes who were exposed in varying degrees to the infectious agent in the brain and spinal cord during the mortuary feasts. Males ceased to have exposure from the age of 6 or 7 when they entered the male cult house, and this explained the low incidence of kuru in males. Adult males had incubation periods of decades from childhood exposure (Alpers, 2007; Alpers et al., 2007). Familial cases and the clustering of cases in local clans was explained by their exposure to the same feasts (Klitzman et al., 1984). Once transumption was banned by the Australian administration in the mid1950s those born after 1960 were kuru free. Vertical transmission was quickly discounted as mothers who had been exposed to kuru gave birth to babies that never developed the disease. Further transmission studies showed that CreutzfeldtJakob disease was also transmissible to chimpanzees, and this gave rise to a group of infectious diseases characterized by spongiform encephalopathy, which became known as transmissible spongiform encephalopathies. It was Stanley Prusiner who proved that the infectious agent was protein only, and he coined the term prion to describe the infectious proteinaceous particles (Alpers, 2007). Although kuru is nearly at an end, surveillance continues to establish the length of incubation of human prion disease. Its importance has recently been highlighted by the outbreak of bovine spongiform encephalopathy (BSE) and its human form, vCJD, in the United Kingdom. The important connection between kuru and vCJD is the oral transmission of these diseases. The long incubation period of kuru implies even longer ones for vCJD, as kuru is transmitted from human to human and vCJD from bovine to human; between-species transmission gives rise to a barrier prolonging incubation periods (Alpers, 2007). The four cases of vCJD in the UK that have been transmitted via blood transfusion have much shorter incubation times (Editorial team, 2007). The present research on kuru is part of a
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collaboration, first established in 1996, between the then Director Michael Alpers and Professor John Collinge of the MRC Prion Unit in London. This collaboration has continued under the present Director Professor Peter Siba. Professor Michael Alpers continues to collaborate as Professor of International Health at Curtin University of Technology in Perth, Australia. As well as continuing kuru surveillance, the present collaboration has collected blood samples from all the linguistic groups of the Eastern Highlands for genetic studies (Collinge et al., 2006). Present studies are very much focused on collecting stories on mortuary rites in the kuru-affected region. These data will be used in conjunction with the epidemiological records to see what effect variations in practices would have had on the spread of kuru. The success of the present, and indeed the past, kuru studies has depended upon the relationship between the researchers and the participating communities. Many of the early researchers founded friendships amongst the kuru-affected peoples that have lasted for more than 50 years. The present field staff, Mr Henry Pako, Mr Anderson Puwa, Mr David Pako, Mr Jolam Ove, Mr Kabina Yaragi, Mr Jack Kosinto, Mr James Kisava, Mr Pibi Auyana and Mr Steven Kaguya have made the present collaboration possible and successful. Their hard work and initiative is a great example as to what can be achieved by the Papua New Guinea Institute of Medical Research. Most importantly, they have explained to the participating communities the reasons why kuru research is being conducted and have encouraged the communities to make an informed choice to participate or not to participate. Finally, it is a great achievement for the PNGIMR that kuru research has gone hand in hand from the founding of the Institute to the present day and has contributed so much to the international reputation of the PNGIMR.
References Alpers, MP. A history of kuru. PNG Med J 2007; 50:10-19. 50: 10-19. Alpers MP Kuru Surveillance Team. The epidemiology of kuru in the period 1987 to 1995. Comm Dis Intell. 2005; 29:29: 4: 391-399. Alpers MP, Whitfield J, Collinge J, Gajdusek C, Kuru Surveillance Team. The imminent disappearance of the disease kuru from Papua New Guinea. Poster. The end of kuru:50 years of research into an extraordinary disease. London, 2007. Collinge J, Alpers MP. Introduction to the End of Kuru Conference Proceedings. Philosophical Transactions of the Royal Society. 2007 in press. Collinge J, Whitfield J, McKintosh E, Beck J, Mead S, Thomas DJ, Alpers MP. Kuru in the 21st century-an acquired human prion disease with very long incubation periods. Lancet, 2006; 367: 20682074. Editorial team (2007). Fourth case of transfusionassociated vCJD infection in the United Kingdom. 2007;12:1: E070118.070114. Gajdusek DC, Fetchko P, Van Wyk NJ Ono SG. Annotated Anga (Kukukuku) Bibliography. Mimeographed. National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, Maryland (December). 1972 85pp. Glasse RM. The spread of kuru among the Fore. A preliminary report. Mimeographed. Department of Public Health, Territory of Papua and New Guinea (June), 14pp. Reissued, National Institutes of Health, Bethesda, Maryland, 1962 18pp. Klitzman RL, Alpers MP. Gajdusek DC. The natural incubation period of kuru and the episodes of transmission in three clusters of patients. Neuroepi demiology.1984;8:3:3-20. Lindenbaum S. Kuru Sorcery: Disease and Danger in the New Guinea Highlands. Palo Alto: Mayfield,1979. Mathews JD, Glasse, R Lindenbaum S. Kuru and cannibalism. Lancet 1968;2:449-452.
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COMPUTING AND STATISTICS
COMPUTING AND STATISTICS
Mr William Yeka
Head of Computing and Statistics Unit
he Computing and Statistics Unit is one of the service departments of the Institute. It is responsible for providing services in information technology (IT), data management and analysis for the Institutes research and development activities. The unit is based at the IMR headquarters in Goroka and mainly supports the activities of the research and administrative staff in Goroka. The Units staff work in close consultation with colleagues at the Madang branch. Before the major IT upgrades in 2003, the unit was a small one and was manned by four staff. One of the staff, at that time, carried out both computing and statistics duties eg, installing hardware and upgrades, attending to network problems and carrying out data management and analysis responsibilities. The department now has 7 permanent staff and two parttime staff. Due to the rapid expansion of the Institute and the installation of a state-of-the-art computer network, the responsibities of the Unit have doubled with the result that we now have two sections the computing section and the statistics section. Computing Section The computing section of the unit is managed by a computer manager assisted by two technical staff.
Together they provide dedicated services in IT for the administrative and support staff and the scientific staff. The core of their activities involves managing and providing support for the computer network which caters for over 80 personal computers and their users. They also manage and service a number of laptops. In addition to that the staff carry out tasks such as routine backups, software and hardware upgrades, user support and staff training in various software packages. The computing staff manage a broadband internet connection (through VSat Satellite) as well as an intranet and a PABX (telephone) system. Computing staff monitor the daily use of the Institutes internet and email system. In addition to that they work in close consultation with the Information and Communications Unit to create and update the Institutes website. Statistics Section Four staff, comprising a statistician, a data manager and two data entry clerks provide the necessary statistical and data handling services for the scientific staff of the Institute. The statistics staff provide support in statistical and data management aspects of all research activities based in Goroka. The wide range of data management tasks carried out include database design, programming of data entry procedures, data
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2008 Computing and statistics Unit. (L-R standing), Colin Haili, Sunnry Talipe, Irene Semos, Namarola Lote, William Yeka, (L-R seated) Colin Kotale, Posing Pomat, Kuzahe Iva and Yalum Siba
cleaning (range checks and validation), data entry and data analysis. The staff are also involved in training others including post-graduate students in introductory statistics and data analysis using various statistical software. The official data management system of the Institute is DMSYS (Data Management System for Clinical Trials) from SigmaSoft International Inc, however staff still manage data for smaller projects in Microsoft FoxPro and Microsoft Excel. The section adheres to good clinical practise (GCP) protocols in place for data management and follows standard operating procedures outlined in the protocol. This ensures that data management is GCP compliant. The official statistical analysis software for the Institute is Stata (Stata Corporation). Staff are also familiar with other specialist statistical software such as Epi Info, Splus, SPSS and RDSAT (Respondent-driven Sampling Analysis Tool). Working in collaboration with IMR staff and with international collaborators, the section has been involved in disseminating research findings in the form of reports, conference presentations and peer-review publications. The following publications are examples of some of the Sections most recent work: Original Articles 1. Suarkia DL, Mgone CS, Lehmann D, Passey ME, Lupiwa T, Paniu MM, Kono J, Kakazo M,
Yeka W, Alpers MP. Chlamydia trachomatic infection and distribution of serovars in the Eastern Highlands Province, Papua New Guinea. PNG Med J 2007;50:000-000. 2. Yeka W, Maibani-Michie G, Prybylski D, Colby D. Application of respondent driven sampling to collect baseline data on FSW and MSM for HIV risk reduction intervention in two urban centres in Papua New Guinea. J Urban Health 2006;83:60-72 Conference Presentations and Published abstracts 1. Yeka W, Millan J, Pantumari J, Obiero W. High risk sexual behaviour among women who sell sex in Papua New Guinea. 8th International Congress on AIDS in Asia and the Pacific (ICAAP), Colombo, 13-17 August 2007. 2. Millan J, Yeka W, Pantumari J, Obiero W. High risk sexual behaviour among out-of-school youth in Port Moresby, Papua New Guinea. 8th International Congress on AIDS in Asia and the Pacific (ICAAP), Colombo, 13-17 August 2007. 3. Yeka W. Risky sexual behaviour among women who sell sex. Abstract 51 in programs. Abstracts of the Forty-third Annual Medical Symposium of the Medical Society of Papua New Guinea, Port Moresby, 3-7 September 2007:49.
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4. Bun K, Lupiwa T, Toliman P, Yeka W, Hill L, Siba P. Comparisons of human papillomavirus in an urban and a rural setting in Papua New Guinea. 2007 Biomedical and Social Sciences Group meetings. 3-7 September, 2007. 5. Lupiwa T, Toliman P, John B, Hammer L, Maibani-Michie G, Yeka W, Mgone C, Reeder JC, Siba P. HIV and STIs in a voluntary population: findings from eleven sites across ten provinces. Abstract 51 in Program and Abstracts of the Fortythird Annual Medical Symposium of the Medical Society of Papua New Guinea, Port Moresby, 3-7 September 2007:47. 6. Maibani-Michie G, Jikian M, Kavanamur D, Yeka W, Prybylski D, Siba P. Evaluation of STI and HIV prevention program for female sex workers by an NGO in Goroka. Preparation at 2007 Biomedical and Social Sciences Group meetings, Port Moresby, 3-7 September, 2007. Reports 1. Baseline Research for the Poro Sapot Project: An HIV Prevention program among FSWs in Port Moresby and Goroka and among MSM in Port Moresby, Papua New Guinea, November 2005 2. Evaluation of the Poro Sapot Project: Baseline
and Post Intervention Studies - An HIV Prevention program among FSWs in Port Moresby and Goroka and among MSM in Port Moresby, Papua New Guinea, November 2007 3. Enhancing Pregnancy Outcomes A joint program of UNICEF PNG and PNG National Department of Health implemented by the PNGIMR (April 2008, draft stage) Staff We have the following staff members in the department. 1. William Yeka - Head of Computing & Statistics 2. Kuzahe Iva - Computer Manager 3. Namarola Lote - Data Manager 4. Sunnry Talipe - Technical officer, Computing 5. Colin Haili - Computer Assistant 6. Yalum Siba - Data Entry Clerk 7. Collin Manasseh - Data Entry Clerk 8. Posing Pomat - Computer assistant (part-time) 9. Irene Semos - Fogarty Honours Student (Biostatistics)
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INFORMATIONS AND COMMUNICATIONS INFORMATION AND COMMUNICATIONS
INFORMATION AND COMMUNICATIONS
Mrs Susan Gandi
Head of Information and Communications Unit
he Information and Communications Unit consists of the Michael Alpers Library, Archives and the Communications section. It is one of the support units of the Papua New Guinea Institute of Medical Research. With a total staff of six, we perform different functions to meet the research needs of the Institute. Michael Alpers Library From its early beginnings in 1970 after the Institute moved from Madang to Goroka to occupy the few remaining buildings of the old hospital, a small library was set up for books and journals with a table and space for reading and writing. It then moved into a properly designed library in 1981 when the Institute relocated to this current location. A branch library was established in the main IMR building at Yagaum especially with a collection of literature relating to malaria. Quite recently in 2004, PNGIMRs brand new Michael Alpers library was inaugurated together with the Adolf Saweri Lecture Theatre and other refurbishments of the Institute. Under the Directorship of John Reeder and the assistance of Deb Chapman, AusAID incentive fund was secured using a development initiative plan of Professor Michael Alpers. Past administrators and staff of the Institute have all played significant roles in these developments. Currently, this modern research and academic library boasts to have a library that is compatible with other research libraries around the world.
The library collection has been developed throughout the years under the watchful eyes and thorough bibliophile interests of Professor Michael Alpers. With the new library, we have since moved on from card catalogues and manual library management processes to web based online public access catalogue and electronic library management processes. Had it not been for the foresight and wisdom of the man whom the library is named after and his team, namely Cynthea Leahy, Norris Pomat Clare Mile and past library staff we would still be fumbling our way through in trying to adopt to the inevitable invasion of Information and Communications Technology. Standardised bibliographic rules and recording systems were strictly adhered to in those early days, thus making the transition from the old system to the current web based technology smooth and almost era free. The library collection is extensive in its scope covering not only subject areas of the research carried out at the Institute but also supporting subject areas such as: religion, history, anthropology, philology etc. Records for all library holdings, regardless of their format are contained in the Library System (Liberty3). The collection comprises over 5000 monographs, 247 serial titles in print of which, 36 titles are current library subscriptions with 21 of these titles available online. The collection holds approximately 2200 publications authored by PNGIMR staff over the years, approximately 200 records containing selected
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2008 Information and Communications staff (L-R standing) Irene John, Douglas Diave, Cynthea Leahy, Llane Munau, (L-R sitting) Susan Gandi, Agnes Patma, Dianne Kumit.
archival material and over 100 videos and maps. An equally important part of the collection is the re-prints of publications accumulated over the years. As the team leader of the unit, it gives me great pleasure to admit that when I embarked on this transition 5 years ago I had the undivided support of Deb Chapman, who was then the co-ordinator for the incentive fund, my staff, Diane Kumit, Irene John, Agnes Patma (casual) computing staff and three Australian Volunteers, namely, Monica Rothlisberger, Widya Paul and Jason Kovacs. The Library provides, research support in terms of literature search, interlibrary lending, user education classes, acquisitions, processing and dissemination of appropriate information for our staff both within the Institute and surrounding academic institutions and the Goroka Base Hospital. Our compatibility with other libraries in developed countries is one of the factors that has contributed positively to the libraries capabilities to supply and receive necessary information in a timely manner. Since the acquisition of the internet broad band, our output has increased steadily with timely access and dissemination of required information. Apart from the use of our traditional online medical data base called PubMed/Medline from the Medical Library in Washington DC and similar resource databases we are privileged to also have access to HINARI (Health
InterNetwork Access to Research Initiative), a WHO initiative which provides free online access to over 3750 biomedical journals in developing countries. Our library is the first library outside of Australia that has been accepted to be a part of an interlibrary network of Medical Libraries in Australia called GRATISNET, a reciprocal arrangement between libraries to share information. We met their requirements by providing electronic copy of our Journals holdings to qualify for inclusion into this network. As a result we have been receiving lots of requests from libraries in Australia which we have been supplying in PDF formats. Our expense on sourcing of articles and research materials from overseas libraries has been reduced substantively through this reciprocal arrangement of interlibrary network. Archives The first significant effort to formally establish an administrative unit to manage the archives of the Institute began in October 2003 as part of the Capacity Strengthening Project, funded by AusAID. The archival collection reflects the research that has been carried out by or in collaboration with the staff of the Institute in the field of malaria, enteric diseases, pneumonia, kuru, sexual health, womens health, filariasis, and nutrition. Apart from research-related records the PNGIMR Archive also has in its custody minutes of meetings of the Institute Council and of
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the Medical Research Advisory Committee (MRAC). The MRAC was established in 1962 to guide and co-ordinate research activities in the territory. Its term of reference was to assess the ethical and scientific value of research proposals. Other archives include correspondence, health patrol reports, field notes, manuscripts, conference papers. Some of the archives pre-date the Institute. These were brought to the Institute by members of staff or Council who had arrived in the Territory prior to the establishment of the Institute. The Institutes invaluable archive collections new home is adjacent to the library collection and at the basement of the new lecture theatre. With the contractual engagement of Sam Kaima, an archivist, the professional input of Widya Paul, an Australian Volunteer, and support of Dianne Kumit our archives officer, all the documents were accessioned, classified, and shelved. Our records have been entered into Heritage Document Management System (HDMS), a software donated to us by Gavan McCathy, from the Australian Science and Technology Heritage Centre at the University of Melbourne. Communications The Communications Unit is a very vital part of the Institute that is responsible for the promotion and dissemination of information to all stakeholders including staff, government and industrial bodies, the general community, community organizations, and international funding and research bodies. It also provides internal support to staff in providing technical advice and training on the use of different forms of multimedia presentations. The Unit has two professionally qualified and dedicated staff namely, Llane Munau and Douglas Diave who have confidently performed their tasks. These tasks include, the assembling and production of PNGIMR Annual Report, quarterly IMR Newsletters, maintenance and development of PNGIMR website, production of Institute documentaries and films and writing and dissemination of PNGIMR news. One of their most challenging tasks has been the coverage of the visit of the Prime Minister of Australia, Mr Kevin Rudd. I also wish to acknowledge the contribution of past staff of the Unit and especially the commitment of Jason Kovacs, an Australian Volunteer, who was engaged as the Multi
Media Officer through the Capacity Strengthening Project of AusAID between 2003 and 2005. One of his major contributions being the redesign of PNGIMRs website, training of unit staff on different aspects of multimedia, development and building of the library intranet site and the establishment of the HF (High Frequency) radio frequency. Finally, I wish to commend Llane and Douglas for their efforts towards the preparation and dissemination of information on the 40th anniversary colloquium. Though it was initially strenuous to collect materials together, the efforts of all those concerned has made it possible for us to produce this Colloquium magazine. We appreciate the efforts of the organising committee for the colloquium, the publicity team and the contribution of Cynthea Leahy who did most of our editing and Professor Michael Alpers for providing information about the early beginnings of the library.
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LABORATORIES
Mr Matthew Omena
Lab Manager
aymond Alexander Sparks was the pioneer laboratory manager of the PNGIMR. He was responsible for laying the foundation for laboratory management services at the Institute. He was the laboratory manager from 1980 to 1990. Gideon Philip took over from Raymond Sparks in 1990 and was the laboratory manager till 2002 when he resigned to take up work at the University of Papua New Guinea. I was then appointed to the position of laboratory manager in 2003 and am currently serving in this position. The laboratory manager administers four staff at the Institute. They are Philip Ove working in the media room, Anem Ove and Martin Kilome who work in the wash up room and Tusu Pako is a technical assistant responsible for repairing equipment in our laboratories at all the Institute sites. This section has lost two staff through death over the years. They are the late Kilome and late Michael Yamaneo. Over the years notable changes began to take place especially in the infrastructure capacity building of the Institute. We were involved with the ordering and installation of the sound system in Adolf Saweri Lecture Theatre. The system was purchased from Rabone Systems in Brisbane, Australia and installed by the company. Other changes include converting the animal room to freezer rooms, installation of the new 32 KV standby generator for the Institute and disconnecting the power mains from the Goroka base hospital. In
addition there has been the installation of the new incinerator for the biological waste disposal which is safe and environmentally friendly. We are in the process of ordering a new incinerator for Maprik which we hope will arrive in a few weeks time. Since 2003 the responsibility of ordering goods was transferred to the Procurement Officer however, our office continues to provide technical advice on the purchasing of equipment and laboratory consumables. We have IATA certified staff who have dealt with the shipment of biological/infectious items all over the world to our international collaborators. We have handled outgoing shipments without encountering any problems over the years. We are now in the process of entering all the data on study bleed codes so that we can have an electronic database of the bleed codes for easy access. The laboratory managers office took on a new responsibility to oversee occupational health and safety at the Institute. Though it seems to be a new field the Institute has ventured into, we have grown from strength to strength since 2004. We are currently working on improving our fire fighting capability at the Institute. This involves upgrading all fire fighting equipment such as fire extinguishers as well as installing fire hose reels and repair of fire hydrants. The fire detection panel at the reception area will also be replaced with an upgraded system, as the old system is now obsolete.
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GLOBAL INFECTIOUS DISEASES RESEARCH TRAINING PROGRAM
Mrs Suzie Greenhill

Training Coordinator
he Global Infectious Disease Research Training Program (GIDRTP), commenced in 2006. It is sponsored by the Fogarty International Centre (FIC), USA. The GIDRTP is a five year program supported through a co-operative effort between the PNG Institute of Medical Research (PNGIMR), the University of PNG (UPNG) in Port Moresby, and Case Western Reserve University (CWRU), Cleveland, USA. The program provides the learning environment to enable bio-science post-graduates, medical and nursing students, and physicians to expand their capacity for contributing to infectious disease research and health care in PNG. The goals and objectives for this training program have been designed to be relevant to the ways that infectious diseases affect the lives of individuals and communities throughout urban and rural areas of PNG. Infectious diseases are responsible for at least 40% of PNGs public health burden and the PNG research workforce continues to be dependent on a small number of expatriate specialists, whose laboratory-based studies focus on specific pathogens to clarify mechanisms of infection, disease, drug resistance and vaccine development, associated with microbial pathogens. While it is important to maintain international collaborations to effect future advances, Papua New Guinean infectious disease specialists, who are familiar with PNGs rich cultural diversity, must acquire the basic skills needed to provide consistent health care throughout the country,
perform routine diagnoses, and develop strategies for translating the products of biomedical research into effective health care practices. The primary goal of the GIDRTP is to improve the health of PNG communities. The program seeks to accomplish this goal through the capacity building of the research workforce, using broad-based educational experiences in the sciences, followed by specialized training in epidemiology, microbiology, pathology, diagnosis, disease management, ethical responsibilities, communication skills and information management. The end result will be a pool of PNG scientists, with the knowledge, skills and experience to provide infectious disease awareness to PNG communities, who eventually assume primary responsibility for training infectious disease specialists, and continue the promotion of infectious disease research in PNG on an international scale. Program Content Training in infection disease research requires a broad-based education in the sciences and mathematics, followed by specialized training in: Epidemiology Microbiology Pathology Diagnosis Disease management
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Research analysis Understanding of ethical responsibility underlying human participants in infectious disease research studies Guidelines governing good laboratory and clinical practice Levels at which trainees can participate in infectious disease research include: data entry information management laboratory technician field-study co-ordinator project co-ordinator research scientist medical scientist Programs and Progress Summer Internships (6 weeks), Honours Fellowships (12 months) and Masters Fellowships (18 months) are available through the GIDRTP. Since initiation of the Program in January 2006, 30 students have participated in Summer Internships (4 of these students have continued on as Honours Fellows, 2 have enrolled in the Honours Program at UPNG), 14 students have participated as Honours Fellows, and 5 students have participated as Masters Fellows. Results from evaluation of the first year GIDRTP BSc, Honours fellows returned 1st Class marks for all four students. Results from the evaluation of the second year GIDRTP BSc. Honours fellows are pending. Current Honours and Masters Research Projects Ms Dulcie Lautu is completing her honours degree and is based in Madang. Her project is titled Analysing and comparing the in-vitro susceptibility of Plasmodium falciparum to some commonly used antimalarial drugs from three different provinces in Papua New Guinea. She is supervised by Mr Livingstone Tavul and Dr Pascal Michon. Mr Bangan John is completing his honours degree and is based in Goroka. His project is titled Detection of human immunodeficiency virus subtype 1 incidence by polymerase chain reaction using samples from Port Moresby. His supervisor is Mr Tony Lupiwa. Ms Gwendalyn Vengiau is also completing her honours degree in Goroka. Her project is titled Investigation of adult lung health and indoor air pollution in the Eastern Highlands of Papua
New Guinea. Gwen is supervised by Dr Suparat Phuanukoonnon. Ms Irene Semos is the fourth current honours student. She is working on Stunting, malnourishment and wasting as an outcome of child development in children less than 5 years in the Eastern Highlands and Madang Provinces. Her supervisors are Mr William Yeka and Dr Suparat Phuanukoonnon. Ms Daphne Sepe is a Masters in Biological Sciences student in Madang, under the supervision of Dr Pascal Michon and Dr Moses Bockarie. She is researching Vector competence and malaria transmission dynamics in Wosera, East Sepik Province. Dr Moses Laman is a Masters in Medical Sciences fellow, based in Madang. He completed a Medical Bachelor and Bachelors of Surgery (MBBS) in 2004 from UPNG. His project is titled Is routine lumbar puncture indicated in PNG children following febrile convulsion? The project is supervised by Dr Laurens and Professor John Vince. Technical Advisory Group (TAG) The GIDRTP is supported by the TAG, who provide overall direction to the Program, evaluate applications, assess the program and student progress through discussions with project supervisors and trainees. The TAG group includes: Director, Professor Peter Siba PNGIMR Academic Advisor, Professor Lance Hill, UPNG PNG-CWRU GIDRTP Director, Professor Peter Zimmerman, Case Western Reserve University, Ohio, USA. James W. Kazura, Director Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA Daniel Tisch, Department of Epidemiology and Biostatistics, Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA Professor John Reeder, Director of International Health Research Strategy, Burnet Institute for Medical Research and Public Health Mrs Suzie Greenhill, GIDRTP Study Coordinator International Collaborators GIDRTP has benefited from the generous contributions of international collaborators - Deborah Lehmann, Charles King, Uriel Kitron, Christopher King,
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Brian Grimberg, Andrew Greenhill, James Beeson, Louis Schofield, Tim Davis and Harin Karunajeewa. The mentorship of Professor Michael Alpers, who
continues a very active role in emphasizing the importance of infectious disease research in PNG, is also of great benefit to the program.
Past and present students Student Name

Bradley Aumora Beverly Senau Joyce Vida Keruna Kiromat John Benjamin Jossie Tonar Helen Keno Krufinta Bun Ore Topurua Elvis Guore Bosley Boting Sarah Javati Steven Paniu Lisol Luke Annemarie Laumaea Joseph Nale Rosemary Benjamin John Bosco Keven Neysa Mai Paul Mondia Robin Oge Toko S. Pagi Deborah Panao Gselle Parua Aileen Sagolo Irene Semos Helen Keno Krufinta Bun Ore Topurua Mak David Melanie Koinari Moses Laman Elaine Wain Cecily Kaira Juith Gawi Maxwell Johnson Sabeth Charles Hogande Kiafuli Cathy Kupe Hane-Nou Newton Numi Albert Lui K Apolos Gwendalyn Vengiau Bangan John Dulcie Latau Irene Semos Daphne Sepe Annemarie Laumaea Melinda Susapu
GIDRTP Year
2006 2006 2006 2006 2006 2006 2006 2006 2006 2006 2006 2006 2006 2006 2006 2006 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008
Position
6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern BSc Honours BSc Honours BSc Honours BSc Honours BSc Honours M Med Sci 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern BSc Honours BSc Honours BSc Honours BSc Honours BSc Honours M Med Sci 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern 6-wk intern BSc Honours BSc Honours BSc Honours BSc Honours M Med Sc M Med Sc M Med Sc
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Awards
PNG Medical Symposium
GIDRTP Progress Award Thesis 1st class honours GIDRTP Progress Award Thesis 1st class honours GIDRTP Oral Presentation Award Thesis 1st class honours, Presidents Award GIDRTP Poster Award Thesis 1st class honours PNG Medical Symposium
PNG Medical Symposium
GIDRTP Progress Award GIDRTP Oral Presentation Award GIDRTP Poster Award GIDRTP Progress Award GIDRTP Poster Award
A reflection of life in PNGIMR
Stories of long serving staff
Pioto
am so privileged and feel great to contribute to this important magazine reflecting on how far the Institute has come and the achievements made during my 17 years of employment with the PNG Institute of Medical Research. Over the years the PNGIMR, from a very small humble start, has made big contributions in terms of conducting research activities into major health issues that affect the people of Papua New Guinea and has made recommendations that have lead to policy formulation and eventual implementation by the National Department of Health. At the institutional level, in a short pace of time, there has been achievement with developmental changes in infrastructure, human resource development and improved research programs and activities. We have seen the office buildings in Goroka and the extension of laboratories at all IMR sites and the building of new staff houses. The Institute has an excellent training program for national scientist and researchers who wish to move on to the next level in their respective career path development.
Namugui
I want to thank the PNG and Australian governments for setting up the Incentive Fund which has made these improvements possible for PNGIMR and the country. My very special thank you and appreciation goes to Deborah Chapman who was behind preparing the proposal and securing the needed funds. During my stay I have seen many PNG people come and go for reasons only known to them but a few have kept on working with the PNGIMR, regardless of the work conditions mostly because they love the work they do here and have an ambition to contribute towards medical research, to find better solutions to alleviate many of our common health issues and problems that are affecting our people and country. Under the change of leadership those who kept on with the Institute would start to notice rewards surfacing to reward our endurances and patience. Things do not happen over night, it requires patience, time, understanding, total commitment and cooperation for good things to happen. PNGIMR has spent so much time and resources training a lot of PNG scientists and researchers however after obtaining experience, knowledge and training they have just walked out to greener pastures. Now I start to see other research institutions as well as NGO groups who are starting to conduct medical research and do medical surveys that once only the PNGIMR did and this will mean that the securing of research funding will be more competitive for us. One of the challenges for the future will be how PNGIMR can maintain the high quality of research work and how they can hold onto the young and upcoming scientists and researchers so as to raise the Institute to the next level.
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Peter
he PNG Institute of Medical Research has had a colourful history over the last forty years of its existence, and I am very proud to be associated with it. I have been working at the Institute since 4th December 1984, after graduating with a Bachelor of Science (Food Technology) from the PNG University of Technology. It was tough in those early days when I joined the Institute, because there were no training programs in place and we had to apply the learn on the job approach, with minimum or no supervision. I was employed as scientific officer in the Virology lab, bearing in mind that I had no theoretical knowledge or work experience about virology. But I took on the challenge and enjoyed a career in laboratory-based virology, and this was all because of sheer determination,
Siba
perseverance and commitment. There were numerous research projects associated with virology that I was engaged with, and these included respiratory, gastrointestinal, arbovirus, enteroviruses, Hepatitis B, HTLV-1. After being awarded my PhD degree in 1997 from Murdoch University in Western Australia, I was entrusted with more administrative responsibilities. The transition from laboratory science to executive management was a new and very challenging role, and with the support of my family, staff and professional colleagues, I was able to adapt well into my new job as the first Papua New Guinean and 4th Director of the Institute. Finally, I wish to acknowledge and pay tribute to all who have been very supportive and loyal to me during my career at the Institute over the last 23 years. Best wishes for the Colloquium and enjoy the 40th Anniversary celebrations in Goroka.
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Gerald
first heard of the IMR when they advertised for the position of field supervisor for a project to investigate paediatric acute respiratory infections and diarrhoeal diseases in the Asaro Valley. I was interviewed by Dr Peter Howard and Dr Deborah Lehmann and was offered the position. My first impression of the IMR was that it was a white mans institution, and to a large extent I was correct at the time. Most Papua New Guineans at that time had a yes masta mentality. The only Papua New Guineans that were different were Dr Candy Lombange and Ms Michalene Gorogo. Other Papua New Guineans who worked at the Institute at that time included Audrey Michael and Tony Lupiwa (bacteriology), George Koki (genetics), Naomi Yupae (nutrition) and Peter Siba (virology). A small number of those who worked at the Institute when it was moved from the old hospital grounds to the present site included Martina Yambun and Nivia Weti. Tari and Wosera were not exactly known then, apart from periodic patrols by IMR project teams on various field trials. There were great stories about IMR staff involvement in sports and community activities like soccer and canoe racing which saw scientists and general staff participating together. My involvement was in the cross country marathon and the IMR mens soccer. IMR to me in those days was a large family unit under Michael Alpers directorship, IMR resembled a union of families from the most successful scientist to the oldest
Saleu
village hunter/gatherer. There was a great range of people associated with the IMR and one would see Okapa villagers walking straight into the directors office, without shoes and with layers of mud underfoot. Everybody called each other by their first name rather than by title and with Michael Alpers at the helm, everybodys birthday was known and celebrated. We celebrated every new arrival and every departure from the Institute. The kinship between everyone can only be measured by individuals who came to know IMR in the 80s. I for one will remember the tremendous support of all who worked at the IMR in 1987, when our son was kidnapped by criminals and went missing for 4 days. My special thank you is extended to Johannes Haay and Mexy Kakazo who were my chaufers because I could not drive then. Characters at the IMR have come from a variety of backgrounds some aggressive and others timid, some careless and untidy while others were neat and well groomed. An example of one who really stood out for me was a medical student from Liverpool called Duncan McCormack who would leave the IMR office at 3:00 in the afternoon, have some drinks at the Kama Village, dance with locals in muddy conditions at the Nalepa Kunai Club, front up at the Bena Vista, sing his head off with the Genoka guys well into the early hours of the morning, snore under Don Lewis house or find himself sun burnt on the stairs of a strangers home, all the time leaving some of his valuables everywhere he went. He would leave a belt here, a shoe there, a shirt in another place forgetting
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whom he had gone out with in the first place. Somehow he managed to return to the IMR safe and sound but his search for missing items was forever! Other characters came from all walks of life and all regions of the globe have been represented; they all had different stories to tell. The most memorable PNG character was a chap called Steven Tiwara - a Sepik, off course! The IMR lived like one big family up until the time when Bill Skate became Prime Minister and decided in one budget to downscale all research institutions in the country - including the IMR. I was one person who scrambled for the support of the trade unions and the Public Employees Association to have the decision reversed. Perhaps the greatest highlight of my time at the Institute was when we negotiated with the administration to allow training opportunities for National staff. Our negotiations with the Director through the Laboratory manager Ray Sparks resulted in Monica Sungu being sent to the Medical School at UPNG and Gairo Gerega being sent to the London School of Tropical Hygiene and Medicine. This began a chain of training opportunities for Papua New Guineans which included Tony Lupiwa, Peter Siba, Peter Sapak
and William Pomat undertaking post graduate studies. Laboratory staff had an exchange program with Bohol in Nothern Philipines and a string of others from Goroka and Madang, including myself, received various qualifications from different universities overseas. The work in Wosera has never been easy. I was a pioneer of demographic work, under the direction of Kuldeep Bartia, in the area. This work caught the community unprepared and resulted in the physical removal of Lubus Kaukesa, Simon Kabintik, Jane Simbrandu and myself by Nale villagers. At the time there was a number of nationalities and Papua New Guineans on the team and the mixture of people confused the locals and they labelled us the 666 group thinking that we were a new religious group. This was at a time we had a cocktail of characters and nationalities from India, Malaysia, UK, Bougainville, Tolai, Morobean, Central and Manus on the team. This was a good mixture, enough to confuse the locals into labelling us the 666 group in an already Christianised population. Eh, mipela I katolik pinis na mipela I gat fo square, na yupela wonem lain..? Blari em yupela ol 666 lain, kamon karim samting bilong yupela na raus! Good luck IMR with the challenges ahead, I wish you all the very best.
Cynthea
I
joined the Institute in 1992. One of the best things about my time here has been the friendships formed they will last forever.
Leahy
the guidance of Michael Alpers and then with Charles Mgone and Peter Siba. Michaels passion for the journal has certainly rubbed-off on me and it has now become very important in my life.
The Institute has a wonderful family atmosphere over the years there has been great Mothers Day and Fathers Day celebrations, secret friend Christmas parties, birthday celebrations and the celebration of achievements and successes for individuals and the Institute. During my time here I have been fortunate to work on the Papua New Guinea Medical Journal first, under
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Livingstone
t was February 1990 when I first arrived in beautiful Madang. I had very little knowledge about the PNG Institute of Medical Research. Even the amount of knowledge I had about the subject on malaria was very limited because it was only covered during an intensive two weeks period in the Medical Laboratory Certificate course that I had just completed. After being introduced to the OIC and then brought to my new house, I asked the secretary where the Institutes mess was. She broke up with laughter and replied, Sorry son, now you have to do your own cooking. School days are over. We all laughed and I realized then that school days were over for me. My official duties with the Institute commenced on the 8th of February 1990. I started working in the Immunoparasitology Section as a medical lab technician doing parasite cultures and field epidemiology surveys under Karen Days supervision. After working with Karen for sometime, she realized that I had the potential to do better than just being a technician for the rest of my life. One day, while we were working in the culture room, she told me that I had the potential to become a scientist and she even offered to assist me to fulfill that dream. Karen did not waste time and in 1993 she arranged for me to do some training with her in her lab at the Imperial College, London, UK. This trip was my greatest motivation and after completing three months at Karens lab, I returned to Madang where I re-enrolled at the Madang University Centre to do matriculation studies. While doing my studies I was working with Peter Beck and Ingrid Felger in the Molecular Parasitology lab, where I remain today. In 1995, I applied to UPNG to do Science. Many thanks to the then Director of PNGIMR, Professor Michael Alpers for giving me a full, four year PNGIMR sponsorship to do the studies and to my wife and daughter, who had to bear with four years of my being absentee-daddy.
Tavul
After graduating from UPNG in 1999, I proceeded to do Postgraduate Diploma Studies doing filariasis research on Bagabag Island, Madang Province, under the supervision of Dr Moses Bockarrie. Last year (2007) I completed a Masters Degree in Medical Science through the SMHS, UPNG, looking at severe malaria anemia and human genetic polymorphisms in the Wosera area, East Sepik Province. This year (2008) I have enrolled again with UPNG through SMHS to do a 3-4 years PhD program. During my eighteen years with the Institute, I am honoured to see that there are is a lot more nationals being trained within the field of medical research. Thanks to our former directors Professor Michael Alpers who had the vision, and Professor John Reeder who implemented and also piloted the process of localizing positions within the Institute. Thank you also to the present Director, Professor Peter Siba for continuing with the vision. To all our valued collaborators and donors from abroad and locally (past and present); where the Institute is today is the fruit of your loyal partnership given over the years. My most exciting moments in doing research have been (i) significant research findings that become effective strategies for achievable interventions to improve the quality of health for the affected communities and (ii) generating new knowledge for basic medical science which eventually end up as publications in peer journals, text books, etc, for the benefit of all mankind.
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David
started working for PNGIMR in October 1982 as a computer data entry officer after working at the Prime Ministers IT and Informations department in Port Moresby. Comparing IMR from the past especially in my field of computing I can say that things have changed so much. There have been three major changes in the IMR computing systems. The first is that when I first came to IMR we used the PDP 11 system, which was just one system with one working disk that was 5 megabytes. However the disk itself was huge and you had to lift it with both hands. The second system used was the desk top computers operated by DOS. The third system and the current one is the laptops and desktops operated by Windows. And what makes it more advanced is that we now have the networking system, the internet, websites and a better way of managing
Kotale
data systems in place. Whilst working in the computer and data entry section I have attended workshops to update my computing skills. That is one area which I am really thankful to IMR for supporting me in. The only thing that worries me sometimes whilst working at IMR is that the standard of living is increasing and goods and services are becoming very expensive and it is sometimes very hard to manage for two weeks with the income we get especially when we are in a place like Madang or Wewak, but otherwise working for IMR has always been a joy for me. Now I am the Administrative Assistant in Yagaum looking after the Properties and Inventory System Program Management and I am still enjoying my work here just like when I first started 26 years ago.
Gol
Dadok
communities need IMR more. His people are happy to have IMR in Yagaum and says that they plan to give a piece of land to IMR if IMR wants to expand but they only have to ask, however they have never asked because maybe they really want to move to town. Gol says if IMR moves to town its name will be hidden from the villages and communities in the rural areas.
ol comes from Yagaum, Madang Province and is the electrician at IMR Madang. He joined the Institute in 1985 as a security guard but when Peter Heywood, the Deputy Director, found out his real trade was as an electrician he was then employed as the electrician/plumber. He said that though his salary income is low he still loves working for IMR. Maybe one of the reasons why Gol loves IMR is because the Institute is situated on his home ground. The current plan to move IMR into town does not settle down properly for Gol as he says people in town dont need IMR but the people in the village
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Joe
started working for IMR in 1979 as a grounds person, just a year after I had completed grade 10 at the Kondiu Rosary High School in Simbu Province. I was only 19 years old then. My first task was to clear out the big jungle that engulfed the present IMR Yagaum laboratory and office buildings and staff houses. The laboratory and office complex used to be a dormitory used by the malaria control teams in Madang Province. Cleaning the area was a huge task to take on because apart from the thick jungles covering the buildings, there were also huge trees growing on the roof tops of the buildings and the interior of the buildings were also very filthy. I worked tirelessly with two other lads, Thomas and Paul from Bogati in Madang Province to clear up the jungle and it took us 3-4 months to do a thorough cleaning. All this work happened when the then deputy director Peter Heywood and Samuel Pariva where in charge of IMR Madang. When the maintenance and cleaning jobs were completed, I joined the demography project to carry out census in IMR study villages around Madang. Comparing IMR 29 years later, I can say that the Institute has grown from strength to strength and many of us who have spent half of our lives working for the Institute have grown with it. There were times in my life that I used to be anxious about the running of the Institute. I used to fret, if IMR ceased to operate, my contribution in building IMRs reputation and well being would be gone forever. However looking at IMRs operations today, I can proudly say that my hard work and contribution towards IMR has born fruit. Many well educated nationals are now being employed by the Institute, more projects are on the ground and funding from International collaborators gives IMR a stronger stance in Papua New Guinea. Lastly I want to share an experience which I enjoyed
Paino
whilst working for IMR. In 1999 a group of IMR staff including myself were selected to work with AusAID in Port Moresby along side Dr Jane Thomason from June 6th to August 11. We travelled around six provinces of PNG to carry out a survey for AusAID on how health services were delivered in the country. Then in year 2000 we revisited the areas in the Central Province from April 3rd to 27th of May. I enjoyed this time most because I had the opportunity to visit other provinces; the job was challenging and rewarding, the allowance was excellent and we were well looked after whilst on the job. I enjoy doing field work and desire to return to the field if such projects happen again. The only time I was disappointed whilst working for IMR was when I was laid off on July 26th 1994. I was based in Wewak as the transport officer for Wewak and Maprik sites but due to bad road conditions many IMR cars were breaking down. I was laid off on the note that too many vehicles were breaking down. However, they didnt understand that the road situation in the area was really bad and everyday travelling from Wewak to Maprik wore out the cars very quickly. However, I returned to work the following year and was sent to Maprik to await for the Vitamin A and Zinc study coordinated by Dr Anuraj H. Shankar. Now I am the head of transport in Madang and I can say I am thankful to IMR because it has helped me and my family alot. I take this time to congratulate the Institute for its 40 years of services to the people of Papua New Guinea.
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Walaf
s Walaf Sakel comes from Daben in Madang Province. She has been working for IMR since 1983. First as a casual in the entomology lab and then in 1984 March 11th as a full time staff. Walaf recalls when Raymond Paru, Tom Bakot and Patricia Grave from the Entomology Unit were looking for a person to train in rearing mosquitoes at the Units insectaria. She was chosen and trained on how to breed the mosquitoes and how to keep the colony growing. She proudly points out that she knows all the recipes for the mosquitos food and knows more about rearing mosquitoes than many of her colleges. Walaf says that a lot of changes have happened in her Unit and IMR since she started working for the Institute. Alot of young graduate scientific officers have joined
Sakel
the entomology lab and have adapted well to the working environment that the old staff had set up. The cooperation in the Unit is still the same as the past. However for the whole of IMR Yagaum, Walaf says that things are not in the same order as in the past. Bifo olgeta samting i bin save gat gutpela order bilong ol. Dispela em mipela ol lain blong bifo save tok. Taim yu husat igat wari, yu bai save husat man yu gen lukim long tokim wari blong yu, olsem long sait blong mipela ol grassroots. Nau mipela save painim hat long painim husat man o meri inap long halivim mipela, said Walaf. Olgeta samting ikamap long han blong yumi ol nationals na mipela sampela I confuse she added.
Nasi
asi Sinup started working for PNGIMR in Madang as a cleaner in 1980. He recalls the first time he started work: IMR Yagaum buildings were covered in lush jungle. He was a very strong man at that time and worked very hard to keep the place clean. IMR grow wantaim mi (IMR grew with me), he said. Now old and grey, Nasi still works for IMR but says that his strength has worn out and he will soon retire however that day will be a sad one for him because all his young life was spent tending IMRs grounds in Yagaum. The place has become his livelihood. Nasi claims his first pay salary was K22 however
Sinup
the bosses at IMR Yagaum helped him pay for his first born childs education. Later his income was raised to K40 but as the living standard got higher IMR increased his pay to a three digit number which he says is just enough to feed his family. Comparing the past to the present day, Nasi says in the past the place wasnt too good but today IMR is clean and there are many employees from all walks of life that make the place very exciting.
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Mannaseh
was trained at the Madang Paramedical College and completed my schooling in 1982. I started working for PNGIMR as a Health Extension Officer based in Yagaum in 1984. The first position that I held was Field Supervisor for the Village Help Aid Program Project which was coordinated by Doctor James Moiya. The projects aim was to determine the prevalence of malaria in the Amele and North Coast areas of Madang Province to get an idea of the number of malaria cases in the community and to see if it could be controlled. We recruited and trained people from the villages on how to recognize the symptoms of malaria and how to treat malaria with chloroquiun. After every seven days I visited the field workers and collected their record books and the blood slides they had collected and rechecked and then monitored them in Yagaum to see if the field reporters had identified the malaria correctly. This study was completed in 1985. Later AusAID gave funding to do a National Nutritional Survey, so I was sent to Karanui in the Simbu Province for a year. In 1986 I joined an AusAID team that did a national assessment of health services. In 1987 Michael Alpers and Peter Heywood wrote a proposal to do a study in the Wosera area. When funding was granted for the study I left Madang and went to live in Kunjigini for a year but was never paid any allowance for living there. This work was to give birth to the malaria vaccine trial in 1988-1989.
Baea
During 1988-1989, I was transferred to Goroka to become an understudy of those who were doing the demography work in the Asaro Valley so that later the demography work could be carried out in Wosera. In 1990 I moved with my family to Maprik and became the officer in charge of Maprik. Twelve years later we moved back to Madang and I took up the position of Deputy Manager and Administrator of IMR Madang. There has been a lot of changes that have happened at the Institute since I first joined, and one of the major changes is the type of vehicle used by the IMR. In the past we had Suzukis to go out into the field and carry out our studies. From there we moved onto the Dahatsus to do our work. When we went to Maprik we started to use the Toyota twin cab vehicles but look at us now - the public says that we are a branch of Ela Motors! During my time the Institute has grown and increased its man power and nowadays we have more national scientists compared to when I first joined the Institute. I am always happy to work with the people and one of the reasons for this is because of the satisfaction of problem solving I love helping other people to solve their problems. Whether it is marital problems, house maintenance or anything that I can do that will make someone else happy, especially my colleges in IMR. I wish IMR 40 more years of good service to the people of Papua New Guinea.
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Lubus
come from Bukava, Morobe Province and my wife comes from Beon, Madang Province. I started working for the IMR on the 20th of June 1984 employed as a mosquito collector. My first job was to work with a Canadian by the name of Tom Burkov, however, 18 months later PNGIMR ran out of money and I was laid off. Then in December 12th 1988 Dr Jeffrey Hii took me back on as a mosquito collector and in 1991 I went with a group of IMR Madang and Goroka staff to do a big survey in Wosera with Dr Hii and Professor Kuldeep. We went to 12 sites in the area and after that a team of mosquito collectors went into the area. In 1993 I was promoted to supervisor of the mosquito collectors in the field.
Kaukesa
Professor Moses Bockarie and his wife Florence taught me how to do ElIZAs and how to grow the mosquitoes then in 1995 I became a Lab Technician. Comparing employees of the past to employees today; in the past we knew how to do everything from going out into the fields to collecting mosquitoes, then growing larva, then coming back to the labs to do ElIZAs and entering the data on the computers. Now I am the assistant lab technician. We help a lot of expatriates who come here to get their experiences and titles in their country. In the past IMR didnt employ a lot of graduates but employed normal grassroots people and they taught us to do everything and we supported each other very well. And we were very dedicated to our work and we are still here.
Dianna
D
ainas association with the Institute started in 1978. She was Dr Peter Heywoods house meri.
Lai
Daina worked for years along side Dr Jenkins and was among the patrol group who made first contact with the Hagahai people. She says working in the field has always been challenging and enjoyable for her and she hopes that she can go into the fields again. Today Daina helps out in the laboratories.
Peter was PNGIMRs Deputy Director and was based in Madang. However in 1981 she was introduced to the laboratories by Dr Heywood when they needed lab assistants. Daina has worked along side many international scientists who have been associated with the IMR. But the most memorable of all was Dr Carol Jenkins.
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William
arrived fresh faced, unfamiliar with research, no grounding in work ethics, slim, with a similarly built beautiful wife by my side and a chubby son on my shoulder on May 11th 1987. Two decades later, I am still here, chubbier, shorter, graying and most definitely the wiser from all the experiences I have gained while working here. How time flies when you are enjoying yourself! My being employed began with a phone interview with Mr Ray Sparks, the then Laboratory Manager, keen butterfly collector and jack of all trades good guy. He offered me a job in the Immunology Unit and a house to go with it if I accepted. Of course I accepted, who in his right mind would not? I had just completed my BSc at UPNG in 1986 and this was my first real job interview while working part-time at UPNG and living with relatives at Gordons/Erima area. Ray Sparks (Rees Baki) met us at the airport and took us to our house at Lopi Street in his short-wheel base Mitsubishi Pajero together with all our worldly belongings. It was a 3 bedroom house but we only ever used 1 bedroom. I remember being informed by my relatives that getting a job in the highlands was bad. They (the highlanders) killed people, had tribal fights and will kill you, they said, but I still came here because I was determined to look after my young family. I began work under the supervision of Dr Campbell Witt, the resident immunologist and Ms Michaeline Gorogo, whose position I was filling as she was resigning for greener pastures. The main project then was the BOSTID projects, which had established the Asaro Surveillance Unit (ASU), looking at the aetiology of respiratory and diarrhoeal diseases. Immunology was a crucial component of that vast study, so began my induction into research and immunology. Campbell taught me all about Counter Current immunoelectrophoresis (or CIE for short,) latex agglutination, rockets, antibodies, antigens, ELISA, Streptococcus pneumoniae, Haemophilus influenzae, T cell, B cells, constant region, variable
Pomat
region, idiotypes and more. The complex interaction between host and pathogen continues to elude me and get more and more complicated and intriguing. I do appreciate the knowledge I have gained in aiding me to understand some of these complexities. Dr Ray Sanders, resident virologist, became my mentor when Dr Witt left in 1988. Under Dr Sanders I successfully completed my Post Graduate Diploma Certificate from UPNG in 1989. In 1993 I succeeded in acquiring an AUSAID scholarship to do a Masters Degree at the University of New South Wales under the supervision of Dr Andrew Collins and Prof Graham Jackson. Professor Jackson passed away in 1994 and that threw my project into some confusion. My thesis was finally accepted in 1997. Animal research provides a lot of clues to biomedical research, but it is one hell of a smelly job! On returning home, I was tasked with continuing work on measuring antibody responses to pneumococcal polysaccharide vaccine (PPV) given to pregnant mothers in Tari, Southern Highlands. This work is published and shows that antibodies passed from mother to child decline in the first 4 months and begins to increase from 8 months of age. PPV vaccination is able to increase antibodies to some serotypes that cause serious pneumococcal diseases in early childhood and maternal vaccination may protect against these serotypes and reduce the huge burden of pneumococcal diseases in PNG. In the meantime, I was lucky to win the prestigious Pocchiari Student Fellowship a scholarship, given every two years to two students world-wide, to learn technologies that will impact on health research in developing countries. The scholarship allowed me to head off to the National Public Health Institute of Finland to learn more about ELISAs, antibodies, and antibody concentrations and mucosal antibodies. Winter near the North Pole is not a pleasant experience, especially for us tropical beings as the sun hardly comes out. In 2001, I was accepted to do a PhD program at
88
the University of Canberra. Unfortunately, the University of Canberra was not listed as an AusAID funded institution so an alternative institution in Australia had to be located. Fortunately, with the help of Deborah Lehmann and Michael Alpers, I was offered a space at the School of Paediatrics and Child Health, University of Western Australia with Dr Peter Richmond as my main supervisor to commence work on mucosal immunity to pneumococci. So I headed to Perth with my family. I am now working towards that final full-stop on my PhD thesis, having successfully established a pneumococcal research laboratory at the Childrens Clinical Research Facility. Progressing from being a junior scientific officer to my current position was not easy. There is still a lot to learn and lots to do to improve the health of Papua New Guineans. The most important attributes to being successful, from my experience, are good work ethics, persistence and perseverance and as they say 97% brawn and 3% brain. Many great people have been my mentors and have molded my outlook, including Michael Alpers, Ray Sanders, Deborah Lehmann, Kuldeep Bhatia, Cambell Witt, Ray Sparks and the list goes on.
I currently head the immunology laboratory, thanks largely to a successful Wellcome Trust and NHMRC grant to investigate the safety and immunogenicity of pneumococcal conjugate vaccine given to neonates and infants. The funding has re-established the Immunology laboratory with equipment and reagents to successfully conduct serological tests to pneumococal capsular polysaccharide antigens. The project is now in its 4th year, with successes in recruitment and followup of study participants. Immunological data will be available soon, and so far early results look very promising. The data we generate here has the potential to change PCV vaccine schedules for developing countries as well as high-risk populations in developed countries who have high rates of pneumococcal diseases. This is a milestone study and definitely worth ensuring that it is successfully completed. Current work is leading to more collaborations and more studies will take place in the future. Already proposals for neonatal immunology, IgE genetic polymorphism and others are going through ethic processes. A trial of 13-valent PCV may take place in both the highlands and coastal areas to look at the safety of the vaccine, immunogenicity and the influence of malaria on immune response. The scope of work to be done is endless. An important facet for these collaborations is that Papua New Guineans should take the lead and coordinate these studies, learn to procure funds from funding agencies and be independent scientist with international reputations for great research. These attributes will only enhance the reputation of PNGIMR further. Cheers.
89
Johannes
ohannes has worked in transport since joining the IMR in 1981 and was in charge of the section until 2003 when he was demoted for allegedly being involved in a car crash. This ever-smiling West Papuan has millions of stories to tell about his life and work at the Institute. But the one he remembers most is what he calls the Hagahai story. In the early 90s Johannes, with a collegue, Mr George Anian, boarded a Hevi Lift helicopter in Mt Hagen, to take supplies to Dr Carol Jenkins and her team working in the Hagahai area. They arrived at Hagahai and dropped off Mr Anian, who was to help Dr Jenkins with her work there. Johannes and the pilot then made their trip back to Hagen, with eskies full of blood samples that where to go back to the Institute in Goroka. Whilst flying between Hagahai and the Baiyer River, Johannes noticed that something strange was happening to the choppers electronic devices; they started to make strange sounds and red lights started to blink rapidly. He turned to the pilot and saw that the old pilot was struggling to control the chopper. Then unexpectedly the rotor stopped. Johannes recalls that when the rotor stopped, for him, time also stopped. When he turned to look at the pilot they had started to free-fall from the sky towards the ground like a giant rock. He saw the pilot frantically trying to gain control. All Johannes could do was close his eyes and let his whole life run through his mind. Amusingly, Johannes says that he was giving the pilot the thumbs-up signal when they were going down and to this day he does not know why he was doing that, but concludes that maybe he was signaling the pilot to get the chopper back into the air where it was supposed to be! Then there was the crash. Fortunately the chopper went down on very tall, thick savanna
grasses, which acted like a big mattress and cushioned the choppers, landing and stopped it from smashing into the ground. Seconds later they both opened their eyes and Johannes realized that he and the pilot had just cheated death. They both came out alive with no scratches whatsoever! Two hours later, a rescue team arrived to evacuate them from the crash site. Arriving in Hagen, Johannes took the samples and drove straight down to Goroka against his bosses wishes who wanted him to spend the night in Mt Hagen. He remembers arriving at the Institute in Goroka at around 7:00pm and being met by a very worried Professor Michael Alpers who was the Director at that time. Johannes put the samples in the freezers and headed home to his family, carrying on as if nothing traumatic had happened that day. All he could think of was, maybe the spirits in the area did not want us to take the Hagahai peoples blood. Later Dr Carol Jenkins was deported from Papua New Guinea just because of these blood samples. Johannes closes his eyes and goes back into time as he speaks; ating wanem samting tru ibin ken kamap suppose mi na pilot being bungim traipela hevi steret na ol blood sample blong ol Hagahai ibin bagarap. Ating gavman bai no nap rausim Dr Jenkins? Olsem em tingting blong mi tasol, olgeta taim mi save tingim. (What if the pilot and myself had a devastating crash and all the Hagahai samples were lost, maybe Dr Jenkins would not have been deported from PNG. Well its just my thought. Johannes looks me in the eyes for a second and says, thats the most memorable moment in my life, whilst working in IMR.
Haay
90
Long serving staff in

agani Elias, Peter Gukoli and Titus Wangunar are 3 of the longest serving staff in IMR Maprik. They joined IMR as security guards in 1991 and 1992, when the work on building the sites laboratory and office complex began. Magani comes from Serikum in the Maprik district and had previously been working with Undai Building Constructions the company that built the IMR laboratory and office complex. After the construction work finished he joined IMR as a security guard and has been working since then. Magani says that for the 17 years working for the IMR, he has observed quite a lot of changes in terms of staff employment, new building infrastructure, new projects and vehicles. The other 2 guards nod in unison with what he says. Peter comes from Nelikum in the Maprk district and is a traditional landowner of the grounds where the IMR is built says Ol man long hia save tok olsem, man, IMR mas baim aut Ela Motors ya. Ol save baim kar olsem oli baim klos na kaikai. (Everyone here say that IMR must have bought out Ela Motors because they purchase vehicles like buying food and clothing. He said the purchasing of vehicles was a sign of
Maprik
IMRs growth. Before joining the IMR, Peter was a collector with the malaria control team for 9 years in Maprik. He says he thanks God that he is working with IMR because with the income he gets from IMR he has been and is still able to send his children to school, but points out that he is lucky because of IMRs Henoni club, which helps him and the other guards to get loans for their childrens school fees. Titus who is Peters cousin talks about the good developments IMR Maprik has gone through but also points out that the standard of living has risen immensely and their fortnightly income is not enough to meet these standards. One can only imagine what it would be like for a person with 8 children and a string of grandchildren. As a traditional landowner Titus points out that since IMR was set up in the area, the Institute has had a good relationship with the surrounding communities, which is very important for IMR. All 3 guards said they were happy that IMR was set up in Maprik because it was the only major Institute in the area and working for such a recognized Institute made them proud and they hope to serve the Institute whole heartedly in the following years to come.
91
PNGIMR IN PICTURES
The Molecular parasitology team Simon Kabintik, Hans Peter Beck, Livingstone Taval and Ingrid Felger
USAID Evaluation team and IMR staff outside Jais Aben Resort - February 1992.
Dutch Researchers and Professor Charles Mgone IMR Madang entemology team
Dr Moses Bockarie and team
IMR soccer team 1985-1986
92
Lisol Luke and Bangan John IMR staff 1988 Medical Sympposium at Lae Technical College
Willie, Peter, Anem Ove, John Taime, Ayo Uri, Violet
2008 Fogarty students and their coordinator
Laboratory technicians and scientist during one of their lab trainings Okapa Kuru team
93
George Koki treating a child
Dr Carleton Gajusek with Marandugai people September 1988
Treating a sick child in the 1960s
George Anian relaxing after a long days work
Eye specialist checking an old patient
George Koki during the pneumonia study in Tari
Trapping mosquitoes
94
Jerome Whitfield working among the Fore people of Okapa
Yalum Siba, Sivon Makeso, Makit Kajol, Julie Lombange, Nikki Van Kamen Dr Daffgde Thomas checking a kuru patient in Okapa
Nursing Officer Mr Albert Sie taking a blood slide from an elderly women in Kaintiba station, Gulf Province for the malaria study.
Dr Blaise Genton and Dr Inoni Betuela
Enrolling participants for a new study
IMR land cruiser stuck in the muddy road to Okapa
Taking a childs blood slide
95
The malaria study team resting after patrolling the Aseki area in Morobe province Scientific officer Ms Helen Keno and lab technician Mrs Mition Yohannes
PNGIMR media officer Ms Llane Munau at the Paedietric Ward at Goroka Base Hospital during the IMR womens hospital visit
PNGIMR Madang transport officers
Professor John Collins examing a kuru patient IPTi workshop in Madang

Helicopter bringing supplies for the kuru team in Purasa
IT staff putting up the post to put the broadband disc on
Nursing officer Mrs Agnes Javati taking blood from a study baby Malaria team on patrol in Kaintiba in Gulf province
2008 - IMR staff in Wewak Nursing officer Ms Janet Totave taking a childs nasal swob for the PCV study
Opening the IMR headquaters in Goroka, 1983 Professor Michael Alpers and Prime Minister Sir Michael Somare during the opening of the IMR Goroka headquater buildings in 1983
Professor Peter Siba welcoming Australian Prime Minister Mr Kevin Rudd to PNGIMR Goroka
A toast to the new building
Launching of Youth in Danger! - 1997 in Port Moresby
Professor Michael Alpers celebrating 25 years in PNG
98
Professor Michael Alpers and USA Ambassador Mr Farrand and his wife during the opening of the PNGIMR Maprik laboratory and office building
Australian High Commissioner Mr Chris Moraitis talking to PNGIMR finance manager and HIV social research cadets team leader Dr Angela Kelly
Professor Peter Siba presenting rugby jerseys to the IMR Mosquitoes team manager Mr Morries Andy
Martina and Michael breaking it down
Fransica Adiguma and Deborah Lehmann

Mothers bringing their children to the study clinic in Madang
Weighing a baby for the IPTi study
Dr Nicholas Senn and Joe Paino in one of the study sites Giom and Severina
Chris Taput doing microscopy work at Modilon Hospital
IMR Staff in Alexishapen
100
Can you recognise these faces?
101
102
IN MEMORIUM
BETTY LLODY
CAROL JENKINS
DAUGA ANAKAPU
PHILIP BOKO
GIMA WAIIN
HELEN VRBOVA
Niky Gibson
STEVE TULLOCH
ROPPE AVUMPA
TOBIAS KUM
TOBIAS NORUNGA
ANDREAS KIMBANGE
ZACHERY SATA
NATHAN ANIAN
KILOME YAMANEO
MICHAEL YAMANEO
GALAUD KUMA
SONDAST TOM
TRAVIS JENKINS
WILLIE GRIBAI
AUGUST MALAMBA
RATO MADOL
PHILIP WAIMBA
ROY HEALTH
TOM WIWINUM
ALLAN KELLY
MEDIR YAHIMAU
105
106
NOTES
NOTES
NOTES

PNGIMR 40th Anniversary and Colloquium

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CONTENTS

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

Thank you to our sponsors:

PNGIMR Colloquium and 40th Anniversary Magazine

Colloquium Organizing Committee

Food and Social Committee

Open Day Committee

Special Recognition Committee

Media and Information Committee

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Council Members from 1968-2008

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

Welcome address from the Governor of Eastern Highlands

Mr Malcom Smith Kela, CMG, MBE, DFC, MP

Message from the Colloquium Patron

Message from the Buttressing Coalition Chairperson Professor Fiona Stanley

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

Welcoming remarks from the PNGIMR Director

PNGIMR Director: Professor Peter Max Siba 2006-2008

Professor Peter Siba Director

PNGIMR Colloquium and 40th Anniversary Magazine

Foreword from the Colloquium Co-Chairmen

PNGIMR Colloquium & 40th Anniversary Celebration Co-Chairman - Mr Samson Akunaii

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Directors Report

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Past Directors Reports

expert Cobb an EEG Dick with Bill - late 1960s

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

LAISANS AUTOPARTS LTD

Genuine & Replacement Automotive Spareparts & Accessories

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

Finance Managers Report

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

Administration Managers Report

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Branch Reports

Manager Mr John Taime

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine

East Sepik Branch

Manager Mr Lawrence Rare

PNGIMR Colloquium and 40th Anniversary Magazine

2008 - some of IMR Mapriks staff

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Unit Reports

Public Health, Social and Behavioural Research Section

PNGIMR Colloquium and 40th Anniversary Magazine

PNGIMR Colloquium and 40th Anniversary Magazine