Papua New Guinea's battle with a surging COVID-19 outbreak is at a "critical" stage as health authorities battle a fragile health system, slow and limited testing and vaccine hesitancy.
The World Health Organisation (WHO) convened a special panel of experts to discuss the situation with the media on Thursday evening, where concerns were aired about widespread community transmission and more healthcare workers becoming infected.
The country of eight million people has received about 140,000 vaccine doses, including 8000 from Australia, but is far from protecting all of its doctors and nurses, let alone the rest of its population.
WHO director-general Tedros Ghebreyesus said Australia's closest neighbour was "a perfect example of why vaccine equity is so important."
"It has held COVID-19 at bay for so long," he said.
"But with rising infections, understandable fatigue with social restrictions, low levels of immunity among the population and the fragile health system, it's vital that it receives more vaccines as soon as possible."
According to Health Minister Jelta Wong, PNG has recorded 9343 cases of COVID-19 and 89 deaths, but half of those are from the last month alone.
Dr Ghebreyesus said the trajectory was "worrying" and the situation "fragile". Case numbers have dipped somewhat in recent days but low testing rates mean the real figure is certainly much higher.
Aside from altruistic concerns, the situation has the potential to directly affect Australia. By the end of last month, more than two-thirds of the COVID-19 cases in Queensland's hospital system, from which Australia's most recent outbreak escaped, came from Papua New Guinea.
There is widespread community transmission in the capital of Port Moresby, all provinces have now recorded infections and more than 270 healthcare workers have been infected.
WHO Papua New Guinea acting representative Anna Maalsen said "intense transmission" was putting "enormous pressure" on hospitals, intensive care units, health workers and communities, leaving the country at a "critical" stage.
She described a chain reaction of sick health workers resulting in fewer people to care for patients even as the healthcare system came under increasing pressure from rising rates of COVID-19.
Ms Maalsen said long turnaround times for PCR testing made further complicated attempts to respond quickly but hailed the widespread rollout of rapid antigen tests — cheaper and faster but less accurate — as a "game changer".
Australia's support for PNG, through PPE, healthcare workers and the recent donation of 8000 doses of the AstraZeneca vaccine was praised but WHO Western Pacific regional director Dr Takeshi Kasai pointed out some countries in the Pacific were yet to receive a single jab.
"In remote Pacific countries, even a few cases, could have a devastating impact," he said.
"As we've heard from the earlier speakers, the COVID-19 situation in Papua New Guinea is extremely challenging right now."
Mr Wong, the PNG Health Minister, said the country's immediate priority was to project health workers but admitted constant work was needed to overcome conspiracies, misinformation and vaccine hesitancy.
"Measures have been introduced, including mask-wearing, social distancing, restrictions on travel, mass gatherings, and passenger limits on public transport," he said.
"However, we know that there are ongoing challenges with compliance.
"We did not expect this to happen overnight, we continue to work to address this.
"Our biggest challenge is seemingly to the late adoption of, or acceptance of the new normal and the disbelief in the disease itself."