Club Meeting Summary 2026.08.20

Rtn Rendi Moke: “Tuberculosis Programs in Papua New Guinea”

Dr Rendi Moke presented on tuberculosis programs in Papua New Guinea and sharing his experience as a tuberculosis physician working in the health sector for about two decades. He discussed the challenges of detecting and treating tuberculosis, including the need for laboratory-supported diagnosis and addressing patients' psychosocial and financial needs. Dr Rendi Moke also explained the basics of tuberculosis, including how it spreads and the difference between latent and active tuberculosis.

The presentation began by showing that tuberculosis is a bacterial disease caused by the Mycobacterium tuberculosis bacterium received through inhalation and affecting the lungs. 

Diagnostic tools for identifying tuberculosis include:

• Microscope.

• Culture, drug susceptibility test.

Rotary e-Club of Change Makers member, Rendi Moke

Rtn Rendi Moke: “Tuberculosis Programs in Papua New Guinea”

Dr Rendi Moke presented on tuberculosis programs in Papua New Guinea and sharing his experience as a tuberculosis physician working in the health sector for about two decades. He discussed the challenges of detecting and treating tuberculosis, including the need for laboratory-supported diagnosis and addressing patients' psychosocial and financial needs. Dr Rendi Moke also explained the basics of tuberculosis, including how it spreads and the difference between latent and active tuberculosis.

The presentation began by showing that tuberculosis is a bacterial disease caused by the Mycobacterium tuberculosis bacterium received through inhalation and affecting the lungs. 

Diagnostic tools for identifying tuberculosis include:

• Microscope.

• Culture, drug susceptibility test.

Dr Rendi Moke highlighted the limitations of these diagnostic tools, but showed the Xpert® MTB/RR ultra/ Xpert® MTB/XDR machine shown left, introduced in 2011, that can detect both tuberculosis and drug-resistant tuberculosis.

Dr Rendi Moke presented statistics on tuberculosis prevalence in Papua New Guinea noting that it has a high incidence rate compared to other countries like Australia, and reported approximately 1 000 drug-resistant tuberculosis cases in 2024. In 2024, the estimated incidence of tuberculosis in Papua New Guinea was ≥ 500 per 100 000 population versus Australia with < 10 per 100 000 population.

Dr Rendi Moke traced the history of tuberculosis in Papua New Guinea. He noted in:

• Pre Colonial era (pre 1800), there was no tuberculosis detected.

• Colonisation, Exploration, Evangelism & Wars (WWI/II) – Tuberculosis detected in 1914 through expatriates, plantation workers and sanatoria. He explained that a sanatorium was built near Port Moresby in 1935 to isolate tuberculosis patients due to detection of cases under Australian government administration.

• Post Nationhood in 1975 with the emergence of Multi Drug Resistant (MDR) Extensively Drug Resistant (XDR) strains:

  • High MDR/RR (1995)

  • XDR/Pre-XDR (2012)

  • 40 000 cases/year (2026) with strains including:

    • L2 Beijing strain (93%).

    • L4 Euro-American strain.

    • L1 Indo-Oceanic/East-African-Indian strain.

Dr Rendi Moke outlined the current health service structure for tuberculosis treatment across different facilities, from aid posts to the national referral hospital, noting that testing should ideally take 24 hours but often takes 2-3 days due to patient volume. Rendi highlighted significant challenges in accessing healthcare, including long travel times, lack of appointments, uncertainty about which doctor patients would see, and difficulties with patient accommodation when seeking treatment.

He explained that while tuberculosis testing and treatment are free by law, challenges include long wait times for drug susceptibility testing results (up to two months) as samples are sent to Queensland, and low treatment success rates at 73% compared to the target of 90%. Rendi discussed his research findings on drug-resistant tuberculosis strains, including the prevalence of the Beijing strain. He outlined plans to implement new genetic testing technology that would reduce costs from the current level of $500 000.00.