Public-Private Partnership: Lessons Learned from a Large Project in a Developing Country Setting

Nowosiwsky, Andry; Prest, David; Moore, John D.; Krieger, Gary R.

doi:10.2118/179425-ms

Cited by 3 publications

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“…The overall effort is known as the Partnership in Health Program (PiHP). The details of this private-public partnership are presented in a parallel SPE paper (Nowosiwsky, 2016).…”

Section: Introductionmentioning

confidence: 99%

Development of an Integrated Community Health Program for a Large Oil and Gas Project

Nowosiwsky

Moore²,

Hancock³

et al. 2016

SPE International Conference and Exhibition on Health, Safety, Security, Environment, and Social Responsibility

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OBJECTIVE: Onshore oil and gas projects can have large footprints with potentially significant impacts on local communities over its producing life. In complex developing world country contexts, project execution challenges are often exacerbated by a high background burden of disease and a fragile local health system. The ExxonMobil-constructed and operated Papua New Guinea (PNG) LNG Project (Project), the largest private investment in the history of Papua New Guinea, is an example of a large development in a significantly challenged community health context. Having recognized the healthrelated risks early, the Project team developed an integrated community health impact mitigation and investment plan consisting of: (i) the development of a private-public partnership with the PNG Institute of Medical Research (PNGIMR) to execute a robust longitudinal surveillance system, (ii) capacity building efforts to strengthen both local and national health care and diagnostic capacity, including (a) a state of the art infectious disease research laboratory managed by PNGIMR and located at the PNG School of Medicine campus and (b) a teaching and clinical support by both PNGIMR and seconded faculty from Texas Children's Hospital and (iii) strategic impact prevention measures, e.g., water/sanitation, domestic violence, health lifestyles, executed by local NGOs across all project areas. METHODS:Based on the findings of a pre-project health impact assessment, the Project assessed that a comprehensive integrated impact mitigation and focused capacity building program for potentially impacted communities was essential. Because of the complexity and geographical distribution of the project, control/comparison sites were also developed so that any significant changes in community health outcomes could be placed in context. Health stakeholders included the Project workforce, affected communities and both provincial and national health authorities. Interventions followed best practice in building public-private partnerships and were fit to purpose, i.e., tailored to address local and provincial / national issues that would be directly impacted by the PNG LNG Project. RESULTS: Formal Memorandum of Understanding and Investment Agreements between ExxonMobilPNG Ltd and PNG health authorities were executed. Longitudinal surveillance included two project impact sites and two comparison sites covering over 50,000 persons. The entire surveillance system was accepted into the INDEPTH Network and is fully compliant with international health monitoring standards. The PNG LNG Project was the first oil and gas sponsored project in the 45-member, 20-country, 50ϩsite INDEPTH Network. A variety of population demographic and specialty studies have been executed that have accurately tracked changes in socio-economics and in/out migration while determining prevalence and incidence for major diseases such as tuberculosis and sexually transmitted infections, including the first ever study of HPV in PNG women. NOVEL/ADDITIONAL INFORMATION:Key findings are ...

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“…The overall effort is known as the Partnership in Health Program (PiHP). The details of this private-public partnership are presented in a parallel SPE paper (Nowosiwsky, 2016).…”

Section: Introductionmentioning

confidence: 99%

Development of an Integrated Community Health Program for a Large Oil and Gas Project

Nowosiwsky

Moore²,

Hancock³

et al. 2016

SPE International Conference and Exhibition on Health, Safety, Security, Environment, and Social Responsibility

Self Cite

View full text Add to dashboard Cite

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What Happened? Retrospective Health Review of the PNG LNG Project

Kumar

Balge²,

Krieger³

2017

Day 1 Tue, April 04, 2017

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Objectives/Scope The PNG LNG Project began baseline data collection in the 2006-2008-time period prior to the Project construction phase. ExxonMobil PNG Ltd. developed a private-public partnership in order to objectively document potential positive and negative health impacts on local communities during construction and operations. Data were collected for over 50,000 lives at impact and control/comparison locations covering key health and social indicators. This longitudinal monitoring and surveillance effort is a pioneering effort for the oil and gas industry. Key findings will be presented. Methods, Procedures, Process A public private partnership with the PNG Institute of Medical Research (PNGIMR) was established. Comprehensive household level demographic health surveys were conducted twice a year. Specialty medical surveys including, maternal and child health outcomes, tuberculosis and sexually transmitted disease incidence and prevalence were also conducted. Key social outcomes including changes in wealth status and in and out migration were analyzed. All surveys were conducted using processes and procedures established by the global INDEPTH Network of demographic health surveillance sites (DSS). The PNGLNG DSS is the first private company sponsored effort to be officially approved and recognized by INDEPTH. Results, Observations, Conclusions A comprehensive monitoring system has been established and changes from pre-project baseline can be observed covering almost 10 years. The pre-project health impact assessment predictions were objectively assessed based on long-term longitudinal household/community data and found to be generally accurate. Construction related socio-economic and demographic changes during construction are documented; however, the ‘stickiness’ of these changes is less certain in some locations. Project in-migration impacts were generally modest and within pre-project predictions. Based on sequential morbidity and mortality surveys, the project potentially accelerated an ongoing epidemiological transition from infectious to non-communicable diseases in some locations. Concerns regarding increases in community level STIs were not documented. The rise of a silent epidemic in tuberculosis, unrelated to HIV infection, has been objectively documented and evidence provided to key public health authorities. Similarly, the objective decline in community level malaria rates is also observed. The difficulty in producing long-term positive maternal and child outcomes is observed. The demographic surveillance system has created the most robust set of longitudinal health data in PNG so that public health officials can make evidence-based decisions. Objective project-related impacts on community health were generally positive and/or neutral. Fears of large-scale negative health impacts were not realized based on longitudinal data and comparison to baseline conditions. Novel/additive The PNG LNG health surveillance system is a landmark for the oil and gas industry and represents one the largest and most comprehensive longitudinal health monitoring effort ever developed for a private sector project. Sequential objective data with appropriate control/comparison locations are available including comparison to pre-project baseline data. Pre-project health impact assessment predications are largely confirmed. Significant negative project-related health impacts have not been documented. Changes in demography, socio-economics and morbidity/mortality patterns are observed.

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Preventing Workplace Transmission of Tuberculosis in a High Tuberculosis Endemic Country

Kapiri

Kumar

2018

Day 3 Wed, April 18, 2018

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Objective Scope Papua New Guinea is a developing country with a high incidence rate of tuberculosis (TB) and drug resistance TB. For 2015, the World Health Organization (WHO) reported an incidence rate of 432 / 100,000 population with an estimated 3.4% of cases being multi drug resistance TB. In order to protect our workers, ExxonMobil PNG Limited (EMPNG), as the operator of the PNG LNG Project, implemented a TB Control Plan at our work sites to detect and prevent the spread of TB among our workforce. An outbreak of TB at the work place would result in significant disruption in operations resulting in a drop of productivity. Methods, Procedures, Process The TB control plan is implemented at all work sites where workers work and live together i.e. where there are camps or dormitories. The program covers all workers including short-term visitors who spend more than 30 days per year at a camp. The components of the TB Control plan are i) awareness of TB where every worker at the camp is given an educational talk on the signs and symptoms of TB, preventive measures and when to seek medical attention and ii) screening of all workers at the workplace by a TB questionnaire and Quantiferon Gold blood tests annually. Those identified with latent TB will undergo further tests to determine if they have active TB or not. During the construction phase of the PNG LNG Project in 2010, TB screening was done by a questionnaire and subsequently in 2012, Quantiferon Gold testing was introduced to enhance the TB screening process. This was in response to the increase number of TB cases detected at the Project areas. Results, Observations, Conclusions Since 2012 when screening using the Quantiferon method was implemented, 14,704 workers had undergone TB screening at our worksites. Out of this, a total of 3802 workers were found to have latent TB and were subjected to testing for active TB. With close monitoring of workers with latent TB, we detected 28 workers who converted from latent to active TB over a period of time while working at our sites. Assuming that one person with active TB can infect up to 10 people, the screening and monitoring program helped prevent at least 280 active TB cases which would have resulted in significant operational disruption of the PNG LNG Project. Novel/additive information The ExxonMobil PNG Ltd TB Control Plan has succeeded in detecting and preventing the spread of TB at the workplace. As more companies operate in TB endemic countries, implementing a robust control plan will help ensure a safe, healthy and productive workforce

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Public-Private Partnership: Lessons Learned from a Large Project in a Developing Country Setting

Cited by 3 publications

References 1 publication

Development of an Integrated Community Health Program for a Large Oil and Gas Project

Development of an Integrated Community Health Program for a Large Oil and Gas Project

What Happened? Retrospective Health Review of the PNG LNG Project

Preventing Workplace Transmission of Tuberculosis in a High Tuberculosis Endemic Country

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