ABSTRACT
Papua New Guinea does not fit the more usual profile of the ‘double disease burden’. The phrase applies to developing countries that shoulder a growing load of ‘new’ chronic noncommunicable diseases (NCDs) in addition to the burden of ‘old’ infectious diseases (Marshall 2004: 556; WHO 2007: 14; WHO 2010a: 2). To use the World Bank’s classification of countries into high, upper-middle, lower- middle and low income (though income is not the only criterion of development), this double burden is particularly pronounced in the ‘lower-middle income’ aggregation. Here about two-thirds of deaths are caused by NCDs but about one- quarter are still caused by infectious diseases, together with nutritional and perinatal conditions (WHO 2011a: 10). Today most of humanity lives in countries that fall within this income classification, which includes the first and second most populous nations in the world, China and India, plus fourth- placed Indonesia. It also includes Papua New Guinea (PNG). 1
