Timor-Leste’s Institute of Public Health builds links with Australian partners

From left: PHAA's Malcolm Baalman and Terry Slevin, Timor-Leste National Institute of Public Health Director Dr Merita Monteiro, and Dr Andrew Mathieson of the ANU.
Malcolm Baalman, PHAA Senior Policy and Advocacy Advisor

This week the PHAA national office hosted Dr Merita Monteiro, foundation President of the newly created Timor-Leste (East Timor) National Institute of Public Health (Prezidente do Conselho Diretivo do Instituto Nacional de Saúde Pública de Timor-Leste, INSP-TL).

(Photo from left: PHAA Senior Policy and Advocacy Advisor Malcolm Baalman, PHAA CEO Adj Prof Terry Slevin, Timor-Leste National Institute of Public Health Director Dr Merita Monteiro, and Dr Andrew Mathieson of the ANU.)

Dr Monteiro, a general practitioner who later completed her Master of Public Health at the Menzies School of Health Research, has been in Australia to promote the work of the new Institute and build relationships with partners to assist the Timorese as they face some powerful health challenges.

President Monteiro’s Institute, established in April this year, is an independent statutory body separate, from but working to advise, Timor-Leste’s department of health. The Institute’s role is similar to a ‘centre for disease control’ body.

The small nation of around 1.5 million people voted for independence in 1999, and after enduring a brief period of violence, addressed with the help of Australian peacekeepers, established full self-government in 2002. Timor-Leste has gone on to become one of the best-functioning open democracies in East Asia, despite its significant practical challenges. 

Dr Monteiro explained the role and work of her new Institute to PHAA national team including President Tarun Weeramanthri zooming in from Perth, CEO Adj Prof Terry Slevin, and the office’s policy, events, communications and operations staff. She was accompanied by PHAA ACT Branch member Dr Andrew Mathieson from the ANU.

Prof Weeramanthri was interested in the connections between the new Institute and the South-East Asia Regional Office of the World Health Organisation. The WHO has been a significant partner to Timor-Leste. 

The meeting discussed the role of the Institute in addressing non-communicable diseases including diabetes, cancer, and heart diseases. Terry Slevin pointed out that inclusion of a charter to combat non-communicable diseases was one of the commitments behind the establishment of an Australian Centre for Disease Control, and was interested to see how Timor-Leste was handling the issue. 

Dr Monteiro highlighted that the Institute would have several complex preventive health missions to address such diseases, even though the nation’s financial and workforce resources were limited.  

Smoking remains very prevalent in Timor-Leste, especially among younger men and in the highlands regions. Vaping has also entered Timor-Leste in significant quantities, although the exact prevalence has been difficult to measure, with the industry operating essentially without any regulatory constraints. 

Public health information and behaviour change campaigns were limited by only a quarter of Timor-Leste people having internet access. 

The logistical challenges and supporting supplies and infrastructure behind the nation’s health workforce was also an issue. There are actually over 1,200 trained GPs in the country, but service provision in small towns and villages were often constrained by very scarce infrastructure, resources, and pharmaceutical supplies. Complex health issues needing referral of people to larger town facilities were also made difficult by transport challenges. 

Dr Monteiro highlighted the key role of the Family Medicine Programme, provided by the Royal Australian College of Surgeons with support from the Australian Department of Foreign Affairs. 

She highlighted the expense of flying cancer sufferers, and family members, to Darwin or Singapore for treatment, as there were only a small number of local oncologists. 

Another key agenda for the Institute was to strengthen its OneHealth policies, with a range of communicable diseases transmitting from agricultural and other animals presenting problems. 

Dr Monteiro summed up the situation saying “the INSP-TL is a new institution with limited experience and experts, and therefore we are looking for partners that could support us to build and strengthen our capacity as an Institution in order to provide reliable and trusted recommendations to the Ministry of Health.” 

Dr Monteiro was interested to learn of PHAA’s extensive collection of nearly 120 policy position statements, which she would examine for their relevance to Timor-Leste conditions. 

Dr Monteiro and PHAA leaders agreed to work in partnership to encourage Australian public health experts to take an interest in her country, either through professional connections or by considering volunteer work, which can often be supported by funding through Australia’s Department of Foreign Affairs. 



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