Transparency International in Papua New Guinea says the country's standard of health delivery has collapsed since the mid-80s.
To blame, it says, are a combination of corruption and bad management within the health service.
TI chairman Mike Manning says about 50 per cent of medical aid posts operating at PNG's independence in 1975 are now defunct.
According to Mr Manning, in the 80s nobody was supposed to be more than four hours' walk away from primary health care.
Now he says it's often four days' walk.