Date Published: 28/10/2008 03:55
“I want all HIV patients to be helped in the way that people have helped the Nargis cyclone victims. When Nargis happened, people all over Myanmar and other nations came in to help. I want them to help HIV patients the same way”. MSF HIV Patient
HIV sufferers face a critical situation in Myanmar, with an estimated 240,000 people thought to be infected with the disease and 24,000 AIDS related deaths in 2007 alone. A similar number of people are expected to suffer the same fate in 2008, due to the inaccessibility of lifesaving anti-retroviral treatment (ART). “I simply cannot afford to buy it and so I must accept that I will die – I have no other choice”, told a 28year old MSF patient. He arrived at one of the organisation’s Yangon clinics not long after MSF had been forced to cap the number of people for whom they could provide ART. “MSF currently provide ART to more than 11,000 people countrywide, with thousands more registered to start when needed. That is 80% of all available treatment in Myanmar, but it is simply not enough. The lack of response by other organisations has pushed MSF to its limit and now we must go through the painful process of telling people they have HIV but that we cannot treat them. It is heart wrenching”, explains an MSF doctor.
Currently the Government of the Union of Myanmar (GoUM) treats around 1,800 patients with ART, whilst other NGOs engage in HIV care but very few provide treatment. An estimated 75,000 people urgently need ART but cannot access it. “Provision of care is important for people’s recovery, but without ART a patient cannot recover, many people are dying unnecessarily”, adds the MSF doctor. The 2006-2010 National Strategic Plan on AIDS, issued by the GoUM with the support of UN and other NGOs, offers a sound basis for rolling out appropriate levels of care, however the situation as it stands is unacceptable.
HIV is just one of a number of treatable epidemics that causes Myanmar to have some of the worst health statistics in Southeast Asia. Out of its 11 neighboring countries Myanmar has the lowest life expectancy at birth and the highest rates of neonatal and under-five mortality. Malaria remains the number one killer, with deaths in the country equaling more than half of those in Southeast Asia as a whole. 97,000 new tuberculosis cases are detected each year (among the highest rate worldwide) and multi-drug-resistant TB is on the rise. In certain parts of the country, such as Rakhine State where the Muslim population is heavily discriminated against, the health statistics are even worse. The critical need for increased healthcare is evident, yet the lack of investment from both inside and outside of the country remains grossly insufficient. Official sources alone reveal chronic under-funding of the health infrastructure. State health expenditure per person in 2007 was just $0.7 USD and a meagre 0.3% of the country’s Gross Domestic Product, a sum that is disproportionate to both the extent of the needs and the countries overall resources. Similarly, the level of international humanitarian aid is strikingly low, around $3 USD per person 5, the lowest rate worldwide and significantly different to the far greater amounts received by nearby countries facing similar epidemics.
Nargis, in all its horror, threw Myanmar back into the international spotlight and brought to the forefront some of the complex issues around providing humanitarian assistance to the country. It clearly demonstrated that delivering humanitarian assistance in Myanmar is not easy, due to numerous limiting factors; not least controlled access, overbearing administration and the highly politicised environment. But, more importantly, it demonstrated that providing humanitarian assistance in Myanmar is possible, as MSF has been doing for the past fifteen years without sacrificing either independence or accountability.
The task may not be easy but it is unarguably critical if people are to receive the care and support necessary to live healthy and dignified lives. Likewise, the authorities need to increase their efforts to assist those in urgent need of assistance and to facilitate the activities of others who work to do so. The health needs of countless people throughout the country require immediate attention in order to prevent unnecessary suffering. This is not about politics, it is about saving innocent lives. If ever there was a window through which to re-visit our collective responsibility to the people of Myanmar, it is now!
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