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New funding could close fatal 'treatment gap'

A life-saving boost for Myanmar HIV victims

An HIV patient at Aung San Suu Kyi's NLD-run AIDS clinic on the outskirts of Yangon An HIV patient at Aung San Suu Kyi's NLD-run AIDS clinic on the outskirts of Yangon
  • Thomas Toe, Yangon
  • Myanmar
  • November 28, 2012
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Tun never considered the possibility that he had contracted HIV. He thought the weight loss and respiratory ailments that kept him from sleeping well were the result of tuberculosis.

A blood test in 2011 confirmed that the 38-year-old taxi driver from Mawbi township on the outskirts of Yangon was HIV-positive, and the news devastated him.

“I wanted to commit suicide when I found out,” said Tun.

“What upset me most was my mother. As I’m the only son, my old parents are relying on me. My mother says if you die, who is going to look after us, as she is about 80 years old.”

Tun is one of an estimated 240,000 people living with HIV/AIDS in Myanmar. As many as half are in desperate need of anti-retroviral treatment (ART), according to UNAIDS.

A Global AIDS Response progress report last year stated that about 18,000 people die each year from AIDS-related illnesses, while 8,000 new infections were reported during the same period.

Meanwhile, restricted access to life-saving ART has produced what advocacy groups have termed a “treatment gap,” in which only a third of all patients in need of ART actually receive them.

The Global Fund to Fight AIDS, Tuberculosis and Malaria suspended operations in Myanmar in 2005, citing crippling travel restrictions on its project staff, and since that time government and other funding for treatment and prevention has been limited.

What treatment is available has been reserved for patients whose CD4 white blood cell counts – the cells that fight infection – have fallen below 150.

In contrast, the World Health Organization recommends ART for any patient with CD4 levels below 350.

Tun, whose count is currently 400, says sicker patients deserve to be treated first. He was recently refused treatment at a government-run hospital but will try again in three months’ time.

“If I get life-saving medicine, I may stay longer and I can look after my parents.”

But recent developments in Myanmar may increase treatment options for Tun and others who are not yet sick enough to receive ART.

The Global Fund has reached new agreements with Myanmar’s nominally civilian government to provide about US$112 million in funding – $46 million of which will be earmarked for HIV/AIDS – over two years, according to a report by Inter Press Service.

Aung Min Htut, a doctor who has worked on HIV/AIDS prevention and awareness with the UNDP, said lack of funding has been the principal challenge in providing enough ART.

“Without access to ART, patients are just waiting to die,” said Aung Min Htut, who also runs a private clinic in Yangon.

Soe Naing, a social mobilization adviser for UNAIDS, says new funds from the Global Fund will aim to get 96,000 patients on ART by the end of 2015.

But significant challenges remain. Health experts warn that the country’s health care system, hobbled by decades of neglect, will take years to fix.

Soe Naing said health care must become a bigger priority for the Myanmar government, which in 2008 only set aside $200,000 for HIV/AIDS treatment while earning an estimated $8 billion in natural gas revenues.

“[It] needs to put more resources into HIV treatment and prevention, and to reduce the stigma and discrimination of the community to show its commitment to helping those in dire need.”

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