INTERNATIONAL health NGOs, working with the government, are continuing their battle against disease in Myanmar – and trying to reduce the annual death toll of 25,000 among HIV/AIDS sufferers.
Working through local partners, the Three Diseases Fund (3DF) is in the midst of a five-year (2006-2011), US$100 million program to combat HIV/AIDS, tuberculosis and malaria.
Supported by Australia, the European Commission (EC), the Netherlands, Norway, Sweden and the United Kingdom, 3DF has allocated 60 percent of its funding to try to reduce HIV/AIDS-related deaths, dividing the remaining 40pc between TB and malaria.
3DF communications officer Ms Denise Jeanmonod told The Myanmar Times that 240,000 people are infected with HIV in Myanmar and, according to Médicins Sans Frontières (Holland), 70,000 people in the country are in need of anti-retroviral treatment, or ART.
“There are 15,000 people receving ART. The Three Diseases Fund is funding half those treatments, for 6780 people. In just over two years (2007-2009), 3DF-funded agencies have reached out to 440,836 people with HIV prevention,” she said.
She added more funding was needed over and above the $38 million spent each year on HIV prevention, care and treatment activities in Myanmar in order to reduce the 25,000 deaths a year among AIDS patients.
In 2007, the fund provided $23 million to 23 implementing partners, UN agencies, international non-governmental organizations (INGOs) and local NGOs working on 34 projects, Ms Jeanmonod said.
Earlier this year, 3DF allocated $70,000 to eight NGOs to carry out projects in Kachin, Mon, Shan, Kayin, R akhine, Yangon and Mandalay States and Divisions.
“The fund is committed to working more closely with local NGOs and community-based organisations because they have strong grassroots networks and can reach the people who are not easily accessed by public health services or international NGOs,” she said, adding that the government coordinates disease control efforts with the World Health Organisation (WHO) and the Joint United Nations Program on HIV/AIDS (UNAIDS).
Other international actors agree that community efforts are essential in fighting diseases in Myanmar.
Dr Kosuke Okada, project team leader of the major infectious diseases control project of the Japan International Cooperation Agency (JICA), said community involvement was particularly useful in fighting TB in Myanmar.
According to a national survey on tuberculosis in 2002, 4pc of new smear-positive patients and 15.5pc of those seeking re-treatment were multi-drug resistant (MDR) TB. This is because, despite the wide availability of TB treatment, about 8pc of patients interrupt treatment for various reasons, allowing the disease to develop resistance to drugs. These patients are at high risk of developing the more virulent MDR TB in the future.
JICA launched its six-year (2004-2009) TB projects in Yangon and Mandalay Divisions with the overall goal of eliminating TB as a public health problem.
Dr Okada said one of the best ways to fight TB is to strengthen private-public partnerships (PPP) and to expand laboratory capacity. “Some townships are very large, but there is only one diagnosis clinic. Access for the public is not easy,” he said.
“MDR is a man-made disaster and it has many side effects and is difficult to cure systematically,” he said.
Dr Chit Soe, project adviser to the Quality Diagnosis and Standard Treatment of Malaria project (QDSTM), as well as president of the internal medicine society of the Myanmar Medical Association, said the challenges facing the anti-malaria effort included lack of funding and public behaviour.
“Malaria is commonly found in populations that live in mountain ranges, who don’t see malaria as a life threatening disease,” he said, adding that public involvement in the fight against malaria was weak.
“We distribute mosquito nets, which are very useful, but we found that people don’t use them – they just keep them for show,” he said, adding that only 55pc of general practitioners nationwide are familiar with malaria guidelines.
“We found that many doctors don’t know that malaria must be treated with artemisinin-based combination therapy (ACT),” he said, referring to a treatment recommended by WHO. He said that one of challenges in combating malaria is the use of fake drugs, which comprise 40pc of all drugs on the market.
