HEALTH: Engaging Burma with Funds for HIV, TB, Malaria

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

BANGKOK, Oct 19 2006 (IPS) - An injection of fresh funds to aid military-ruled Burma’s long suffering people get relief from three killer diseases may help raise the level of engagement between the international community and the secretive junta.

Primarily, ”Three-Disease Fund” (3-D Fund) to combat AIDS, tuberculosis (TB) and malaria worth 100 million US dollars will put to test a view gaining ground in some Western capitals that humanitarian assistance to Burma should be detached from the South-east Asian nation’s troubled politics.

The fund, which becomes operational early next year under United Nations supervision, is backed by the European Union, Australia, Britain, the Netherlands, Norway and Sweden. It is expected to fill a void created after the Global Fund to fight AIDS, Tuberculosis and Malaria pulled out of Burma in August 2005 due to the barriers placed by Rangoon that undermined its programmes worth 98.4 million dollars.

”For humanitarian reasons the international community cannot ignore the plight of the people of Myanmar,” Friedrich Hamburger, head of the European Commission’s diplomatic delegation to Burma, told IPS in an e-mailed statement. ‘’We are convinced that well planned humanitarian support can reach the poor and vulnerable.”

The Europeans have been assured by Burma, called Myanmar by the junta, that the 3-D Fund will not find hurdles placed in its way, Hamburger added. ‘’We have been assured by the relevant government authorities that conditions will be in place to allow for vital resources both to reach those who need them most and to be delivered effectively.”

The 3-D Fund is also expected to make more headway than the Global Fund due to the special clauses included in a memorandum of understanding (MoU), which was signed last week between Burmese Health Minister Kyaw Myint and a ranking member of the U.N. Office for Project Services.

‘’We have an overall political framework to work with. And one of the big differences is that this initiative requires those having programmes through the 3-D Fund to work with the health systems at the township level,” Charles Petrie, U.N. country coordinator for Burma, said in a telephone interview from Rangoon. ‘’You will actually have to engage with the local health authorities.”

According to reports, the MoU also guarantees the officials,overseeing the fund, complete access to all parts of Burma, including states along the border embroiled in ethnic conflict. The Geneva-based Global Fund was not as fortunate, however, since Rangoon placed severe travel restrictions on non-governmental groups working on some of the Global Fund’s programmes in rural areas. Such impediments were imposed on other humanitarian and relief agencies too, prompting some of them, like the France-based Medecins Sans Frontieres (MSF) to pull out early this year.

The prospect of new funds coming to a country plagued with some of the highest HIV/AIDS, TB and malaria rates in the region is being well received by international humanitarian organisations working with local communities that took a beating when the Global Fund quit Burma.

‘’It (3-D Fund) will fill the needs especially for those who are taking ART (anti-retroviral therapy for HIV), and other essential medicines for TB and malaria,” Dr. Kyi Minn, HIV programme advisor in the Burma office of World Vision, said in an IPS interview. ‘’Those who are affected by the three diseases have more hope for survival.”

In fact, World Vision, an international Christian relief agency, was among the non-governmental groups that saw its funding for HIV programmes slashed after the Geneva-based Global Fund pulled out in protest. One, in particular, was a home-based care programme and counselling services for people with HIV in the Ayeyarwaddy Division and Chin State, in western Burma.

‘’We were just about to start the programme and the funding was stopped,” said Dr. Kyi Minn. ‘’The target population were potential migrants and general population. The estimated beneficiaries were about 150,000 people.”

The Global Fund’s choice of Burma as one of the over 120 developing countries it was offering grants to scale-up grassroots and local initiatives was timely, given the spread of the three killer diseases. Now, a year after it took the unprecedented measure to quit, reports suggest that the health conditions in Burma have not improved.

According to the Joint United Nations Programmes on HIV/AIDS (UNAIDS) and other health agencies, there are between 360,000 to 610,000 people living with HIV in Burma. And the adult prevalence rate stands between 1.3 percent to 2.2 percent people infected out of the country’s 50 million people – the highest infection rates in South-east Asia.

In addition, the Council on Foreign Relations, a New York-based think tank, revealed in a 2005 study that Burma was the main source of all strains of HIV spread across a wide arc of countries, from Kazakhstan, on the west, to southern Vietnam, on the east..

The picture on TB is no less comforting. Burma has 97,000 new cases of TB every year, a figure that the World Health Organisation (WHO) says has earned the country a place among the world’s 22 ‘’high burden” countries with the disease. As troubling for the Geneva-based health body is the high prevalence of multi-drug resistant TB (MDRTB) -four percent new cases, making it the second worse country in East Asia after China, which has a 5.3 percent MDRTB prevalence rate.

Malaria is as widespread, with Burma claiming a place among the worst affected countries in Asia, with 716,000 cases reported in 2003, according to a WHO study done last year. In 2001, there were 661,463 malaria cases.

Such a dismal reality has not softened the junta enough to permit health programmes to reach vulnerable communities in areas where Burma’s ethnic minorities live, say opposition groups. They point to the travel restrictions still in place as an indicator of how Rangoon undermines health initiatives that offer hope and relief to the affected.

‘’The travel restrictions that have been placed to stop NGOs (non-governmental organisations) and humanitarian agencies travelling to the border areas are still in place,” says Zaw Min, foreign affairs spokesman for the Democratic Party for a New Society, a political party that was banned in 1991 by the junta.

‘’The 3-D Fund will need local partners to work freely. But the military government is afraid of community-based organisations because they may be able to sensitise people about political issues,” he explained in an interview. ”Recently, HIV/AIDS activists were arrested because of their political affiliations with the (opposition) NLD (National League for Democracy).”