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Burmese junta responding too slowly on HIV, TB, malaria and avian flu
October 10, 2006Burma's authoritarian military regime, the State Peace and Development Council (SPDC), is impeding the health community's efforts to control infectious disease threats in Burma, according to an investigation published in PLoS Medicine.
Dr Chris Beyrer (Johns Hopkins Bloomberg School of Public Health) and colleagues carried out field investigations in Burma in 2005 and 2006, and also searched the medical and policy literature on HIV, TB, malaria, and avian flu in Burma.
The researchers found that the SPDC's investment in health care is one of the lowest worldwide and that the health sector has been weakened by widespread corruption. The SPDC has also weakened the country's laboratory infrastructure, say Beyrer and colleagues, due to disinvestment and through creating a dearth of skilled personnel.
The researchers found that Burma's national reporting system for HIV is "too limited in scale and scope to accurately capture HIV/AIDS in this large and diverse country." They cite evidence that around 40% of Burma's population is thought to be infected with TB. "Burma has been rated by WHO," they say "as moving far too slowly to adequately control TB-a problem identified by WHO as far back as 1998 as being due to a lack of political will and commitment." There is also evidence that the government is spending too little on both TB and malaria control, and troubling evidence of rising rates of multidrug-resistant TB and malaria.
Burma's first report of the avian flu (H5N1) virus describes emergence on March 8, 2006, on a farm in the Mandalay district, and 112 birds died in the outbreak. "Veterinary authorities in the country called for international assistance," say Beyrer and colleagues, "but the state-run media did not notify the Burmese people of the threat until March 17, 2006, more than a week later."
The authors say that attempts by the health community to control infectious disease threats by trying to work through the junta are becoming increasingly difficult. As an example, although in 2004 the Global Fund to Fight AIDS, TB, and Malaria awarded Burma US$98.4 million over five years, the fund terminated the grant on August 18, 2005 due to restrictions recently imposed by SPDC. The fund made it clear, say the authors, that the decision was due to the SPDC having imposed restrictions on access to project implementation areas, and having added additional procedures to the procurement of medical supplies.
Health-related programs, such as Population Services International, Médecins Sans Frontiîres Netherlands, and numerous others that are currently functioning in Burma, are likely to continue conclude the authors, "but from a public health perspective, much more fundamental and widespread change will be required to actually meet the scale and scope of Burma's HIV/AIDS, TB, and malaria epidemics, increasing malnutrition, and other health threats."
Public Library of Science
The researchers found that Burma's national reporting system for HIV is "too limited in scale and scope to accurately capture HIV/AIDS in this large and diverse country." They cite evidence that around 40% of Burma's population is thought to be infected with TB. "Burma has been rated by WHO," they say "as moving far too slowly to adequately control TB-a problem identified by WHO as far back as 1998 as being due to a lack of political will and commitment." There is also evidence that the government is spending too little on both TB and malaria control, and troubling evidence of rising rates of multidrug-resistant TB and malaria.
Burma's first report of the avian flu (H5N1) virus describes emergence on March 8, 2006, on a farm in the Mandalay district, and 112 birds died in the outbreak. "Veterinary authorities in the country called for international assistance," say Beyrer and colleagues, "but the state-run media did not notify the Burmese people of the threat until March 17, 2006, more than a week later."
The authors say that attempts by the health community to control infectious disease threats by trying to work through the junta are becoming increasingly difficult. As an example, although in 2004 the Global Fund to Fight AIDS, TB, and Malaria awarded Burma US$98.4 million over five years, the fund terminated the grant on August 18, 2005 due to restrictions recently imposed by SPDC. The fund made it clear, say the authors, that the decision was due to the SPDC having imposed restrictions on access to project implementation areas, and having added additional procedures to the procurement of medical supplies.
Health-related programs, such as Population Services International, Médecins Sans Frontiîres Netherlands, and numerous others that are currently functioning in Burma, are likely to continue conclude the authors, "but from a public health perspective, much more fundamental and widespread change will be required to actually meet the scale and scope of Burma's HIV/AIDS, TB, and malaria epidemics, increasing malnutrition, and other health threats."
Public Library of Science
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