Burma has one of the highest HIV/AIDS prevalence rates in Asia; UNAIDS estimated that about 190,000 people in Burma were living with HIV in 2013, and that about 11,000 died that year from the incurable illness. The country’s overloaded and under-resourced health system—Burma spends less per capita on health care than any other nation in the world—offers minimal assistance for HIV-positive patients, who also suffer from severe social stigma.
The country’s main provider of anti-retroviral therapy (ART), Médecins Sans Frontières, told The Irrawaddy last year that only 40 percent of patients who needed the treatment were able to access it as of late 2012. Newly pledged assistance from the Global Fund to Fight AIDS, Tuberculosis and Malaria, however, was earmarked for providing ART through MSF programs.
Myanmar Positive Group (MPG) is a non-governmental organization founded in 2005 as a resource network for HIV-related community workers. The group connects organizations across the country, and currently has 159 member organizations whose work ranges from prevention to patient support and treatment. MPG coordinates an annual forum about HIV/AIDS awareness and solutions for the shortage of available care and support in Burma.
The Irrawaddy spoke with MPG Chairman Myo Thant Aung about Burma’s capacity to treat HIV and the challenges faced by both health workers and patients.
Question: What does MPG do to support people living with HIV/AIDS in Burma?
Answer: MPG represents people living with HIV [by liaising with government health officials and coordinating support among community-based groups]. We occupy four seats on Burma’s Health Sector Coordination Committee—a Union-level government agency under the Ministry of Health—which is authorized to make decisions about national health services.
We are also present on Burma’s Civil Society and Lawmakers Joint Committee—a union-level institution that brings together the Health Promotion Committee and community-based networks. As members of this committee, we work on policies to protect the rights of HIV-positive patients.
Q: When did MPG first begin hosting public forums to address these issues?
A: To understand how this came about, we need to talk about the political landscape. HIV was once considered a taboo subject in Burma. The government did not provide any information about HIV, and wouldn’t grant permission [to conduct awareness campaigns] at all. For many years, because of Burma’s prohibitive assembly laws, civil society was effectively deterred from participating in anti-HIV campaigns.
People living with HIV used to be ashamed to admit that they were infected. We began holding these conferences to show that it is OK to speak out about the illness, regardless of pride or the opinions of others. The more people talk about it, the less discrimination we will see. We want to deliver a message to people living with HIV that they don’t need to worry, they should be free to speak up.
Q: MPG’s forum is now in its eighth year. What kind of progress have you seen over that time?
A: In the past, people would come but they wouldn’t speak up because of the fear that is entrenched in our society. They wouldn’t ask any questions. When things started opening up around 2010, participants started to speak out. It has only been four years since then, and already we are seeing people actively participating, having discussions and making suggestions.
Q: Has MPG made progress toward combatting discrimination and stigmatization?
A: We have two primary goals: increasing access to medicine and ending discrimination. There are three main reasons that HIV-positive people suffer so much from discrimination: They are ashamed, they are scared, and they are uninformed. With more awareness, they know that they can live a normal life, they will not die immediately as long as they have proper treatment. When the fear goes away, they are more willing to speak out. Regarding information, when patients know more about their illness, they are better prepared to live among other people. All of these things help to reduce discrimination.
Q: What can the government do to improve its efforts to fight HIV/AIDS?
A: The health system needs to be strengthened, and that will require better health infrastructure and adequate human resources. Burma receives some aid from the Global Fund [to Fight AIDS, Tuberculosis and Malaria], which is meant to meet those needs.
But the most important thing is for the Ministry of Health to work together with the people. The ministry can improve the system and the community-based organizations [CBOs] can improve the community. Right now, the two are not effectively working together, but measures are underway to improve collaboration.
Q: Can MPG and its member groups work more freely now, under the new government, or is the situation still the same?
A: The government initially did not want help from the Global Fund primarily because it didn’t want to take responsibility for the CBOs that were involved. We drew up detailed plans and budgets with personnel from the Global Fund and we presented it to the government. They found no reason to refuse and they had to accept it.
We now plan to open 20 offices in various places. Right now we have only nine offices in five areas, and we mainly help AIDS patients that are in hospitals.
Q: Are Burma’s treatment facilities and equipment adequate for treating HIV, and are those facilities available nationwide?
A: Things have improved. We have asked the international community to help us by providing medicine. We have also asked for CD4 machines [diagnostic equipment used repeatedly throughout treatment]. The government bought 74 of these machines, from the state budget, but we do not yet have national coverage. We still need to ask the government for more equipment. Handling health services for people living with HIV is an endless task.
