RANGOON — The Union minister for Health and Sports Dr. Myint Htwe announced details of a US$460 million plan to combat HIV/AIDS in Burma at an event in Naypyidaw on Wednesday.
The Burmese government will contribute 18 percent of the budget with the rest funded by international organizations and NGOs—including the Global Fund to Fight AIDS, Tuberculosis and Malaria, Three Millennium Development Goals Fund, and UN agencies, according to the Myanmar National Strategic Plan on HIV/AIDS (2016-2020).
Savings of $100 million compared to the previous five-year plan were outlined by a stringent review of costs, with a reduced number of organizations and agencies implementing services to reduce overheads—a crucial move as global funding to combat the HIV/AIDS epidemic in Burma wanes.
According to the Myanmar Medical Association, there are around 200,000 people living with HIV in Burma, with an estimated 115,000 receiving antiretroviral therapy (ART).
The plan commits Burma to achieving UNAIDS’ “five 90s” by 2020: 90 percent of priority populations having access to HIV combination prevention services, 90 percent of people living with HIV knowing their status, 90 percent of people living with HIV and knowing their status receiving treatment and having repressed viral loads, and 90 percent of people affected by HIV reporting no discrimination.
The plan promises further decentralization of HIV/AIDS treatment away from major cities—a process which began in 2013 and has expanded to 140 townships—as well as a shift as to who provides treatment, from NGOs to government hospitals and clinics.
Independent consultant on HIV Dr. Jamie Uhrig, who has worked in Burma, said transferring care for patients who previously received HIV treatment from nongovernmental organizations to government facilities was a “major undertaking.”
“Global Fund financial resources for HIV treatment have been limited so there is a risk of a return to longer waiting periods before people living with HIV can start treatment,” he told The Irrawaddy.
UNAIDS Country Director for Myanmar Mr. Eamonn Murphy noted that some NGOs would need to continue to provide treatment as the services are taken over by the government closer to 2020, but welcomed the plan for identifying and prioritizing the most effective ways of responding to the epidemic.
“It is a plan to be used, not to just [stay]sit on the shelf,” he told The Irrawaddy on Thursday.
Mr. Murphy also praised geographic prioritization which categorizes townships based on HIV epidemic burden and risk of new infections and awards resources accordingly. The plan also allocates different approaches to reach different priority populations—including sex workers, men who have sex with men, and people who inject drugs—and improve their access to services.
The government’s move to integrate prevention and treatment was a crucial step in ending the epidemic, he said, and applauded Dr. Myint Htwe’s pledge to improve “health literacy” which will help to combat social stigma around HIV/AIDS.
Dr. Myint Htwe explained that “expanding health services for HIV/AIDS is good, but the real success is to bring down the number of new infections,” and encouraged the prioritizing of an HIV awareness campaign, according to the health ministry’s website.
Despite the government’s commitment to HIV treatment, a black market for ART in Burma remains.
A doctor from Waibagi Communicable Disease Hospital in Rangoon’s North Okkalapa Township who asked not to be named said: “Some HIV patients or those who work at organizations that supply ART sell it on the black market to HIV patients who are too afraid to take the medicine at hospitals.”
The first five-year strategic plan was introduced in 2005 under Burma’s military regime, and a second plan was finished in 2015. The National League for Democracy (NLD)-led government, after reviewing the new strategic plan, gave it the green light.
Since 2010, new infections in the country have fallen by 24 percent, and AIDS-related deaths have decreased by 40 percent, according to UNAIDS figures.