Greater integration of HIV into broader health and development agenda in Myanmar: challenges and opportunities
12 July 2013
In an official visit to Myanmar, UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle called for greater integration of HIV into the broader health and development agenda. During her interactions with government officials, parliamentarians, women leaders and civil society representatives, Ms Beagle also stressed the importance of a ‘people-centered’ AIDS response—making sure that systems and services are set up based on people’s needs and realities.
After 50 years of military rule, Myanmar is experiencing greater political freedom and economic change, including an influx of foreign aid and private capital into the country. This presents opportunities for reforms that can have a direct impact on the lives of people living with and affected by HIV.
This is a great era of opportunity for the people of Myanmar and for the AIDS response. Aligning and coordinating HIV efforts within an integrated approach to health and development will save lives, reduce costs and get the most out of the money invested.
UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle
To further strengthen accountability and governance, Myanmar has established a new Health Sector Coordinating Committee. The committee serves as the main convenor for health partners and stakeholders across the country. Officials hope that with better coordination Myanmar can increase access to essential health services and information.
In May 2013, Myanmar became the first country from Asia and the Pacific to successfully apply to the Global Fund’s new funding model for HIV, TB and malaria. The Global Fund allocated more than US$161.2 million for HIV for 2013-2016.
“This is a great era of opportunity for the people of Myanmar and for the AIDS response,” said Ms Beagle. “Aligning and coordinating HIV efforts within an integrated approach to health and development will save lives, reduce costs and get the most out of the money invested,” she said. For example, noted Ms Beagle, integrating services for the prevention of new HIV infections among children into maternal, newborn and child health programmes will produce greater results than if they are considered as stand-alone initiatives and systems.
There are an estimated 200 000 people living with HIV in Myanmar and the country has the third highest HIV prevalence in the Asia-Pacific region at 0.47%. HIV prevalence among key affected populations is even higher. According to national estimates, in 2012, the HIV prevalence among people who use drugs was 18%; HIV prevalence among men who have sex with men and among female sex workers was 8.9% and 7.1% respectively. Coverage of antiretroviral treatment has grown from 12% in 2008 to 43% in 2013. While this represents an impressive scale-up, additional concerted efforts and resources are required to ensure increased and sustainable access to treatment.
At Mingalardon Specialist Hospital, one of the largest public providers of antiretroviral therapy in the country, Ms Beagle reiterated the need for a people-centred approach to ensure greatest access to HIV services. Dr Htin Aung Soe, HIV treatment specialist, highlighted how the AIDS response has had a positive impact in strengthening the health system as a whole.
Addressing stigma and discrimination
Community groups raised concerns that punitive laws, policies and practices have led to heightened stigma and discrimination against people living with HIV. In particular, they cited work place and health care settings. During the meeting stakeholders asked for a holistic approach to HIV, one that would not only increase accesses to services but also create an enabling environment.
UNAIDS Global Advocate for Zero Discrimination Daw Aung San Suu Kyi discussed with Ms Beagle a range of issues in relation to stigma and discrimination, inequities and the empowerment of women. She emphasized the need to raise HIV-awareness and to have open discussions on HIV prevention. Daw Aung San Suu Kyi also reiterated her call for compassion for all people living with HIV.