To whom is this first 'case for investment document' directed? One hopes they read it critically. The [him] moderator would be happy to get comments or replies to his analysis below from any of the stakeholders who were consulted on the contents: "Alliance, East-West Center, Médecins Du Monde, Ministry of Health, MSF-Holland, Myanmar Positive Group, National AIDS Programme, Population Services International, Save the Children, UNAIDS, UNDP, UNICEF, and WHO."
Page 1 - The first sentence reflects only a very partial truth. "Through sustained prevention efforts among high-risk populations and a scale-up of treatment and care, Myanmar has witnessed a decline in HIV prevalence among all key populations – female sex workers and their clients, people who inject drugs, and men who have sex with men – since 2007." A peek at page 24 of the Myanmar Estimates and Projections 2010 - 2015 document shows that aggregate peak prevalence was reached several years before 2007. And the graphs on pages 25 and 26 of the latest HIV Sentinel Serosurveillance Survey Report in 2012 show a much more complex situation with fluctuating seroprevalence among key populations in different sites. Whether sustained prevention efforts are wholly responsible for declines in prevalence is an open question. Probably not.
Page 5 - "Within each key population, we will increase the focus on young people as they at the highest risk of infection." Grammatical error aside, young people are not always at the highest risk of infection.
Page 10 - HIV counselling and testing is listed as a prevention intervention. It is not one. And on the next page "... HIV counselling and testing ... will be promoted as the main HIV prevention strategy for people who inject drugs because these interventions have proved to be effective in reducing HIV prevalence and incidence" The [him] moderator challenges the author(s) to show evidence that HIV counselling and testing have been proven effective in reducing prevalence and incidence.
Page 12 - "Although there is low coverage of MMT among PWID, we choose not to dramatically increase investment in MMT, since the cost of this intervention is high and the return on investment is low." Who is "we"? Lifesaving MMT costs the same at lifesaving ART but is usually not taken for life.
Page 13 - A massive increase in funding, over ten million dollars a year, might annually prevent only two thousand extra infections!
Hmmm.
Jamie
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Myanmar Invest Now to End AIDS. UNAIDS. (2013)
Dec 16, 2013 10:47 am |
Through sustained prevention efforts among high-risk populations and a scale-up of treatment and care, Myanmar has witnessed a decline in HIV prevalence among all key populations – female sex workers and their clients, people who inject drugs, and men who have sex with men – since 2007. This was achieved largely without access to the substantial resources that have been available to other countries in the region to fund their responses to HIV and AIDS.
Read more: http://aidsdatahub.org/Myanmar-Invest-Now-to-End-AIDS-UNAIDS-2013
