Since a new fact sheet on the HIV response among people who inject drugs in Myanmar was produced by UNAIDS we expect it to be world class. I have a few comments and questions.

https://www.dropbox.com/s/en43q5znaabfo9n/UNAIDS%20Harm%20reduction%20may%202016%20%2827-5-16%29%20printed%20%20version.pdf?dl=0

Although the publication notes that HIV prevalence in PWID is higher in some places than others, it ignores information on the trajectory of the epidemic. HIV prevalence in people who inject drugs in Yangon and Taunggyi doubled between 2013 and 2014. It went up one and a half fold in Muse. Prevalence was almost unchanged in Mandalay, Lashio, Tachileik, and Myitkyina. Increasing prevalence means increasing incidence.

Drop in centres, tuberculosis services, and primary health care are not part of the key UN recommendations for HIV services among people who inject drugs. What proportion of the expenditure is used for them? Could these funds provide more effective services if they were used for evidence-informed harm reduction services?

The report notes that 22% of people who inject drugs had been tested in the previous year. It is important to know and report how many of the people who test positive began antiretroviral treatment, isn't it? If those most at risk were tested then 22% is is a high proportion. If implementers are simply retesting of people at low risk then it is a waste of time and money and the figure is not important. Annual testing is recommended by WHO.

Donors are paying for TB screening and treatment among people who inject drugs. Why are figures not available?

Most of the recommendations are, alas, not new.

Jamie