The 9th ICAAP begins this weekend in Bali. It is worth looking back two years at a posting made by the [him] moderator from the 8th ICAAP in Colombo. How much has changed? How much hasn't?
[him] moderator
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8th ICAAP: Preparing for Universal Access in Myanmar
cross-posted from HIV Information for Myanmar [him]
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The UNAIDS Secretariat in Myanmar sponsored a satellite meeting at the end of the first full day of the programme at the 8th International Conference on AIDS in Asia and the Pacific ICAAP in Colombo. Over sixty people heard several presentations and a short audience discussion of the issues raised. Slide presentations were made by the National AIDS programme manager Dr Myint Thwe and the Country Director of AZG or Medecins sans Frontieres Holland, Dr Frank Smithius. Presentations should appear on the UNAIDS website soon after which they will be put on the HIV Information for Myanmar website and posted on the [him] email list.
New HIV prevalence estimate figures for Myanmar were presented. It is now estimated that 230,000 people aged 15 though 49 are presently living with HIV. This corresponds to a national adult prevalence of 0.67%. There are thirteen thousand new HIV infections a year, seventy-three thousand people are presently in need of antiretroviral therapy, and twenty thousand people die of HIV related causes every year. There appears to be little doubt that national HIV prevalence in Myanmar is decreasing. In partial explanation, evidence was presented that condom and needle distribution have been greatly expanded and the number of units distributed continue to rise. Conclusions about the incidence of the disease could have been made by the presenters but were not. New prevalence figures from Myanmar are rarely released to the public this quickly. It is a rare treat to see these figures made public so soon after they were estimated.
One of the most disappointing aspects of the governmental response to HIV presented is what Dr Myint Thwe paradoxically calls a cornerstone of the national programme: prevention of mother to child transmission. There is little of substance presented about this cornerstone: national reach and coverage for this intervention are dismally low, substandard nevirapine-based antiretroviral therapy is used, and there is almost no provision of continuing antiretroviral therapy for mothers who need it. It is hard to rationalise increasing financial support by international donors for such a low quality programme as it simply throws good money after bad.
AZG has now put a cap on the number of people it begins and continues on antiretroviral therapy. The Medecins sans Frontieres programme throughout the country currently treats 6,500 people and a further 8,000 people on their rosters will need to begin antiretroviral therapy in future. AZG will now begin treatment only for their own staff members and the family members of people already on treatment through their programme. Nationally, fewer than ten per cent of the people who now require antiretroviral treatment receive it and there was little indication that this figure will change much in the near future.
Two major constraints to increasing coverage of the national programme were noted. One was the challenges in registration for smaller local nongovernmental and community based organisations. This is a real constraint. Dr Min Thwe noted that it is the Ministry of Home Affairs that is in charge of NGO registration and we have to follow their direction. The other constraint mentioned was funds. There was generally acknowledged to be enough money to conduct prevention and care activities at the present levels of coverage. But to increase coverage more funding will need to be provided. It is time for the bilaterals to increase the cash, for the government to increase spending outside of providing human resources, and for stakeholders in Myanmar to get together on a new proposal to the Global Fund.
Email: HIV.Information.for.Myanmar@gmail.com
Website: http://www.hivinfo4mm.org
cross-posted from HIV Information for Myanmar [him]
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