The Mid-Term Review (MTR) of the Myanmar National Strategic Plan on HIV and AIDS 2011-2015 (NSP II) is seventy-five pages long. Although it is wordy, there are a few pages of solid analysis in it.
On page 11 it says that there is high incidence among young men who have sex with men and female sex workers. I haven't seen any evidence that this is so. And on page 50 the author says there is no evidence: "the small sample sizes per site for the HSS do not allow calculation of HIV prevalence in the younger age group (15-24 years old) that can be used as a proxy of HIV incidence given the shorter duration of exposure to HIV for this age group." Seems like magic, or at least inaccurate, to say that young people among these two key populations have high incidence.
On the same page it mentions decentralisation of ART sites. Does this mean passing control from the Ministry of Health to the regions or sites or does it mean the opening of more sites and treatment slots further from the two major cities? Or even both?
On page 16 it says: "6. The number of women needing PMTCT interventions may decline by 25 per cent between 2010 and 2015. An increasing number of pregnant women will need to be tested to maintain the number of HIV positive women that are detected." This makes me laugh. Soon the entire population will need to be tested to maintain this number of detections. Is the goal to decrease transmission or to maintain detections?
Page 33 tells us "There is no M&E plan for the Methadone Maintenance Therapy program." Whose oversight was this? Who is responsible?
On page forty we learn that over half of all people beginning ART three years ago were newly diagnosed with tuberculosis. Some would consider this a success of the national TB programme. I'm not sure. No wonder there are not enough treatment spots for people who live outside the TB diagnosis hotspots of Yangon and Mandalay.
Page 45 has boxed text that says: "Geographic coverage of ART varies significantly between states and regions." This is true.
Enough. On to the revised NSP
Jamie
