This 'story' has legs! For the second time in a couple of months we are treated to an MSF story that oversimplifies the challenges of increasing the number of people living with HIV taking antiretroviral therapy. This time the story was even more widely spread in the mass media. And the facts are even more distorted than they were before.
In fact, there is no shortfall in HIV and AIDS drugs (Are they different?) in Myanmar. There are presently enough drugs in the country for the people taking them and stockouts are rare. If I am wrong about this please let me know.
A decision was made by the Myanmar Country Coordinating Mechanism two years ago NOT to apply for Global Fund Round 10 funding for more antiretroviral treatment. And MSF in Myannar was on record saying that its headquarters told the office that it could not expand antiretroviral treatment. Lack of funding is only ONE of the MANY constraints that is preventing more people taking antiretroviral treatment.
If it is hard for the doctors, just imagine how hard it must be for the patients.
[him] moderator
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Burma suffering from huge shortfall in HIV and Aids drugs, warn doctors
Patrick Bodenham
guardian.co.uk, Wednesday 9 May 2012 10.09 EDT
MSF bemoans 'tragic' shortage of antiretroviral drugs as new drug-resistant tuberculosis strand causes further concern
Burma's Aids crisis: 'For a doctor, it's a horrible situation' video link: http://www.guardian.co.uk/global-development/video/2012/may/09/burma-aids-crisis-doctor-video
Doctors in Burma are calling for the "devastating gap" between people's need and access to treatment for HIV and Aids to be bridged. There are approximately 240,000 people with HIV in Burma, half of whom are in urgent need of life-saving antiretroviral treatment (ART), say doctors. According to national estimates in 2010, less than 30,000 of them were receiving it.
Burma is the least developed country in south-east Asia and receives only a fraction of the aid from which some of its neighbours benefit. With the Burmese ministry of health underfunded, around 70% of all healthcare expenditure is left to households. In a country where nearly 33% of people live below the poverty line, thousands of Burmese are unlikely ever to be able to afford ART, which, according to Médecins Sans Frontières (MSF), cost $30 a month.
"We see patients crawling in, some lethargic and near death, some trying to drag themselves in," said Dr Maria Guevara, medical co-ordinator at MSF, which is the largest provider of ART in Burma. "As doctors, to be faced with that and have to say we can't give them treatment because they don't meet our criteria; it's tragic. We are having to say no to people we know will just get sicker and die."
MSF had hoped the next round of grant-making by the Global Fund to Fight Aids, Tuberculosis and Malaria – to which nations pledged the provision of ART for an additional 46,500 people by 2018 – would bring Burma up to speed with the rest of the world.
That hope, however, was dealt a blow last November when the Global Fund announced the cancellation of the next grant-making round due to lack of funds. The board is due to meet on Thursday to discuss the institution's future.
"The fact they have withdrawn the round is a true failure," said Guevara. "Understandably, there are issues economically and internationally, but the commitment is still there. The pledges were made. By doing this they didn't just fail themselves, they failed everyone they made commitments to. And that means lives."
The shortfall in the amount of ART available means doctors have had to ration the drugs, giving prescriptions only to the weakest patients while leaving others without treatment until they become seriously ill. Local aid groups said death rates among people who arrived in clinics too late were up to 25% last year.
Meanwhile, another crisis is looming. Tuberculosis in Burma is nearly three times the global average. It attacks people with poor immune systems, preying especially on HIV patients. MSF said the number of tuberculosis cases in Burma may be as high as 300,000, up to 20% of them HIV positive.
Because of poor-quality and interrupted treatment, tuberculosis has evolved a new and contagious drug-resistant strand. Multidrug-resistant tuberculosis (MDR-TB) has the same airborne transmission as normal TB. It can infect healthy people and takes up to two years on a cocktail of drugs to treat.
Guevara estimates the number of cases diagnosed with MDR-TB at 93,00 annually. MSF has the budget to treat only 300-350 of them. The next round of the Global Fund was supposed to cover 10,000 patients, which, says MSF, could have made a significant difference. "It's a scary thing," said Guevara, "because MDR-TB, if not treated, can build up to [the point where it becomes] extreme or totally drug resistant, where there is no treatment and it will be fatal."
http://www.guardian.co.uk/global-development/2012/may/09/burma-shortfall-hiv-aids-drugs?newsfeed=true
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And here is a comment left on the new [him] website:
Can you confirm that availability of ARVs is this bad inside country? or is this an exaggeration. By putting out this kind of story, does the SPDC hope the NGO’s will continue to support ARVs when they are not willing to ramp up treatment with their own funds??
see news article below:
AIDS/HIV drugs woefully short in Burma
Thursday, 10 May 2012 12:50 Mizzima News
(Mizzima) – Of the estimated 240,000 people with AIDs and HIV in Burma, half are in urgent need of life-saving antiretroviral treatment (ART), say doctors. According to estimates in 2010, less than 30,000 of those infected were receiving the drugs.
“We see patients crawling in, some lethargic and near death, some trying to drag themselves in,” Dr. Maria Guevara, medical co-ordinator at Médecins Sans Frontières (MSF), which is the largest provider of ART in Burma, told The Guardian newspaper.
“We are having to say no to people we know will just get sicker and die,” she said.
The hope that more drugs would soon be available was dashed last November when the Global Fund announced the cancellation of the next grant-making round due to lack of funds, the article said. The board is due to meet on Thursday to discuss the institution’s future.
Doctors are rationing drugs, giving prescriptions only to the weakest patients, said The Guardian. Death rates among people who arrived in clinics too late were up to 25 per cent last year, said MSF.
Burma is the least developed country in Southeast Asia and receives only a fraction of the aid from which some of its neighbours benefit.
The Burmese Ministry of Health is woefully underfunded. Nearly 33 per cent of Burmese live below the poverty line and thousands are unlikely ever to be able to afford ART, which cost $30 a month, said MSF.
In August 2011, Mizzima reported that Health Minister Dr. Pe Thet Khin told Parliament that his department received about 43 per cent of its essential budget needs in the latest fiscal year.
The shortfall will cause a lack of medicine and services in government hospitals and clinics, he said. The minister said his agency needed 8 billion kyat per year, but received 3.5 billion kyat.
http://www.mizzima.com/news/inside-burma/7087-aidshiv-drugs-woefully-short-in-burma.html
