Here is an analysis from the UNAIDS website on the generalised epidemic in the country.
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COUNTRY SITUATION ANALYSIS
Myanmar has one of the most serious HIV epidemics in south-east Asia. However, there are early indications that the epidemic might be diminishing (UNAIDS/WHO AIDS Epidemic Update: December 2006).
In recent years, the Ministry of Health has cautiously but steadily expanded its policies on HIV through, for example, the increased provision of information and acknowledgement of the epidemic's characteristics, continued enabling of a small but active number of international partners within the framework laid down by the government, and some progress towards implementing the "Three Ones", in so far as allowed by the general policy environment.
In 2006, HIV policy in Myanmar advanced significantly through the elaboration of a multisectoral National Strategic Plan 2006 - 2010 and an accompanying targeted three-year rolling Operational Plan. The National Strategic Plan highlights people most likely to be exposed to HIV, including sex workers, their clients, injecting drug users and men who have sex with men. International and national organizations participated in its development.
New coordination structures were established, led by the government and inclusive of United Nations (UN) organizations, international and national nongovernmental organizations, and individuals living with HIV. The Ministry of Health undertook the first external review of the National AIDS Programme in 15 years, released its first behavioural surveillance report (data from 2003) and submitted a United Nations General Assembly Special Session on HIV/AIDS report, a draft of which had been shared with nongovernmental organizations for comment. It will also shortly issue a progress update of the national response for 2005, the first time the Ministry will report on the activities of all partners working on HIV.
Funding for HIV is dominated by a limited number of international donors. Ministry of Health expenditure on HIV is low. No official figures exist, but the UNAIDS Country Office estimates that in 2005 the Ministry of Health spent US$ 137 000 on HIV, equivalent to less than half of US$ 0.01 per person. This compares with US$ 1.43 per capita in Thailand and US$ 0.07 per capita in Cambodia, the other two high-prevalence countries in south-east Asia.
Service coverage has improved, particularly of sex workers, of which up to 50% are reached by peer or outreach programmes. Pilot activities for other people at risk need scaling up. Coverage of antiretroviral therapy and prevention of mother-to-child transmission services are improving significantly, but still probably do not exceed 10 - 15% of the need.
Challenges and emerging issues for 2007
Despite progress, the national response remains vulnerable to many challenges. First, it is extremely reliant on international finance, which is scarce and under intense political scrutiny. The World Bank, Asian Development Bank and the United States President's Emergency Plan for AIDS Relief are not involved in Myanmar. Overall, overseas development assistance per capita in 2004 for Myanmar was US$ 2.4, compared with US$ 22 in Viet Nam, US$ 35 in Cambodia, and US$ 47 in Lao People's Democratic Republic. The national response depends upon making the new Three Diseases Fund successful.
A second challenge is the restricted space in the national response for community organizations. There is great demand for self-help groups and networks of people living with HIV, and some groups are now emerging. However, the overall environment is not conducive to their development and growth. The media is controlled and debate about public policy is not encouraged. A more enabling environment would allow national and international nongovernmental organizations to scale up services more rapidly.
Third, government public health structures are weak and receive little funding, domestically or internationally. There are insufficient human resources, infrastructure and equipment.
Finally, HIV is heavily politicized, especially internationally, interfering with objective analysis of the epidemic progress in the response, and areas in continuing need of improvement.
UNAIDS SUPPORT TO THE NATIONAL RESPONSE
Activities in 2006
In January, UNAIDS adopted a Division of Labour clarifying roles among the UN, and used it as a basis for mobilizing UN participation in all joint activities, especially the national strategic planning development process, the most important UNAIDS activity of the year. A three-year rolling Operational Plan was also produced, which is targeted, costed and prioritized.
Policy development was advanced in the areas of community and home-based care: a national workshop outlined a minimum national package of services.
For the 100% Targeted Condom Promotion programme, a study tour to Cambodia offered new insights.
UNAIDS undertook several joint advocacy activities, including the production and broadcast of two joint UN television spots on World AIDS Day, the organization of a joint HIV diplomatic tour to visit sites of harm reduction and other HIV-related activities, and the mobilization of heads of UN agencies to advocate with regional authorities.
A Procurement and Supply Management Officer was engaged to assist with the National AIDS Programme's capacity to manage commodities procured with international assistance.
At the end of 2006, UN agencies supported national public health services in their bid to access the Three Diseases Fund, using the Division of Labor as a coordinating guide.
The UNAIDS Secretariat helped national services to produce and disseminate strategic information, including the activities and output of nationwide services, presence of partners, estimated coverage and financial data. A national progress report for 2005 was produced and disseminated.
The UNAIDS Secretariat continued to act as the Chair Management Committee for the Fund for HIV/AIDS in Myanmar (FHAM), for which it oversaw an estimated US$ 10.3 million in expenditure in 2006. In collaboration with United Nations Development Programme as Principle Recipient, the Secretariat also furnished facilitation and monitoring services for use of the Global Fund Round 3 grant, which although terminated still expended more than US$ 4 million in 2006.
Plans for 2007
Annual priorities have been developed, but not yet endorsed by the UN Theme Group on HIV/AIDS.
Joint action will include:
. resource mobilization;
. policy development for continuum of care;
. UN leadership in functioning thematic working groups;
. development of a UN Joint Support Programme;
. advocacy.
It was agreed that advocacy messages should focus on:
. a multisectoral response;
. improved policy work on mobile populations, the faith-based sector (especially Buddhist) and harm reduction;
. World AIDS Day campaign;
. resource mobilization.
I. DEMOGRAPHIC, SOCIAL AND ECONOMIC INDICATORS
Estimated Population (thousands) 50 519
Population Growth Rate 1.1%
Life expectancy at birth Men Women
56 63
Human Poverty Index Rank Value
50 21.9
Human Development Index 129
Percentage of people living with less than US$2 --%
Per Capita Gross National Income US $ --
Per Capita Governement Expendaiture on health 10
II. HIV AND AIDS ESTIMATES
Number of people living with HIV 360 000 [200 000 -- 570 000]
Adults aged 15 to 49
HIV prevalence rate 1.3 [0.7 -- 2.0]%
Adults aged 15 and up living with HIV 350 000 [200 000 -- 550 000]
Women aged 15 and up living with HIV 110 000 [53 000 -- 190 000]
Deaths due to AIDS 37 000 [20 000 -- 62 000]
GENERALISED EPIDEMICS
Children aged 0 to 14 living with HIV --
Orphans aged 0 to 17 due to AIDS --
III. COUNTRY PROGRESS INDICATORS
GENERALISED EPIDEMICS
Expenditures
National funds spent by governements for domestic sources
National Programmes
Percentage of pregnant women receiving treatment to reduce mother-to-child transmission
Percentage of HIV-infected women and men receiving antiretroviral therapy 7%
School attendance among orphans N/A non-orphans N/A
Knowledge and Behaviour
Percentage of young people aged 15 to 24 who currently identify ways to prevent HIV Men Women
N/A N/A
Percentage of young people aged 15 to 24 who had sex with casual partner inthe past 12 months Men Women
N/A N/A
Percentage of young people aged 15 to 24 who had sex before 15 Men Women
N/A N/A
Percentage of young people aged 15 to 24 who used a condom last time they had sex with a casual partner Men Women
N/A N/A
COUNTRY ASSESSMENTS
The national adult prevalence of HIV infection is between 1% to 2%. Myanmar is thus characterized as having a "generalized" epidemic. However, the spread of the HIV infection across the country is heterogenous varying widely by geographical location and by population sub group. HIV was introduced in Myanmar in mid-to-late 1980s and by the end of 2003, a cumulative 7,174 AIDS cases and 3,324 AIDS deaths have been reported. The male-to-female ratio among reported cases is 3.6:1. Among cases with known mode of transmission, 65% acquired infection by heterosexual route, 26% by injecting drug use, and 5% by contaminated blood. The spread of HIV infection in Myanmar continues to increase. Among military recruits tested in Yangoon and Mandalay, the prevalence of HIV infection has increased from 0.5% in 1992 to 1.4% in 2000, to 2.09% in 2003. Among blood donors, HIV prevalence has consistently increased from 0.3% in1992, to 1% in 2000, to 1.23% in 2003. The prevalence among ANC women was 2% and 0.5% in Yangoon and Mandalay, respectively in 2003 and has remained somewhat constant over the past five years in these major urban areas. Outside major urban areas, the median HIV prevalence in 2003 was 1% with a range of nil to 7.5%. Among IDUs, the median HIV prevalence in six sentinel sites in 2003 was 48%, ranging from 23% to 77%. Among commercial sex workers the HIV prevalence in Yangoon and Mandalay was 33% and 53.6% respectively in 2003. Among male and female STD patients, median HIV prevalence in the same year was 6% and 12.55%, respectively. There are an estimated 330,000 people living with HIV/AIDS as of 2002 of whom 60,000 PLWHAs are in immediate need of antiretroviral treatment. The government of Myanmar is planning to scale up the antiretroviral programme as funds become available.
http://www.unaids.org/en/Regions_Countries/Countries/myanmar.asp
