World AIDS Day was marked in the capital city of the Union of Myanmar last week.

Harry states that: "Myanmar has achieved a unique distinction of bringing a gradual decline in HIV prevalence of 0.94 per cent in 2000, 0.67% in 2007 and 0.61% in 2009. Such an achievement is due to multi-sectoral coordinated efforts of all implementing partners and the entire community."

This is certainly a distinction, though not unique by any means. Most countries in the region have already achieved reductions in prevalance. It may or may not be an achievement to be proud of. Please read this explanation of prevalence. HIV prevalence is the percentage of a population currently living with HIV and only sentinel surveillance can be reliably used to measure prevalence. Prevalence can DECREASE for three reasons. Each one of the reasons has a D in it if you need help remembering them: 1) different data, 2) deaths, and 3) decline in new infections.

1) Changes in the way that data is collected commonly lead to wide variations of prevalence over rounds of sentinel surveillance: the peaks and valleys of many of Myanmar's old prevalence graphs are due to this.
2) If people die, prevalence goes down. This is the major reason that prevalence has fallen in injecting drug users over the past ten years of sentinel surveillance in Myanmar.
3) Finally, if there are fewer new infections, prevalence will decrease. This may be happening in Myanmar as incidence or new infections are estimated to be slowly falling.

Antiretroviral treatment allows more people to live causing prevalence to INCREASE, not decrease, in a population if people on antiretroviral treatment are included in sentinel surveillance. Success in universal access to antiretroviral therapy can have a paradoxical effect on prevalence if sentinel surveillance is not properly conducted.

So is this an achievement? Is it a positive distinction or a negative one? The moderator thinks it is mildly positive. Let's see.

[him] moderator

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Myanmar achieves unique distinction of bringing gradual decline in HIV
prevalence of 0.94% in 2000, 0.67% in 2007 and 0.61% in 2009
New Light of Myanmar
December 3, 2010

Nay Pyi Taw — A ceremony to mark the World AIDS Day 2010 took place at the
Ministry of Health, here, this morning.

Speaking on the occasion, Minister for Health Dr Kyaw Myint said: Today,
we are celebrating the World AIDS Day Commemoration Ceremony. Every year
World AIDS Day commemorative activities are being implemented on 1st
December and following 7 days in all the countries around the world. The
commemorative activity of the ceremony is to be participated with the
entire people including departments, social organizations and HIV
patients.

Every year, appropriate slogans are selected for implementing World AIDS
Day commemorative activities. This year slogan is “Stop AIDS, Keep the
Promise. Avoid Stigma and Discrimination: Towards Universal Access”. By
reselecting last year World AIDS Day slogan, “Stop AIDS, keep the promise”
which is meant to strengthen the coordinated efforts of implementing
HIV/AIDS prevention and care activities by related departments, NGOs, the
media, local businesses, community members including people living with
HIV/AIDS and their families in countries all over the world.

Second line of this year World AIDS Day slogan is “Avoid Stigma and
Discrimination: Towards Universal Access”. This is chosen so as to have
empathy towards people living with HIV and AIDS and their families and to
give psychological support without stigma and discriminations and to make
them accessible to available services.

Following the diagnosis of first AIDS case in 1981, HIV has spread to all
countries throughout the world. According to Global AIDS epidemic update
2009, a total of 33.3 million individuals have been living with HIV and
AIDS globally in 2009. Due to the rapid spread of HIV, 2.6 million
individuals had been infected with HIV and 1.8 million individuals had
died during 2009. All over the world, highest mortality of individuals
between age group of 15-49 years is due to AIDS. In some countries, life
expectancy is now declining because of AIDS.

Coordinated and collaborative efforts of all implementing partners have
become essential to achieve the target of United Nations Millennium
Development Goal 6: “have halted by 2015 and began to reverse the spread
of HIV/AIDS”: as well as to achieve “Universal access to HIV prevention,
treatment, care and support by 2015”. In Myanmar, 11 local NGOs, 21
International NGOs and 7 UN agencies are actively collaborating with the
Ministry of Health in responding to HIV and AIDS. Moreover, being a member
nation of ASEAN and a member of ATFOA (ASEAN Task Force on AIDS), Myanmar
is actively participating in the ASEAN work programme in HIV and AIDS; and
Mekong regional HIV and AIDS projects. In addition, Myanmar has been
actively participating in the global and regional activities initiated by
various UN agencies.

In Myanmar, AIDS is one of the priority diseases of the National Health
Plan and Prevention and Care activities for HIV/AIDS are being implemented
as a National Concern. Since 1989, multi-sectoral National AIDS Committee
was formed in accordance with the guidelines laid down by National Health
Committee. Under National AIDS Committee, a Working Committee was
organized with various departments and national NGOs, and AIDS Committees
were formed at various administrative levels. Myanmar Country Coordination
Mechanism is also formed, comprising Ministry of Health, related
ministries, UN agencies, National and International NGOs, and people
living with HIV in order to get effective coordinated response to
HIV/AIDS.

As national response to HIV, National AIDS Programme, Department of Health
with coordinated efforts of related ministries, UN agencies, NGOs and
other implementing partners has developed and is implementing National
Strategic Plan on HIV and AIDS (2006-2010) through multi-sectoral
approach. In accordance with 13 Strategic Directions of the National
Strategic Plan, the following ten major activities comprising of Advocacy
Meetings; Awareness raising on HIV/AIDS for various population groups;
100% targeted condom promotion programme in 170 townships; voluntary
confidential counseling and testing services; provision of STI services to
prevent sexual transmission of HIV; prevention of transmission of HIV
among intravenous drug users; nationwide screening of HIV for safe blood
supply; prevention of mother to child transmission of HIV in 210 townships
and 38 general hospitals; provision of ART treatment in 30 hospitals;
treatment of opportunistic infections; and community home based care for
AIDS patients and their families with involvement of PLHIVs; promotion of
multi-sectoral collaboration and cooperation; and implementation of
monitoring, supervision and evaluation activities have been implementing
by the National AIDS Programme. Since 2005, ART has been provided to the
patients at Specialist Hospitals (Waibagi) and (Mingaladon) from
government sector; and more than 26,300 PLHIVs are accessing to ART from
both government and NGOs. In order to make PLHIVs stay conveniently in a
healthy surrounding while coming to Yangon for ART, arrangements are being
made for them to stay in Thakayta Hospital very recently.

According to the results of the Workshop on Estimation and Projection of
HIV and AIDS in Myanmar which was conducted with technical inputs from
UNAIDS and WHO, it is evid
ent that Myanmar has achieved a unique
distinction of bringing a gradual decline in HIV prevalence of 0.94 per
cent in 2000, 0.67% in 2007 and 0.61% in 2009. Such an achievement is due
to multi-sectoral coordinated efforts of all implementing partners and the
entire community.

Besides the strong national commitment towards the fight against HIV/AIDS
and support from three disease fund, Myanmar has successfully gained round
9 global fund grants in 2010. With all these, we are quite sure that
prevention, treatment, and care activities could be momentously scaling up
in the coming years.

We would like to encourage all implementing partners to keep on the speed
of fighting against HIV/AIDS so as to maintain the current achievement
while giving equal weight on scaling up the implementation of prevention
and treatment activities In conclusion, I would like to express our
sincere thanks to related departments, UN organizations, local and
international NGOs, community based organizations that have contributed to
the commemoration of the 2010 World AIDS Day.

UNHCR Resident Representative Mr Bhairaja Panday read the message sent by
the UN Secretary-General.

UNAIDS Country Coordinator Dr Sun Gang read the message of UNAIDS.

Minister for Health Dr Kyaw Myint presented prizes to winners in the basic
education high school level essay contest.

Deputy Ministers Dr Mya Oo and Dr Paing Soe awarded winners in the basic
education primary and middle level painting contests.

Also present on the occasion were Deputy Minister for Progress of Border
Areas and National Races and Development Affairs U Tin Ngwe, Deputy
Minister for Immigration and Population U Win Sein and officials.

After the ceremony, the minister and the deputy ministers visited the
booth to mark the World AIDS Day 2010.

This year’s motto for World AIDS Day 2010 is “Stop AIDS. Keep the Promise.
Avoid Stigma and Discrimination: Towards Universal Access”. - MNA

http://www.myanmar.com/newspaper/nlm/index.html