In an official visit to Myanmar, UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle called for greater integration of HIV into the broader health and development agenda. During her interactions with government officials, parliamentarians, women leaders and civil society representatives, Ms Beagle also stressed the importance of a 'people-centered' AIDS response - making sure that systems and services are set up based on people's needs and realities.
After 50 years of military rule, Myanmar is experiencing greater political freedom and economic change, including an influx of foreign aid and private capital into the country. This presents opportunities for reforms that can have a direct impact on the lives of people living with and affected by HIV. In May 2013, Myanmar became the first country from Asia and the Pacific to successfully apply to the Global Fund's new funding model for HIV, TB and malaria. The Global Fund allocated more than US$161.2 million for HIV for 2013-2016.
"This is a great era of opportunity for the people of Myanmar and for the AIDS response," said Ms Beagle. "Aligning and coordinating HIV efforts within an integrated approach to health and development will save lives, reduce costs and get the most out of the money invested," she said. For example, noted Ms Beagle, integrating services for the prevention of new HIV infections among children into maternal, newborn and child health programmes will produce greater results than if they are considered as stand-alone initiatives and systems.
There are an estimated 200 000 people living with HIV in Myanmar and the country has the third highest HIV prevalence in the Asia-Pacific region at 0.47%. HIV prevalence among key affected populations is even higher. According to national estimates, in 2012, the HIV prevalence among people who use drugs was 18%; HIV prevalence among men who have sex with men and among female sex workers was 8.9% and 7.1% respectively. Coverage of antiretroviral treatment has grown from 12% in 2008 to 43% in 2013. While this represents an impressive scale-up, additional concerted efforts and resources are required to ensure increased and sustainable access to treatment.
At Mingalardon Specialist Hospital, one of the largest public providers of antiretroviral therapy in the country, Ms Beagle reiterated the need for a people-centred approach to ensure greatest access to HIV services. Dr Htin Aung Soe, HIV treatment specialist, highlighted how the AIDS response has had a positive impact in strengthening the health system as a whole.
Addressing stigma and discrimination
In the various stakeholder discussions, punitive laws, policies and practices leading to heightened stigma and discrimination towards people living with HIV were underlined as critical barriers to accessing HIV services and hindering progress on AIDS in the country.
Representatives of key affected populations argued for a holistic approach to HIV. One that goes beyond the provision of services to focus on ensuring an enabling environment that guarantees equal access to HIV services.
UNAIDS Global Advocate for Zero Discrimination Daw Aung San Suu Kyi discussed with Ms Beagle a range of issues in relation to stigma and discrimination, inequities and the empowerment of women. Aung San Suu Kyi emphasized in particular the ongoing need for education and awareness raising on HIV to encourage open discussion and to prevent new HIV infections.