Myanmar: 20 years of assistance to people living with HIV

In January 2021, Doctors Without Borders began transferring patients into the NAP for treatment. One month later, Myanmar faced political upheaval when the military replaced the elected government. In response to this takeover healthcare workers across Myanmar went on strike.  While the public healthcare system was already in the grip of major staffing challenges, the lack of public spending along with importation blockages also added to the healthcare shortfalls in Myanmar.

The transfer out was put on hold and Doctors Without Borders began to register new patients in our Dawei HIV programme for the first time since 2019. Just a few months later, in June, Doctors Without Borders teams in Dawei received a letter from the regional authorities asking us to suspend all activities. At that time, the Dawei clinic was administering ART to 2,162 people living with HIV. Although Doctors Without Borders managed to restart after a two-week pause, the suspension curtailed the support from other international and local non-governmental organisations for the communities in this district area.  

This year, Doctors Without Borders resumed the handover of HIV patients to the NAP which is once again able to provide ART. However, Doctors Without Borders remains committed, and from 2024, it will work in a Support Model alongside NAP. In Dawei, all patients will complete their transfer by the end of 2023. This marks a huge step in the right direction and the hope is that with the NAP functioning, patients will not have to travel so far to reach a clinic, making adherence to treatment far easier.

Receiving HIV treatment in Myanmar 

For Gay Gay* (name has been changed), who is living with HIV, the availability of clinics has always been one of the most difficult things to manage.

“When I was young and first found out about this disease, I had to deal with a lot of difficulties since there were no clinics or hospitals to go to and receive any treatment. I had to go to another village to receive treatment. I came back to Dawei because the treatment I was receiving was not effective and did not show any good results.”

“I took my first medication since I was 13 and moved to Yangon for high school education. During that time, I have been receiving treatment in Yangon for eight consecutive years,”  Gay Gay* continues.

“Patients living with HIV who are receiving treatments can improve their health and live a normal life just like anybody else. Things have changed now in terms of perceptions of people living with HIV. Receiving proper medical care was challenging before but all of that has changed now because of the availability of more clinics and hospitals providing testing and treatment. It’s easier to go to the clinics and receive treatment now.”

“[Even so] there are a range of challenges living life as an HIV-positive person in Myanmar. Some struggle to make a proper living or livelihood due to their family situations while also taking into consideration transportation when going to clinics,” says Gay Gay*.

The transfer-out and reshaping the project

This time around, the transfer-out looks a little different than the initial handover that was stopped in 2021. Many of the gaps in the public healthcare system remain, particularly in terms of staffing. With limited water and sanitation resources clinics struggle to operate smoothly, despite the support provided by organisations such as Doctors Without Borders.

The population in Dawei is made up of many migrants who work away for long periods of time, like Ko Maung Myint*, who works on a deep-sea fishing operation in Kawthaung.

“In the past, I could get six months’ worth of medicine at a time so that I could work five months away and come back here for one month. I have to travel for work so the National Aids Programme is not convenient for me as it only provides two months.”

Without enough medication, patients will have to return to clinic sites again and again. Movement in many parts of Tanintharyi and in Myanmar is currently very difficult and dangerous, and violent conflict is on the rise again. Healthcare workers and facilities have consistently been targeted in Myanmar. Over 1000 attacks on healthcare have been reported since the coup. ¹

While the NAP is improving, and support from organisations like Doctors Without Borders is assisting in this, the context in Myanmar has a heavy impact on HIV patients.

Without unimpeded supply lines for everyone, including the public system, and without the mobilisation of all the medical resources available in and around Dawei, people on HIV treatment will continue to be affected by a lack of regular medication.

Doctors Without Borders welcomes the chance to continue supporting the NAP clinics to ensure quality of care for HIV patients in Myanmar.

Doctors Without Borders has worked in Myanmar since 1992 and was the first international NGO present in the country. In 1994, Doctors Without Borders began providing care for HIV/AIDS and health education in Yangon, as well as the screening and treatment of sexually transmitted diseases. In 2002, Doctors Without Borders became the first provider of antiretroviral treatment in the country and at one stage ran Myanmar’s largest HIV treatment programme.

Read the article in Burmese.

^{1. Insecurity Insight: https://reliefweb.int/report/myanmar/tragic-milestone-more-1000-attacks-health-care-myanmar-february-2021-military-coup↩}