Myanmar (Burma): Fighting disease in a closed country

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The government spends about US$.12 per person each year on health care, and international aid is limited. In this context, malaria, AIDS, and tuberculosis (TB) remain huge public health problems. Malaria strains are resistant to standard treatments Malaria is the main cause of illness and death in Burma. Last year MSF treated over 100,000 people suffering from malaria in Rakhine, Kachin, and Mon states and Thaninthary district. The strains of malaria prevalent in much of Burma have some of the highest rates of resistance in the world to standard treatments such as chloroquine and FansidarÃ?®. The only effective drugs are combinations using artemisinine derivatives, but they are relatively expensive at about US$2 - $3 a patient. MSF is working to find an affordable source for the drugs and is pushing for such treatment to be adopted as the national protocol. Because resistance is so widespread in Burma, MSF treats all patients with an artesunate/mefloquine combination. AIDS is a growing concern MSF is working against the growing threat of AIDS in Burma through education activities for the general public, condom distribution, and treatment of sexually transmitted diseases (STDs). At eight STD clinics in Yangon (Rangoon), the capital, and in Rakhine and Kachin, MSF treats high-risk groups, including prostitutes and their customers. For prostitutes unable to reach the clinics, MSF makes monthly visits to brothels and provides STD treatment on the spot. A rise in TB has gone hand in hand with the AIDS pandemic. MSF diagnoses and treats TB in Kachin State. MSF is also working to reduce the threat of diarrheal diseases, including cholera, through door-to-door hygiene education and a water chlorination program. MSF has been working Burma since 1992. International staff: 18 National staff: 39