Beyond the international spotlight critical health needs in Myanmar remain unmet

On May 2, 2008, Cyclone Nargis, in all its horror, threw Myanmar back into the international spotlight, devastating the Irrawaddy Delta and leaving an estimated 130,000 people missing or dead. Governed by a military regime since 1962 and enduring low-intensity conflict in certain areas, the disaster was the latest blow to a people largely forgotten by the outside world. Meanwhile, chronic and urgent health needs remain unmet throughout the country, compounded by a lack of investment by both the government and the international community. State health expenditure was $0.70 USD per person in 2007, just 0.3 percent of the country's gross domestic product.  The level of international humanitarian aid was around $3 USD per person, the lowest rate worldwide. The selective blindness to countrywide needs, not least in the areas of HIV/AIDS, tuberculosis and malaria, continues to cost the lives of thousands of people year upon year and demands attention.

Nargis prompted an international outpouring of aid, as news of the extent of the disaster trickled out of the country. Within 48 hours of the cyclone hitting, MSF teams began providing emergency assistance to people in the worst affected parts of the largest city, Yangon, and the Delta. Since then, around 750 (rotating) staff has assisted more than half a million people in responding to their emergency needs; providing food, shelter, water, health care, psychosocial support, and relief supplies. The majority of this aid was delivered thanks to the tireless efforts of MSF's national staff, as the regime refused to grant visas for additional expatriate emergency staff for several weeks after the disaster. As the situation stabilized and the number of NGOs present in the Delta significantly increased, MSF was able to hand over many programs. However, adequate assistance remains limited in some harder to reach areas, particularly in the southern parts of Bogaley Township, where MSF continues to work. MSF continues to monitor the nutritional situation in the delta. Sadly, the struggle to get an appropriate level of assistance for Myanmar's most vulnerable people is one that extends throughout the country.

In distinct contrast to the efforts made on behalf of the victims of Cyclone Nargis, the government of Myanmar and the international community have all but ignored HIV/AIDS treatment, a disease that claimed 25,000 lives in 2007 alone. An estimated 75,000 people urgently need antiretroviral (ARV) therapy but less than 20 percent of them can access treatment. As it stands, MSF provides around 80 percent of all freely available ARV treatment in the country (to more than 11,000 people), an untenable and unacceptable situation.  Thus, MSF has had to make the difficult decision to severely restrict admissions to its HIV/AIDS program, while advocating strongly that the government of Myanmar and the international community urgently and rapidly scale-up ARV treatment. 

HIV is just one of a number of treatable epidemics that causes Myanmar to have some of the worst health statistics in Southeast Asia. Malaria remains the number one killer, with deaths in the country equaling more than half of those in Southeast Asia as a whole.  Further, more than 80,000 new tuberculosis cases are detected each year, among the highest rates worldwide, and multidrug-resistant TB is on the rise.

The people of Myanmar cannot wait until the next big disaster for their critical health needs to be recognized; both the government of Myanmar and the international community urgently need to act in order prevent thousands of unnecessary deaths.

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