Government policies in Burma that restrict public
health and humanitarian aid have created an environment
where AIDS, drug-resistant tuberculosis, malaria and bird
flu (H5N1) are spreading unchecked, according to a report
by researchers at the Johns Hopkins
Bloomberg School of
Public Health.
In that report authors Chris Beyrer, director of the
Bloomberg School's Center for Public Health and Human
Rights; Luke Mullany, Voravit Suwanvanichkij and Nicole
Franck document the spread of these infectious diseases,
which if left unchecked could pose a serious health threat
to other Southeast Asia nations and the world.
They believe international cooperation and policies
are needed to restore humanitarian assistance to the
Burmese people but caution that new restrictions imposed by
the military junta are making such efforts more difficult.
The full report was presented at a briefing for State
Department officials on March 24 and is available from the
Johns Hopkins Center for Public Health and Human Rights at
www .jhsph.edu/burma. The report is also under review for
publication with the journal Public Library of Science
Medicine.
The report states that Burma reported its first cases
of bird flu among poultry to the World Health Organization
on March 8. However, the ruling junta censored reports of
the outbreak to its own public until March 17, by which
time the outbreak had killed 10,000 more birds, and 41,000
needed to be culled to stem further spreading.
The report documents a long-standing and severe
underfunding of health and education programs in Burma.
Health expenditures in Burma are among the lowest globally,
including an annual budget of less than $22,000 for the
prevention and treatment of HIV among a total population of
43 million people. Much of the country lacks basic
laboratory facilities to carry out a CD4 blood test, the
minimum standard for clinical monitoring of AIDS care. In
2005, 34 percent of tuberculosis cases in Burma were
resistant to any one of the four standard first-line drug
treatments, which is double the rate of drug-resistant
cases in neighboring countries. Nearly half of all deaths
from malaria in Asia occur in Burma. The report also
reveals that 70 percent of anti-malarial pills sold in
Burma contain substandard amounts of active ingredients,
which increases the risk of drug resistance.
"There is a growing humanitarian crisis in Burma. In
our report, we document how the ruling government's
policies have restricted nearly all aid and allowed serious
infectious diseases to spread unchecked," said Beyrer, who
is also an associate professor in the Department of
Epidemiology at the Bloomberg School. "With the global
spread of bird flu, there is a fear that if a human form of
H5N1 were to take hold in Burma, it could potentially
spread unchecked for weeks or months before anyone knew
about it. Uncontrolled spread of any disease, especially an
emerging disease like H5N1, poses a serious health threat
to Burma's populous neighbors, like China and India, as
well as the rest of the world."
The report also documents threats and restrictions to
foreign relief workers and relief groups, including the Red
Cross. Because of the deteriorating situation, the United
Nations Global Fund for AIDS, Tuberculosis and Malaria was
forced to withdraw its five-year $96 million grant
agreement with Burma. Backpack Health Worker Team, an aid
group that provides primary health care services in rural
areas of Eastern Burma and Thailand, is also raising
concerns about its ability to monitor and contain outbreaks
of bird flu and other diseases.
"The Burmese junta is increasing restrictions on
humanitarian assistance and public health while the health
of Burmese people deteriorates, posing a widening threat to
Burma and her neighbors," Beyrer said.
The report was funded by the Center for Public Health
and Human Rights and the
Bill and Melinda Gates Population and Family Health
Institute.
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