Burma junta faulted for rampant diseases

by Yasmin Anwar, Media Relations

http://www.berkeley.edu/, 28 June 2007

As Congress debates extending political and economic sanctions against Burma's military regime, a new report from the University of California, Berkeley, and Johns Hopkins University documents how decades of repressive rule, civil war and poor governance in the Southeast Asian country have contributed to the spread of HIV/AIDS, tuberculosis, malaria and other infectious diseases there.

Extreme travel restrictions imposed by the Burmese government have forced Médecins San Frontières (Doctors without Borders) in France and the multinational Global Fund to Fight AIDS, Tuberculosis, and Malaria to pull out of the country, and have severely curtailed the work of the International Committee of the Red Cross, according to the report co-authored by researchers from UC Berkeley's Human Rights Center and The Johns Hopkins Bloomberg School of Public Health.

The report was released today (Thursday, June 28), and can be viewed online.

U.S. Senators Dianne Feinstein (D-Calif.) and Mitch McConnell (R-Ky.) introduced a bill on June 15 that would extend the U.S. sanctions, set to expire July 26, against Burma because of continued human rights violations. The sanctions include a ban on imports from Burma and visa restrictions for members of the government.

While 40 percent of Burma's annual spending goes to the military, only 3 percent goes to health care, according to the report. The Burmese military junta spends 40 cents per citizen each year on health care, compared to the government of neighboring Thailand, which spends $61 per citizen a year, the report says.

"Military expenditures should be reallocated to support health care delivery," said Eric Stover, faculty director of UC Berkeley's Human Rights Center. "Burma is not at war with its neighbors, and its security is more profoundly threatened by the rise of drug-resistant malaria and tuberculosis, and by emerging infectious diseases such as avian influenza, than from external military threats."

Stover and fellow researchers from the Human Rights Center and Johns Hopkins launched the project last year to discover the roots of Burma's dire disease epidemics and to determine whether international aid could be delivered in a way that is responsible and effective.

For the report, researchers traveled to the large Burmese city of Yangon, formerly known as Rangoon, and to Burma's borders with China, Thailand, Bangladesh and India. From health clinics in those regions, they gathered data on HIV/AIDS, tuberculosis, malaria and lymphatic filariasis, and interviewed aid officials and health care workers.

The researchers found that the widespread distribution of counterfeit antimalarial drugs, coupled with the rise of drug-resistant malaria and tuberculosis, pose a major health threat to the Burmese people, especially those living in border areas where health care is scarce, if available at all.

Burma has one of the world's highest tuberculosis rates and is home to more than half of Asia's malaria deaths. Those most vulnerable to disease epidemics there are ethnic and religious minorities, displaced farmers, commercial sex workers and intravenous drug users.

Drug trafficking has also played a major role in the spread of HIV/AIDS among intravenous drug users and commercial sex workers, the report says. In addition, aggressive campaigns by the Burmese government and the United Nations Office on Drugs and Crime to eradicate poppy cultivation and heroin production have led to the displacement of tens of thousands of families who have no alternative source of livelihood. Many have relocated to the Thailand border, where communicable diseases are thriving. Meanwhile, methamphetamine production in Burma's border regions is rising.

"Decades of neglect by Burma's military government have turned the country into an incubator of infectious diseases," said Chris Beyrer, a co-author of the report and professor of epidemiology at The Johns Hopkins Bloomberg School of Public Health. "While the health situation deteriorates, the junta continues to limit the ability of international relief organizations to reach those most in need."

In 1990, Burmese voters elected Aung San Suu Kyi, 62, as their democratic leader. But the military rejected the election results and placed her under house arrest, where she has remained for most of the last 17 years. During the 1990s, international relief organizations began responding to Burma's neglect of its citizens' health. By 2004, 41 aid organizations were operating in Burma with a combined budget of about $30 million, and tens of millions of dollars more aimed at fighting infectious diseases, according to the report.

But that changed in 2005 when Burmese government authorities imposed travel restrictions on international organizations. In October 2006, the European Union, along with Australia, Britain, the Netherlands, Norway and Sweden, launched the "Three Diseases Fund" to fight infectious diseases in Burma. Yet the fund, now worth $99.5 million, faces formidable challenges, including the critical task of ensuring that aid reaches Burma's border regions and other areas where infectious diseases are rampant and severe.

The report recommends that:

0. The Burmese government develop a national health care system in which care is distributed effectively, equitably and transparently
0.
0. The Burmese government increase its spending on health and education to confront the country's long-standing health problems, especially the rise of drug-resistant malaria and tuberculosis
0.
0. The Burmese government rescind guidelines issued last year by the country's Ministry of National Planning and Economic Development because these guidelines have restricted organizations such as the International Committee of the Red Cross (ICRC) from providing relief in Burma
0.
0. The Burmese government allow the ICRC to resume visits to political prisoners without the requirement that ICRC doctors be accompanied by members of Burma's Union Solidarity and Development Association or by other junta representatives
0.
0. The Burmese government take immediate steps to halt in eastern Burma the conflicts and human rights violations that are displacing an unprecedented number of people and facilitating the spread of infectious diseases in the region
0.
0. Foreign aid organizations and donors monitor and evaluate how aid to combat infectious diseases in Burma is affecting domestic expenditures on health and education
0.
0. Relevant national and local government agencies, United Nations agencies and non-governmental organizations establish a regional narcotics working group that would assess drug trends in the region and monitor the impact of poppy eradication programs on farming communities
0.
These agencies also collaborate more closely, sharing information, to lessen the burden of infectious diseases in Burma and its border regions, and to develop a regional response to the growing problem of counterfeit antimalarial drugs

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