AIDS, TB, Malaria and Bird Flu Spread Unchecked in Burma

Diseases Pose Threat to Regional and Global Health

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, MD, MPH, director of the Bloomberg
School's Center for Public Health and Human Rights (
http://www.jhsph.edu/humanrights), Luke Mullany, PhD, Voravit
Suwanvanichkij, MD, MPH and Nicole Franck, MHS, 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 (PLoS
Medicine).

The report states that Burma reported its first cases of bird flu among
poultry to the World Health Organization on March 8, 2006 . However, the
ruling junta censored reports of the outbreak to its own public until March
17— by which time the outbreak killed 10,000 more birds and 41,000 needed to
be culled to stem further spreading.

The report documents a longstanding and severe under funding 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 dollar 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," said Beyrer.

The report "Responding to AIDS, TB, Malaria and Emerging Infectious Diseases
in Burma: Dilemmas of Policy and Practice March 2006" was funded by the
Center for Public Health and Human Rights and the Bill and Melinda Gates
Population and Family Health Institute.