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Although Myanmar has approximately 9,000 new cases of
drug-resistant TB annually, the World Health Organization (WHO) estimated in
2012 that only 800 patients had ever received TB treatment. During 50 years of
military rule that ended two years ago, Myanmar’s health system was “buried.”
The military government spent as little as $1 per person on healthcare
annually, and provided few trained health personnel and supplies. This resulted
in escalating TB, HIV/AIDS, malaria, and infant mortality rates.
Although treating normal TB required only a simple,
inexpensive drug regimen, if patients misused anti-TB drugs or failed to take
medications as scheduled, multidrug-resistant TB (MDR TB) could develop. The
MDR TB treatment cost 100 times more, takes much more time, and could be highly
toxic; for these reasons, MDR TB patients often gave up treatment.
The new “quasi-civilian” government has begun to address the
urgent threat presented by MDR TB by quadrupling health spending and building
ties with the international health community. Unni Karunakara, international
president of Doctors Without Borders, stated that the political willingness to
improve Myanmar healthcare was evident, though health spending in Myanmar still
fell far short of the need. This week, Doctors Without Borders, WHO, and
Myanmar’s Ministry of Health hosted a two-day symposium to determine how to
speed up MDR TB diagnosis, improve patient care, and increase patient access to
shortened treatment regimens that use less toxic medications.
Myanmar also lacked HIV drugs and had an annual HIV/AIDS
mortality of 18,000 people; many of these deaths were due to TB that
overwhelmed the weakened immune systems of HIV-infected people.
