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In Burma only one in five people with HIV are treated

Phoebe Kennedy
Tuesday 30 November 2010 20:00 EST
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The first formal visit the Burmese democracy leader Aung San Suu Kyi made on her release from house arrest last month was not to an ambassador's residence or a smart United Nations office, but to a tin-roofed HIV/Aids shelter in one of Rangoon's poorest districts.

Choosing to highlight the plight of one of the most neglected groups in Burmese society was characteristic of Ms Suu Kyi; her eagerness to listen to the voices of the poor and sick stood in sharp contrast to the style of Burma's ruling generals, who prefer to remain aloof in the palaces of their remote, newly-built capital.

Ms Suu Kyi chatted with many of the 80 residents of the shelter, which is funded by her National League for Democracy Party and through her own personal donations. Gaunt faces gazed up at her she clasped hands and listened, her warmth evocative of Princess Diana's visit to an HIV/Aids centre in London two decades ago.

In the Rangoon shelter, residents receive food, reed mats to sleep on, HIV/Aids education and help in accessing treatment. It is a rare haven in a country where attitudes towards HIV are firmly rooted in the past. People infected with HIV are often considered deviant, and most don't come forward for testing. For a long time, government officials claimed that Burma's sexual conservatism and strong moral code of abstinence before marriage and fidelity after could protect the country from the epidemic. Instead, it has one of the worst HIV/Aids problems in Asia.

The visit of 65-year-old Ms Suu Kyi just days after her 13 November release threw the spotlight on an issue that Burma's military leaders have for a long time tried to keep hidden. It was attention the junta did not enjoy.

The next day, local government officials came to the refuge to order the eviction of the residents, saying they would no longer approve requests for overnight guests that are legally required for anyone in Burma if they wish to stay the night away from their home. A week later, after a mass of negative publicity, the order was reversed.

"I am greatly relieved and so are the patients," said Ko Yarzar, the shelter's manager. He said health authorities had offered to relocate the patients to a state-run HIV centre but the patients refused to move, saying their shelter not only offers medical care, food and accommodation but "warmth and affection that no other centre can provide".

Phyu Phyu Thin, a well-known HIV/Aids activist and NLD supporter who founded the shelter in 2002, told The Irrawaddy magazine that the authorities apologised when extending the permit. "In my opinion, the authorities retreated because media inside and outside of Burma, as well as other organisations, focused on the issue," she said.

An estimated 240,000 people in Burma are infected with HIV virus, a figure that comes nowhere close to the numbers infected in parts of Africa. But it is the yawning gap between those who need treatment and those who receive it that marks the country's HIV tragedy. Just a fifth of those in need of anti-retroviral treatment actually get it. The remainder are dying, or waiting to die.

The priorities of the regime lie elsewhere. The government spends nearly half of its budget on defence, but just 0.3 per cent of GDP on healthcare. Of that, only a tiny amount goes towards HIV/Aids.

A key donor in the health sector, the Global Fund to Fight Aids, Tuberculosis and Malaria, pulled out of the country in 2005 citing political interference, but earlier last year approved a new grant of around £100m to fund HIV/Aids treatment in Burma over five years.

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