The Irrawaddy Magazine

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• A Political Cure for What Ails Myanmar’s HIV Community
• Time to End an Era of Disastrous Development
• Burma Business Roundup (February 15)

A Political Cure for What Ails Myanmar’s HIV Community Posted: 14 Feb 2014 07:10 PM PST Dr. Chris Beyrer foresees a dramatic scaling up of treatment for people living with HIV in Myanmar, but major challenges remain. (Photo: Jeanne Hallacy) For decades, Myanmar's struggle against HIV/AIDS was held back by the former junta's reluctance to acknowledge the scale of the crisis facing the country. As a leading expert on the disease since the 1990s, Dr. Chris Beyrer of the Johns Hopkins Bloomberg School of Public Health, in the US city of Baltimore, has long been at the forefront of efforts raise the alarm in Myanmar, which he warned in 2005 faced an explosion of HIV comparable to that of the worst-hit parts of Africa. Dr. Beyrer recently spoke with The Irrawaddy's Marwaan Macan-Markar about the current state of Myanmar's HIV crisis in the wake of recent political reforms. Although many things have improved, he says, the country still has vast unmet health-care needs, with 220,000 people living with HIV and only around half of the estimated 120,000 patients requiring anti-retroviral (ARV) therapy receiving it—and most of those in Yangon and Mandalay, the two largest cities. Still, says Dr. Beyrer, the country's newfound openness could have a dramatic impact on how well it can contain the spread of the deadly disease. But, he adds, much remains to be learned about how deeply rural regions have been affected by decades of neglect. Question: It is now nearly three years since President U Thein Sein paved the way for political liberalization in Myanmar. Has this opening made a difference to the tens of thousands of people living with HIV and those vulnerable to being infected in the country? Answer: There is much more freedom of information now. And I think the single biggest change has been the end of censorship and the opening the media for greater and more open discussions. That, of course, has very great implications for HIV and the people with HIV. It has also marked the end of isolation for HIV professionals, and there has been a large increase in international donor engagement. And what we understand is there will be 50,000 new treatment slots in the pipeline [for people with HIV to gain access to ARVs]. Q: How are the country's public health professionals coping with this shift? A: What the people in the Health Ministry and in the national AIDS program say is that, earlier, they were waiting for resources to come, but now that they are coming, there is a big challenge to strengthen the absorptive capacity. They have to be able to handle that volume of increased funding and increased treatment. This is going to be a real challenge. The backbone of the public health system in Myanmar is midwives and nurses, particularly in rural areas. There will have to be a lot of what is called "task shifting," with many more healthcare workers being able to support people with HIV. Q: What shift in policies is required to make the access to 50,000 new treatment slots for people with HIV meaningful? A: Until now, the government's treatment program had been accessible to people with HIV when it is very late. The levels of the CD4 [the white blood cell that targets the virus] count calculations had been so low that people have full-blown AIDS before they are started on therapy. And that is not good. It is much better to start earlier, when their immune system could recover and they can benefit from the treatment. And that is what MSF [humanitarian aid organization Médecins Sans Frontières]was trying to do during all these years, since it has been a major treatment player. About half the people being treated were treated through MSF. Q: But even this expansion of treatment and care seems to be concentrated in urban areas, as before. How worrying is it that HIV-related care is still limited in large stretches of the country, in ethnic areas shattered by conflicts? A: [The problem is] not just in the conflict zones, but also in the less medically served rural areas, where we still do not have a good handle on what the HIV prevalence rate is. For example, if you look at India, the states with the highest HIV rates are Nagaland and Manipur [on the Myanmar-India border]. And if you look at the [Myanmar] side of Nagaland, there is no HIV care program. And we know that if it is high on the Indian side, it is certainly as high on the [Myanmar] side. There is no treatment capacity there, no laboratory capacity, so you know there are whole parts of the country that have not been reached for HIV testing. So I think one of the things we hope for in this new period of openness and transparency, and as the medical information and health system improves, is that we will start to get a better assessment of HIV prevalence rates. I don't think anybody knows what the exact figure is. But what they are reporting now is a low prevalence rate. Q: The HIV prevalence rates were a very politically sensitive issue when the country was under the junta. What was it like for your contacts in the Health Ministry during military rule? A: It was terrible for them. They were isolated. They knew the country had a very severe epidemic, but people in the ministry were under pressure. A very senior official in the ministry told me he was once ordered by a general to lower the HIV rates, because [Myanmar] had to have a lower infection rate than Cambodia. Q: What year was that? A: It could have been either 2003, '04 or '05. Q: How about you? Your research on HIV was also not well received by the military regime. A: Yes. We had done an assessment of the epidemic in 2000, and our estimates were vigorously attacked by the government. And then, since the political liberalization, one of the people involved in that attack came to see me in Baltimore—he came to my office out of the blue. I didn't know who he was, but he said he was visiting the US as a scholar. And he came to apologize. He told me he was sorry and that I was right, but they had been ordered to attack me. It was nice to be right, but it didn't help all those people with HIV in the country. This story was first published in the February 2014 print edition of The Irrawaddy magazine. The post A Political Cure for What Ails Myanmar's HIV Community appeared first on The Irrawaddy Magazine.

Time to End an Era of Disastrous Development Posted: 14 Feb 2014 07:00 PM PST Paving the way to a prosperous future? (Image: Sai Soe Kyi) In Myanmar, there are few things people dread more than the sudden appearance of rich businessmen in their town or village. Ever since the country's military rulers abandoned socialism in the wake of the 1988 pro-democracy uprising, well-connected cronies and other business partners of the all-powerful generals have been almost as feared as the men in uniform themselves. To stay in power, the hated regime put the whole country up for grabs, and if someone with money or influence wanted the land your family had lived on for generations, it was theirs for the taking. Many things have changed in Myanmar over the past few years, but unfortunately, this isn't one of them. Land grabs and forced displacement are still an inescapable fact of life for many of the country's citizens, and precious little has been done to improve the situation. There are many examples of "development" in Myanmar turning into unmitigated disaster, but none is worse than what has happened in Hpakant over the past 20 years. Famous for its high-quality jade, this region of Kachin State has been reduced to a wasteland since a ceasefire agreement was signed by the government army and the ethnic Kachin Independence Organization in 1994, paving the way for an all-out assault on its jade-studded mountains. Fueled by Chinese demand (and largely controlled by Chinese business interests), the rape of Hpakant has left it deeply scarred. Entire mountains have been leveled and whole new lakes—filled with polluted water—have been formed, all to enrich "investors" and corrupt officials. In exchange for the wealth beneath their feet, the people of Hpakant have received nothing—except rampant crime and drug abuse, which rot their communities the way that unregulated mining has eaten away at the region's landscape. There is more than one guilty party in this sordid tale of social and environmental degradation, but the chief player is the Union of Myanmar Economic Holdings Ltd. (UMEHL), a military-run conglomerate that still dominates large parts of the national economy, despite the transition to quasi-civilian rule nearly three years ago. Aung Zaw is founder and editor of the Irrawaddy magazine. He can be reached at aungzaw@irrawaddy.org. Needless to say, the people of Myanmar will never see any benefit from this wholesale theft of national treasure. Once it is extracted from the ground, much of Hpakant's jade is smuggled across the country's northern border, while the revenues that remain in the country end up in private hands or are used to finance a deadly conflict that further victimizes the powerless people of Kachin State. In some ways, Dawei, in Myanmar's far south, is a very different story. Instead of natural resources, its chief asset is its geography: Located some 350 km west of Bangkok and possessing a deep-sea port, it is ideally situated to become a major transport hub for the region. To realize this dream, billions of dollars will have to be poured into Dawei (whereas in Hpakant, billions have been extracted). Most of that money will come from Thailand, which also hopes to attract Japanese investment in the planned Dawei Special Economic Zone (SEZ). The Myanmar government has boasted that the project will not only transform a coastal backwater into an economic powerhouse employing thousands of people, but will also become an engine for the national economy. The trouble is that none of this can be done without exacting huge social and environmental costs, and the signs so far are that the government has learned little from the travesties of the past about how to mitigate the negative impact of large-scale economic development. In Dawei, as in Hpakant, people have been forced to leave their homes, often with inadequate compensation. Fears of massive damage to the environment from the construction of an industrial zone that will spew toxic chemicals have never been properly addressed. And a hasty ceasefire agreement with former adversaries active in the area (the 4th Brigade of the Karen National Liberation Army) offers no real promise of lasting peace. Strangely, the "experts" and "analysts" who have been flocking to Naypyitaw to applaud the government's economic reforms have been silent on these issues, as if they assume that the "new and improved Myanmar" won't repeat the mistakes of the past. But what is to prevent Dawei becoming a wasteland like Hpakant? Certainly there are no laws in place to protect people's right to their land, or the land itself from the ravages of blind greed. President U Thein Sein, who won praise for suspending the Myitsone hydropower dam in Kachin State—another megaproject designed to benefit a neighboring country at the expense of local people—has also acted as if he sees no need to seriously examine the impact of large-scale foreign investment in Myanmar's economy. It's unlikely that he is unaware of the problems, so we can only conclude that he doesn't care enough about them to exert any political will to find solutions. Since the opening of Myanmar, everyone, including Western governments, has talked about the country's rich natural resources and its vast economic potential. There is no doubt that as Asia's last frontier, Myanmar is ripe for development in many sectors, including energy, mining, tourism, and agriculture. But to realize its true potential, the country will need to radically change the way it does business, away from practices that benefit the powerful while imposing huge burdens on ordinary people. Myanmar has long been the poorest country in a fast-growing region, weakened by a predatory state and vulnerable to exploitation by better-off neighbors. So changing the way Myanmar develops its economy is not just about doing right by its citizens—it is also about building a stronger nation. Aung Zaw is the founding editor-in-chief of The Irrawaddy. This story was first published in the February 2014 print edition of The Irrawaddy magazine. The post Time to End an Era of Disastrous Development appeared first on The Irrawaddy Magazine.

Burma Business Roundup (February 15) Posted: 14 Feb 2014 06:07 PM PST Burma's Tourism Industry Must Diversify to Grow Burma's tourism business is heading in the wrong direction and needs refocusing, an industry leader said. The country is catering too much to big pre-paid tour groups when the future really lies with independent travellers and families, said Union of Myanmar Travel Association Vice Chairman Thet Lwin Toe. "It is true that [Burma] is increasing tourism, but the real profit is to be gained from independent travellers and a change of direction will help the owners of small enterprises," he was quoted by industry magazine TTR Weekly as saying. "We must try to make the cake bigger. If you can't expand your market, you will eventually lose." There is evidence that the tour group market is already declining in Burma but the industry has not geared up to cater for independent travellers, Thet Lwin Toe warned. Bangkok-based TTR Weekly reported the tour group market is losing share when compared with other segments, while little is being done to develop niche or special interest tourism. It said it would take several years to address Burma's lack of quality tourism accommodation. Germany Cancels US$741 Million Debt to Aid Burma's Economy Germany has cancelled US$741 million of debt owed by Burma since the days of the former military regime. The cancellation covers half of the total debt to Germany. The Berlin government has agreed with Naypyidaw that the remaining $741.5 million can be repaid over the next 15 years at the low interest rate of 3%, Burma's state radio reported. The first repayment instalment can be delayed for another seven years. The debt restructuring plan was agreed during the visit to Burma by German President Joachim Gauck. It is part of a wider agreement reached between Burma and other countries of the so-called Paris Club to whom Naypyidaw owes money in order to help with resuscitating of the Burmese economy. Gauck met President Thein Sein and other government leaders as well as opposition leader Aung San Suu Kyi. Muse Listed as Burma's Richest Cross-Border Trading Town Business with China through the frontier town of Muse accounted for three quarters of all Burma's cross-border trade over the first ten months of this financial year, according to Chinese news agency Xinhua Two-way trade through Muse between April and January totalled US$3.1 billion, Xinhua quoted statistics publish by the Naypyidaw government. The total value of trade across all 14 official border trading points with Burma's four land neighbors—Bangladesh, India, Thailand and China—in the ten-month period was US$4.1 billion. The approved border trade points include three other links with China's southwest Yunnan Province—Lewjie, Chin Shwe Haw and Kanbiketee, said Xinhua. Singapore Leads Foreign Investment in Burma in January Tiny Singapore was the biggest country investor in Burma in January, Eleven Media reported, quoting the Directorate of Investment and Company Administration (DICA). Businesses from the city state are investing in hotels and other property development, tourism, agriculture and the energy market. Figures for January indicated a total of US$1 billion foreign investment for the month, with Singapore in top place, followed by Hong Kong, South Korea and Japan, the DICA said. The focus of investment by the leading four countries was in the garment manufacturing, beverages and telecommunications. Hotel development and tourism continues to attract large investment, DICA said, and Singaporean companies are the biggest contributors, with 14 firms in the past year spending around US$880 million. Agencies Sending Burmese Workers Abroad Under Closer Scrutiny Recruitment agencies in Burma that send Burmese workers abroad are to face closer scrutiny following repeated complaints of mistreatment of workers, especially in Thailand. The government will take action against unscrupulous employment agencies, the Deputy Minister for Labour, Employment and Social Security Htin Aung told Parliament this week, The Myanmar Times reported. Some agencies have been accused by human rights NGOs of working in collusion with employers to unlawfully take passports and money off workers, effectively putting them in labor bondage. Burma now has so-called labor affairs officers attached to its embassies in Thailand, Malaysia and South Korea, said Htin Aung, and this service might soon be extended to the embassies in Kuwait and Singapore. These labor officers will be available to help migrant Burmese workers who face problems, he said. Agencies providing jobs abroad are supposed to advise migrant workers on their labor rights in the country they are traveling to, Htin Aung said. Rangoon Seeks Foreign Firms to Build Low-Cost Housing Foreign companies are being invited to bid for contracts to build low-cost housing in Rangoon. The city's development committee is planning housing projects in several townships around Rangoon, The Myanmar Times reported this week. Firms interested in winning contracts have until the end of March to place bids, but must first lodge a US$50,000 bond, said the committee. The Rangoon authorities have been accused of placing too much emphasis on high-end development in the city, such as expensive condominiums and shopping malls, while ignoring the housing needs of people on low incomes. Rangoon has seen a surge in population and more rural people seeking jobs amid the economic boom. The post Burma Business Roundup (February 15) appeared first on The Irrawaddy Magazine.

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