Marwaan Macan-Markar
BANGKOK, Jan 29 2007 (IPS) – International health experts are warning Burma s neighbours that they face more threats from the spread of HIV along the porous borders that they share with the military-ruled country.
The record number of HIV cases in two of India s north-eastern provinces that have Burma as a neighbour offers a troubling sign of what lies ahead, says Dr. Tom Lee, co-director of the Global Health Access Programme (GHAP), based in Los Angeles. Nagaland and Manipur are two states with the highest HIV prevalence rates in India. It is eight percent among women tested at clinics along the border, while it is normally 1 to 2 percent across the rest of the area.
China is also facing a similar crisis along the stretches where its shares Burma s north-eastern border. The HIV prevalence rate is between 1.5 to 2 percent. The Chinese have realised that they have a serious problem from a public health point of view, says Andrew Moss, an epidemiologist attached to the Human Rights Centre at the University of California, in Berkley. The border is completely permeable. Now it is up to the Chinese to deal with it.
Burma has one of the most serious epidemics in Asia, the Joint United Nations Programme on HIV/AIDS (UNAIDS), revealed in its 2006 annual report. There are an estimated 360,000 people living with the killer disease and the national adult prevalence rate for a year was 1.3 percent, it adds. Burma ranks with Thailand and Cambodia as being among the three countries in the region with high annual HIV prevalence rates, with Cambodia having 1.6 percent and Thailand having 1.4 percent.
The warning about Burma fuelling a spike in HIV rates along its international borders was made by the public health experts at the end of a two-day seminar here on infectious diseases in the border regions of South and South-east Asia. Burma s other neighbours are Thailand, Laos and Bangladesh.
This concern is the latest in a line of arguments aimed at getting the spread of killer diseases from Burma to other parts of Asia recognised as an international security threat.
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Such a turn in diplomacy was conveyed in early January, when concerns about HIV from Burma was included in the language of a resolution introduced by the U.S. government at the U.N. Security Council. Burma s generals got away unscathed, since China and Russia came to their defence, casting veto votes against Washington s push for the South-east Asian country to end its human rights abuses.
Including non-traditional security threats, such as narcotics and health issues, in the Security Council resolution convey how serious the problem is, says Dr. Chris Beyrer, director of the Centre for Public Health and Human Rights, at Johns Hopkins University, based in Baltimore. These threats have regional and local security concerns that South Asian and South-east Asian countries will have to consider.
The template for this broadside against Burma was shaped in a September 2005- report, A Threat to The Peace: A Call For The UN Security Council to Act in Burma, that was commissioned by former Czech president Vaclav Havel and South African archbishop and Nobel laureate Desmond Tutu.
Burma has been a primary contributor to the spread of HIV/AIDS in South-east Asia. Because Burma is the heroin supplier for the region, HIV strains that originated there are now spreading to neighbouring countries along the heroin routes, said the 80-page report.
In fact, the inclusion of HIV/AIDS to obtain Security Council scrutiny in Burma placed it apart from other countries that the U.N. s supreme body had been involved in, such as Cambodia, Afghanistan or Rwanda, where conflict among factions and human rights violations had troubled the Council. Problems caused by drugs and HIV spilling out of Burma were as troubling as other factors that required U.N. intervention, like overthrowing a democratic government, conflict among factions, human rights violations and refugee outflows, it added.
The conditions in Burma since that report was released have not changed, says Beyrer, pointing to the country s grossly underfunded health and education systems and that resources are concentrated in the centre not the periphery.
The World Health Organisation (WHO) has ranked Burma as having one of the worst health systems, only one place better than Sierra Leone, which came 191st in a list of countries surveyed. Nearly three-fourth of the country lives below the poverty line, despite the country being rich in natural resources. A large slice of the country s expenses, nearly 40 to 50 percent of the national budget, goes to fund a 400,000-strong armed force.
Consequently, there is very little health care available nor education programmes for people with HIV or vulnerable groups who live along Burma s borders, which are home to the country s ethnic minorities, some of who have rebel groups locked in a separatist struggles with the Burmese army.
As disturbing, says Dr. Lee, is the absence of any surveillance systems to gather credible data of the health situation along the border. These are black zones where international NGOs (non-governmental organisations) are banned from going and the Burmese government does not collect data, either.
The drug routes that run through the areas and the high-risk behaviour, including a rampant sex trade, make the estimated 10 million people who annually cross the Burma-China border vulnerable to the epidemic, says Moss. Burma has created a lot of drug addicted people on both sides of the border. There is no information there to help them.
Better surveillance along borders is needed to keep a track of HIV. You need to have a number of sites located in the area to collect the data, says J.V.R. Prasada Rao, head of UNAIDS Asia-Pacific regional office. This is why migrant communities are recognised as one of the most vulnerable groups.
