Country presentation Myanmar Dr. Min Thwe Program Manager National AIDS/STD Control Programme Department of Health

Map of Myanmar showing locations of HIV Sentinel Surveillance Sites AIDS/STD Teams and HIV Sentinel Surveillance Sites INDIA Myitkyina ¤ BANGLADESH Bahmo ¤ CHINA ¤ Shwebo Muse ¤ ¤ Haka Monywa Lashio Mandalay Myingyan ¤ Kyaington ¤ Pakokku ¤ ¤ ¤ Taunggyi Tachileik Nyaung-U Meikhtila ¤ Sittwe ¤ Magwe LAOS ¤ Loikaw ¤ Pyay ¤ Bago Hinthada ¤ Pa-an ¤ ¤ Myawaddy Pathein ¤ ¤ ¤ Yangon ¤ THAILAND Mawlamyine Ma-u-bin ¤ AIDS/STD Teams Dawei ¤ Teams upgraded to State/Divisional Level Myeik ¤ Kawthaung

Trends of HIV prevalence among urban clinic-based IDUs, HIV sentinel surveillance, Myanmar, 1992 through 2005 Most of the partners have included the prevention of sexual transmission in their approach for IDU Dr. Min Thwe, National AIDS Program, Myanmar

Problem of drug use Different estimates exist 2004 HIV size estimation exercise: 10,000 – 60,000 IDUs UN estimate(AHRN) -30,000 – 100,000 drug users of which 30% are regular drug injectors Geographic – 20 out of 324 townships have IDU problem, located in Kachin and Shan States Most of the partners have included the prevention of sexual transmission in their approach for IDU Dr. Min Thwe, National AIDS Program, Myanmar

Some of the services provided for harm reduction in 2005 26 major drug treatment centers (MOH) 7 social rehabilitation centers under MOSocialwelfare 3 rehabilitation centers under CCDAC 14 Drop-In-Centers > 100 outreach workers and 60 IDU peer-educators are working with IDU 11,500 IDU reached (NGO’s) 150-200,000 condoms have been distributed to IDU Coverage of harm reduction- ? 20% Most of the partners have included the prevention of sexual transmission in their approach for IDU 80% return rate Dr. Min Thwe, National AIDS Program, Myanmar

Opportunities for scale up Problem was well addressed :HIV prevention with a range of harm reduction activities are amongst the highest priority areas in the NSP 2006-2010 Existence of significant stakeholders- Government – MOhealth, MOHome, CCDAC, MOSocialwelfare,etc NGOs- Local & int.: MANA -7 out of 20 IDU high burden township has office AHRN ,ARHP, Burnet, CARE, MDM Success stories in model township – Lashio Working at the field level –usually OK Donors (such as 3DF)have shown interest in supporting Harm reduction activities Most of the partners have included the prevention of sexual transmission in their approach for IDU Dr. Min Thwe, National AIDS Program, Myanmar

Opportunities for scale up..continue Most of the partners have included the prevention of sexual transmission in their approach for IDU Dr. Min Thwe, National AIDS Program, Myanmar

Major Challenges in scaling-up Actual Operationalization of operational plan Need further advocacy Limited services with limited coverage Capacity of stakeholders particularly local NGOs and CBOs need to be strengthen Technical and administrative issues such as supply chain management needs strengthening Human resources will be an issue Most of the partners have included the prevention of sexual transmission in their approach for IDU Dr. Min Thwe, National AIDS Program, Myanmar

Next Steps Need further advocacy Issue Action Who, where When Actual Operationalization of operational plan Activation of HR group under the AIDS TSG Lead initiated by NAP,DTC, CCDAC,UNODC 3rd to 4th ‘07 Need further advocacy Policy visits to successful sites in other countries UNODC and other UN , possibly regional collaboration Late ‘07 documentation of success stories from the model townships CCDAC, NAP, UNODC, LNGOs s.a MANA,& INGOs s.a ARHP,AHRN 3rd Qr ‘07 Limited services with limited coverage Active resource mobilization by NAP,UN and int. stakeholders working with multilateral, and bilateral donors All stakeholders Year round Since only 3D fund is available which is not enough Most of the partners have included the prevention of sexual transmission in their approach for IDU Dr. Min Thwe, National AIDS Program, Myanmar

Next Steps. . continue Issue Action Who, where When Limited services with limited coverage . (Continue) Expand the network of services available and linked to the HR activities VSWs under MOSocialwelfare outreach workers DICs DTCs ’07 Improve the technical Capacity of stakeholders particularly local NGOs and CBOs Technical inputs(counsults) DTCs, UNODC,WHO In-country experts ‘07 Improve the management capacity of above Same as above Financial, supply chain Most of the partners have included the prevention of sexual transmission in their approach for IDU Dr. Min Thwe, National AIDS Program, Myanmar

Next Steps. . continue Human resources will be major issue Issue Action Who, where When Human resources will be major issue Develop human resource development plan in line with NSP and its OP Harm Reduction sub group of AIDS TSG WHO, UNODC Most of the partners have included the prevention of sexual transmission in their approach for IDU Dr. Min Thwe, National AIDS Program, Myanmar