Episode: "Street Life"

Myanmar

Country Background

Myanmar, or Burma as it is also called, is a former British colony that has spent most of its independent years under military governance. In 1990, roughly 30 years after General Ne Win’s junta took control of the state, multiparty elections were held in Myanmar. The primary opposition party, the National League of Democracy (NLD) won, but was not acknowledged by the junta.

In spite of continued political agitation from the NLD and occasional clashes between pro-Democracy activists and the government, Myanmar has remained under military control for the last 13 years. Human rights abuses have been widely documented during this time, but as a medical humanitarian relief organization, MSF has concentrated on the insidious threat to the Burmese people posed by infectious disease.

Fighting a Drug-Resistant Killer in Myanmar’s Border Regions

Since the late 1980s, public spending on health care in Myanmar has declined rapidly, creating a niche for private clinics that are far too expensive to benefit the majority of the population and exist only in urban areas. In Myanmar’s border regions, marginalized ethnic groups and migrant workers experience the brunt of the lack of public health care, most frequently in the form of tuberculosis (TB), HIV/AIDS, and the nation’s biggest cause of mortality, malaria.

In this episode, Dr. Anne Pittet is working on an MSF malaria intervention in the Dawei district, which borders Thailand. Common malaria treatments such as chloroquine don’t achieve results in the region due to growing resistance to the drug – a rapidly growing problem in many countries. Chloroquine was created in 1934. Research and development into new malaria drugs, however, has been virtually nonexistent in the last twenty years because even though malaria kills between one and two million people per year, it does not provide a profitable market for the pharmaceutical industry.

The most drug-resistant strains of malaria in the world are found in the border regions of Myanmar, so MSF’s objective in Dawei is to introduce new methods of diagnosis and treatment that will be effective against the disease.

Project Update

Since the “Street Life” episode was filmed, MSF has switched to artemisinin-based malaria drugs throughout its treatment programs in Myanmar. These are the most effective drugs for resistant malaria: they act quickly, are well tolerated, and have demonstrated no resistance to date.

In Dawei, the MSF malaria control program aims to improve the medical management and prevention of malaria, increase awareness of the community regarding malaria prevention, and diagnose and treat the disease through hospitals and health centers, using mobile clinics to reach people in isolated areas. As of July 2003, MSF was supporting five health centers in Dawei, three public hospitals and three mobile clinics, as well as one private hospital, treating a total of 21,470 people.

To learn more about the ongoing fight for better malaria treatment for the world’s poor, click here.