Woman holds child infected with AIDS

Burma, like many countries, is struggling to contain the spread of HIV/AIDS, but the task is made more difficult by international pressure on the military government to reform. Economic sanctions translate into a shortage of aid funds, and only a small percentage of seriously ill sufferers are receiving the anti-retroviral drugs that could extend their lives.

James Morris, the head of the World Food Program, visited Burma recently to assess the delivery of food assistance for tens of thousands of children and families. While there, he also got a first-hand look at Burma's HIV/AIDS problem.

"I visited two ladies - a lady (of) 31 who had two children," he explained. "Her husband had died of HIV. She was HIV positive (and) she was terrified about her children's future. I visited another lady. Her husband is dead. She had lost a child to death and her other child had been taken and was being trafficked."

The United Nations AIDS program, UNAIDS, rates Burma's HIV/AIDS situation as serious.

According to Brian Williams, the UNAIDS program representative in Rangoon, as many as two percent of Burma's adults, or 610,000 people, are infected with HIV. Even Burma's military government, which keeps a tight control over the flow of information, puts the figure at 340,000.

Mr. Williams says HIV in Burma is no longer confined to high-risk groups such as intravenous drugs users and sex workers.

"The epidemic is growing. It's slowly spreading from concentrated high-risk groups into the general population," he said. "We know the prevalence is above one percent in pregnant women - that's indicative that it's getting into the general population."

But Burma suffers from diplomatic isolation and economic sanctions, a result of its poor human rights record and its refusal to institute democratic reforms.

Mr. Williams says the resulting lack of international donations means the money to fight AIDS falls far short of what is needed.

The Geneva-based Global Fund collects private and government contributions to fight HIV/AIDS, malaria and tuberculosis, and the money is administered by the United Nations. That includes funds for HIV/AIDS projects in Burma.

Burma is due to receive $98 million from the Global Fund over five years.

Mr. Williams says that is not nearly enough.

"We have roughly estimated - the government roughly estimated in collaboration with international partners - that for 2005-2006, $40 million would be needed per year, and we're far short of that goal," he said.

UNAIDS officials say some 46,000 HIV sufferers in Burma are seriously ill and in immediate need of anti-retroviral drugs, but a shortage of resources means only one thousand are receiving the medications.

Some humanitarian workers in Burma have expressed concern that democracy advocates could pressure the United States to cut the amount of money it gives to Burma's AIDS fight.

The U.S. is the largest single contributor to the Global Fund.

Jean-Luc Lemahieu, chairman of the U.N. Theme Group on HIV/AIDS, says such political pressure on the Burmese government ignores the suffering of people.

"The new pressures now on the Global Fund contributions toward Myanmar are definitely not a positive sign in that regard," he said.

Since formalizing its anti-AIDS program in 2002, Rangoon has made some progress in the fight, despite inadequate funding.

Guy Stallsworthy is the Burma representative for PSI International, a private U.S. aid organization. He says the increasing use of condoms is one positive development.

PSI says 18 million condoms were sold in Burma in 2003. Mr. Stallsworthy expects the 2005 target of 28 million to be achieved easily, and possibly exceeded.

"This is clear evidence of changing behavior in the society - which is a good thing," he noted. "The trend's in the right direction. It's nowhere near enough - it never is - and we're never satisfied, but we're encouraged by the trend."

The United Nations' Mr. Lemaihieu says even this small amount of progress indicates a willingness by the government to tackle the problem.

"It's very clear at this moment it is not a lack of willingness but a lack of resources," he said. "We are not in a position to provide the treatment at the levels which would be required, seeing the needs of this country."

Mr. Lemahieu says it is right to pressure Burma's government to bring about political reform. But, he says, it should not be done at the cost of human lives, and an unchecked AIDS epidemic.