In this policy forum published by PLoS Medicine, Chris Beyrer and colleagues assess the health concerns facing Myanmar, and outline policy options for controlling the threat of tuberculosis (TB) and other infectious diseases.

About 40 per cent of Myanmar's population are infected with TB. The disease here is linked with HIV/AIDS — 60–80 per cent of HIV patients also have TB.

A Global Fund grant to Myanmar in 2004 provided much-needed funding to tackle the country's HIV/AIDS and TB epidemics. But allegations of human rights violations by Myanmar's military regime led to the termination of the grants a year later.

The increasing political instability has led to two opposing reactions: a steady stream of humanitarian agencies withdrawing from the region because of the regime's restrictions on the mobility of health workers or humanitarian agents; and calls for even greater outside help to overcome the country's poor health and research sectors, lack of prevalence data, dearth of skilled health workers and widespread corruption.

Beyrer and colleagues highlight the fact that Myanmar's health problems are filtering through its borders into neighbouring Bangladesh, China, India and Thailand. On the Thai border, for example, multidrug-resistant TB accounts for 6.5 per cent of TB cases, compared with 0.9 per cent elsewhere in Thailand.

What should be the policy priorities for health work in Myanmar today? Beyrer and colleagues propose cross-border approaches, the use of independent media for health education and information, and a network of support from international and nongovernmental organisations.

Chris Beyrer is professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, United States. His co-authors are medical researchers in hospitals and universities across the United States.

Link to full article in PLoS Medicine