World AIDS Day: A partnership between experts to end the HIV epidemic in Myanmar 30.11.2018

The Union, a long-standing partner in Myanmar, serves HIV patients as specialist health care providers. Recruiting people living with HIV (PLHIVs) to work as volunteers in clinics and in their own communities, paves the way for The Union to reach and support PLHIVs or who are at risk of contracting the virus.

A PLHIV volunteer facilitates delivery of ART to a patient in the IHC clinic in Mandalay General Hospital. Photo: The Union

The International Union against Tuberculosis and Lung Disease (The Union) is managing an integrated HIV care programme in Myanmar, with support from the Global Fund since 2011. The Integrated HIV Care (IHC) programme is running 16 antiretroviral treatment (ART) centres and 33 decentralised sites for HIV/AIDS care and treatment in Mandalay, Sagaing, Magway and Shan states and in Yangon Region in collaboration with the Ministry of Health and Sports (MOHS). Programme Coordinator Dr. July Moe explains The Union’s partnerships model.

“We work in, by and with the public sector. This means that we do not run our own clinics in parallel to the MOHS healthcare services. Instead, we provide support to the public sector, in particularly the National AIDS Programme (NAP)”, she said.

The Union’s support ranges from human resources management and logistics for ART, to technical support for the NAP, for instance offering training to doctors, paediatricians and nurses.  The IHC clinics are located inside public sector health compounds and The Union staff is working to assist government staff on-site.

A PLHIV patient is supported with care and treatment at an IHC clinic by The Union medical doctors. Photo: The Union

By October 2018, The Union had 31,252 active follow-up patients on ART. Normally, HIV patients are treated at The Union’s IHC clinics at first. Once a patient has stabilised, he or she can be transferred to the care of a decentralised site closer to the patient’s home. There, he or she will continue to manage his or her HIV status by receiving ART from a decentralised site. Prioritised patients – including those co-infected by HIV and tuberculosis and for pregnant women needing prevention of mother-to-child HIV transmission – who are unable to travel to ART clinics for initial treatment, may be able to access treatment at decentralised sites under the supervision of a township medical care officer.

A PLHIV volunteer network. Photo: The Union

The Union also partners with the private sector and with the patients themselves to help halt and reverse HIV/AIDS in Myanmar.  The Union’s medical officers recruit PLHIVs at their clinics to take part in a network of peer volunteers. The network now consists of more than 290 PLHIVs in 27 volunteer networks. At the clinics, the volunteers work with The Union’s medical officers to assist the hospital staff by registering patients, provide counselling and more. The Union trains the volunteer network to deliver counselling, knowledge and support also to the wider community. Volunteers are central to try to overcome the perhaps biggest challenge The Union is facing: missing patients. The IHC programme has a system in place to trace these patients.

“If a patient stops showing up for his or her ART, we try to trace his or her whereabouts to avoid that he or she stops the treatment. For migrant and mobile populations, this is particularly difficult, as these groups of people normally don’t inform health staff when they leave to take up work in another place. We rely on the volunteers to try to trace people who drop out from treatment”, she says.  If the volunteers succeed in finding the ‘missing patients’, they attempt to secure access to ART in their new townships.

The Union’s training of volunteers to carry out clinic- and community-based tasks to tackle HIV/AIDS is being encouraged by the Government, who has asked The Union to attract and train more community volunteers.