Bangkok Post - October 6, 2001
Larry Jagan

Even the United Nations has acknowledged that Burma is on the brink of an epidemic.

According to their figures, 2% of adults have human immuno-deficiency virus or HIV -- and those figures are at least two years out of date.

The World Health Organisation's figures understate the true picture by at least half, according to Aids specialist Dr Chris Beyrer, a US researcher at Johns Hopkins University.

From his research, using the Burmese government's own figures, he estimated the true extent of Aids in the country is nearer 4%.

His research used the government's figures for pregnant women and young men about to enter the army and found that there were some 3.5% with HIV.

He said if you added the vulnerable groups -- drug users and itinerant workers -- to this, the figure more than doubles, with more than 7% of the population suffering from Aids.

The explosion of the disease in Shan state, however, is even more frightening. There, he estimates, more than 10% of the adult male population is now suffering from HIV.

"That's the worst ever incidence of the disease in the region," he said. "It's on the level of that which hit northern Thailand a decade ago. The difference then was the government recognised it and did something about it, whereas the military junta are allowing this one to rage out of control."

Burma's health minister, Maj-Gen Ket Sein, continues to defend his country's efforts to combat Aids.

"Contrary to the gloomy picture presented in some reports in the Western media, HIV/Aids is not rampant in Myanmar [Burma]," he told a WHO meeting earlier this month.

The government was committed to fighting the disease, he said, and was spending a hundred times more than in 1988 on Aids prevention.

In recent weeks, the military intelligence chief Lt-Gen Khin Nyunt and the head of state Gen Than Shwe have both defended the military government's record on Aids.

The international community -- especially the press -- Gen Than Shwe said did acknowledge the efforts the government was making to combat the spread of HIV/Aids.

Despite this rigorous defence in public, diplomats and UN officials in Rangoon believe the Burmese generals have in fact begun to recognise that the country is facing a major Aids problem.

While for years they have denied it existed at all, now they do admit it, at least in private.

Diplomats believe that more and more soldiers are being diagnosed as HIV-positive, especially those who have been deployed in the border regions neighbouring China and Thailand.

The sea-change in the government's attitude, according to aid workers in Rangoon, started more than a year ago.

Privately at least they recognise the problem and were prepared to discuss it more openly with diplomats and UN agencies.

At the beginning of this year, Lt-General Khin Nyunt told the Myanmar Times that HIV/Aids "is a national cause. If we ignore it, it will destroy entire races".

He said culturally it was difficult for the government to adopt the WHO policy of encouraging the use of condoms, but instead had introduced a mass prevention campaign.

"I personally felt," he said, "that many more needed to understand the warning clearly, so I insisted that they put this on all posters: Aids kills, no cure, no hope."

A leading Rangoon-based businessman, Michael Pun, said the campaign is really beginning to work. "There are small towns in Burma where the words HIV and Aids have been recognised; they say it, they joke about it. They know it."

UN officials and Aids experts, however, fear that this is still not the case. In a study to be published shortly, Dr Beyrer found the level of ignorance among Burmese itinerant factory workers of how Aids was transmitted and how to prevent it "abysmally low".

Dr Beyrer interviewed Burmese workers and refugees along the Thai-Burmese border and found that only 12% of married men and 3% of women knew what a condom was.

"This is unbelievable," he said. "Thais would certainly have got 100% on this test."

There is no doubt that a burgeoning Aids epidemic is sweeping across parts of Burma, not only Shan state. UN aid officials admit privately that there is a major cause for concern around Burma's border areas where drug use and the movement of labour is high.

Along the eastern border with Thailand and the northern border with China, the incidence of HIV has already reached epidemic proportions.

In some parts of Kachin state, particularly where the men-folk have been working in the gem mines, there's been a massive death toll.

According to local Aids workers there are some villages where every family has lost someone to the disease.

" This is only going to escalate," said Dr Beyrer, "unless the government takes it more seriously than it has done."

EU officials are keen that the Burmese authorities realise that the extent of the disease in Burma already is a time-bomb that will explode in the near future if something is not done immediately.

"It's not like other infectious diseases," said one official. "Once HIV gets out of control in the population and spreads, it can't be cured and the genie can't be put back into the bottle."

Acting on HIV is also not so much a matter of money as changing attitudes and taboos. Burma's generals may be beginning to grapple with this -- but if they don't make a more concerted effort it will be too late.

The author is the BBC's regional editor for Asia and the Pacific. He is currently based in Bangkok.

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