Myanmar's military government has acknowledged its serious HIV/AIDS problem in the two years since Crisis Group published a briefing paper.^[fn]See Crisis Group Asia Briefing, Myanmar: The HIV/AIDS Crisis, 2 April 2002.Hide Footnote  This has permitted health professionals, international organisations and donors to begin a coordinated response. The international community has boosted funding and shown more willingness to find ways to help victims and counter the pandemic. Some government obstacles have been removed although the regime's closed nature is unaltered. The opposition National League for Democracy (NLD), which has generally opposed aid involving contact with the junta, has supported many HIV/AIDS steps because of the humanitarian imperative. The urgent need now is to boost the local staff capabilities and make more effective use of the money flowing into the country. In the process civil society and small NGOs and other local organisations can be fostered that can eventually help prepare a democratic transition.

Significant problems remain. About 1.3 per cent of Myanmar's^[fn]A note on terminology. This report uses the official English name for the country, as applied by the UN, the national government, and most countries outside the U.S. and Europe. This should not be perceived as a political statement, or a judgment on the right of the military regime to change the name. In Burma/Myanmar, "Bamah" and "Myanma" have both been used for centuries, being respectively the colloquial and the more formal names for the country in the Burmese language.Hide Footnote  adults are believed to be infected with the virus, one of the highest rates in Asia. Government spending on health and education is perilously low, and the economy has been grossly mismanaged by the military. HIV continues to present serious risks to the population, to security and to Myanmar's neighbours.^[fn]See Crisis Group Issues Report N°1, HIV/AIDS as a Security Issue, 19 June 2001.Hide Footnote

Critics of assistance to Myanmar have said the government would misappropriate any funds. This has not been the case so far. Increased international contact with the government on this issue has pushed it towards more pragmatic positions and opened up program possibilities that were not available in 2002. HIV prevention and treatment suffered then from a lack of resources and knowledge. Now the main constraint is the implementation capacity of groups involved in HIV prevention and AIDS care. The critical steps that need to be taken include:

• expansion of assistance through all available channels to border areas where the HIV problem is particularly intense;
   
• expansion of national capacity to deal with HIV, including more technical aid and training;
   
• expansion of support for local and community-based organisations to strengthen their capacity and enable them to be larger providers of grassroots education, counselling and treatment;
   
• more effective outreach to minority and ethnic communities with HIV/AIDS prevention education as well as counselling and treatment;
   
• streamlining of disbursement, evaluation and monitoring procedures for funding; and
   
• expansion of harm reduction programs.

The political situation in Myanmar is extremely uncertain. Former Prime Minister Khin Nyunt is now under arrest on suspicion of corruption. He had chaired a key government committee on health issues and had supported greater involvement of international NGOs in fighting HIV. It is now very unclear whether further steps forward will be possible.

Yangon/Brussels, 16 December 2004