Myanmar's HIV/AIDS epidemic -- estimated at 1.2 percent of the population -- is considered one of the most serious in Asia.

But HIV/AIDS is just the latest problem to afflict this chaotic and corrupt country, which produces much of the world's opium and has long suffered from social problems connected to its massive drug smuggling industry, including disease, addiction and organized crime.

In 1988, the Burmese government was overthrown by a corrupt military junta that changed the country's name to Myanmar. Reports of torture and mass murder followed. Western nations withdrew aid and imposed trade sanctions, which have crippled the nation's economy.

Until 2001, the government denied it had an HIV/AIDS problem. It's now estimated about 320,000 people are living with the disease.

Experts believe Myanmar has now become an incubator for the largest number of new clades, or strains, of HIV in the world. "...[B]ecause of the way that drugs are injected there and used, there was a great deal of viral mixing," explains Dr. Chris Beyrer, an AIDS expert at Johns Hopkins University. "Those viruses have subsequently become the predominant epidemic viruses ... in China, in northeast India."

International aid workers face a difficult moral dilemma here: How to support HIV/AIDS prevention in Burma without also lending support to its corrupt government? The Global Fund to Fight AIDS, Tuberculosis and Malaria had promised $98 million in funding over five years only to pull the plug in August of 2005, citing travel restrictions imposed by the country's government that "frustrate" the delivery of medical supplies and services. The government quickly lifted the travel restrictions, but many aid workers claim that U.S. lawmakers put pressure on the fund to rescind the grant for political reasons. UNAIDS and over 18 other nongovernmental organizations continue to run education and prevention programs in Myanmar, including needle exchanges and heavily-subsidized condom campaigns, but the loss of the Global Fund money was a severe blow.

And despite the prevention efforts, infections continue to rise unabated. The percentage of female sex workers with HIV has exploded from 5 percent in 1992 to 31 percent in 2003. Among intravenous drugs users, about 85 percent are testing positive in the country's main cities. Most alarmingly, about 1.8 percent of all pregnant women are testing positive, indicating that the disease has moved beyond high-risk groups and into the general population.

The situation for those living with the disease looks equally grim. Antiretroviral drugs are in short supply, and even the generic drugs, which can be purchased from India, are too expensive for most people to afford. Only 1,500 of the 46,500 people that UNAIDS/World Health Organization estimated to be in need of antiretroviral therapy in 2004 were receiving it.

If this trend continues, experts believe that Myanmar will lose more than 10 percent of its young people within the next decade. The time may have come for Western nations to reconsider if such a vulnerable country -- no matter how corrupt -- can continue to live in isolation without becoming a danger to itself and the rest of the world.

* Note: Figures reflect most recent statistics from UNAIDS and the World Health Organization.

• Related Links
• Myanmar's Hidden AIDS Epidemic
  Orlando de Guzman of "The World" traveled to Myanmar several times in 2005-2006 to report on its AIDS epidemic. In this two-part radio series he describes how the disease thrived in the country's "perfect storm" of ignorance and oppression and how the international community is divided in its response.
• UNAIDS Country Report: Myanmar
  This page has UNAIDS statistics on HIV/AIDS in Myanmar, an epidemiological fact sheet and analysis of the problem. It notes:"Myanmar faces an epidemic with the potential to be one of the most serious in Asia."
• United Nations Development Programme's (UNDP) profile of Myanmar
  This profile provides general political and economic information about Myanmar, a short history of its epidemic, and a summary of the public health response to this disease.
• World Health Organization Profile: Myanmar
  Here is WHO's"3 x 5 Treatment Scale-up" program report from June 2005 on the implementation of anti-retroviral therapies in Myanmar. It provides detailed surveillance information about the spread of the disease. [Note: PDF, Adobe Acrobat required]
• In Burma, A Setback on AIDS
  A recent article from The Washington Post explains why the Global Fund rescinded its grant to Burma for AIDS treatment and how the infected are fairing without it (Dec. 30, 2005).
• The Global Fund Fact Sheet on the Termination of Grants to Myanmar
  In this August 2005 press release, the Global Fund explains why it terminated its grant to Myanmar.