NAP is slowly recovering, but functioning facilities offer limited services and are unable to accept MSF patients into its program. Transfers likely won’t resume until at least 2023. Instead of reducing HIV activities this year as initially planned, MSF has expanded its services. We are now diagnosing and starting treatment for hundreds of new patients for the first time since 2019. Our teams have provided 7,200 consultations to NAP patients in Shan, Kachin and Tanintharyi states.
This spike in patients, as well as the interruption of medicine imports, threatened MSF’s medical supplies. For months, we were only able to offer shorter ARV prescriptions, which means people have to come to the clinic more frequently. We now lack the drugs to treat opportunistic infections, such as fungal meningitis, and the materials needed to diagnose HIV in infants. If the supply issues are not resolved, many people could die.
In MSF clinics in Myanmar, 2,929 appointments were missed between February and October this year, an 89% increase over the same period in 2020. Many people visiting our clinics have to travel long distances. . Not only is there a curfew that makes the journey difficult for some people, but these journeys are now fraught with challenges that can deter them from making the journey – assassinations, targeted bombings and territorial battles are rife throughout. the country.
“The road between Chipwe and Myitkyina [in Kachin state] has been closed for months, ”said Brang Seng *, a patient diagnosed with HIV in April. “There are a lot of checkpoints and few pilots dare to come. I’m worried that the conflict will escalate, preventing me from traveling and then missing my date. I can only come if there is a taxi. They are not [available] everyday.”
Affordable intercity trains don’t run and bus lines are unreliable, which means people have to use more expensive private cars or motorcycles. The economic impact of the political crisis in addition to the COVID-19 pandemic means that many people cannot afford to visit a clinic. To help overcome these financial obstacles, MSF provides these patients with medicines via public transport. In Shan State, we have made 270 of these deliveries since February. But that’s not a long-term solution, and it means patients who need to see a doctor or receive services like blood tests, which can only be done in a clinic, don’t get the care they need. they need.
Democratic Republic of Congo
Almost half a million people are living with HIV in the Democratic Republic of Congo (DRC), but access to testing and treatment remains a challenge, causing thousands of preventable deaths, 17,000 in 2020 alone. According to the United Nations, nearly a quarter of people living with HIV in the DRC do not know they have the virus. Not only do fear and stigma prevent people from getting tested, access to voluntary testing is almost impossible, and many health facilities do not offer free testing for people with symptoms.