Combating HIV/AIDS, tuberculosis, and malaria with L’Initiative in the Greater Mekong Region

Published on December 16 2024

Asia and the Pacific
Addressing public health emergencies
Health

Dr. Ni Ni Tun, conseillère en innovation et en recherche sur le VIH pour Medical Action Myanmar — Dr. Ni Ni Tun, HIV innovative and research advisor for Medical Action Myanmar - (c) Edouard Pont

L'Initiative, Expertise France's operational tool for global health, is active in forty countries, mainly in sub-Saharan Africa, but also in South-East Asia, where the level of development of countries varies in terms of healthcare. In this article, Dr Ni Ni Tun, HIV innovative and research advisor for Medical Action Myanmar, talks about the work being done in Myanmar.

L’Initiative along with the Global Fund have been supporting initiatives to treat malaria, tuberculosis and HIV/AIDS in Myanmar in remote areas along the Chinese, Thai and Indian borders. Dr. Ni Ni Tun supervises the management of 2100 village health workers (VHW) throughout the country as well as in areas on the northern borders where health care for inhabitants is a few days journey away.

We are bringing health care to these remote areas with 459 village health workers, supported by L’Initiative. At first we trained them to diagnose and treat malaria, and we saw the cases go down. But to eliminate malaria you have to keep the momentum of testing malaria for all fever cases.

Dr. Ni Ni Tun

Testing also showed that people who had fever often had other ailments, such as a common cold, pneumonia, tuberculosis, diarrhoea or skin infections. An additional basic healthcare package was added, and following this initiative “lots of patients came to the VHW,” said Dr. Tun. This meant that more village health care workers needed to be trained. MAM has 70 medical mobile teams working in the remote villages across 28 townships in Myanmar. Seventy percent of the village health workers are women, says Dr. Tun. They receive theoretical training, then get on-the-job, hands-on training supervised by the mobile team, which consists of a medical doctor and field assistants who speak local languages, which boosts villagers’ confidence in the local health care workers. “Continuous field-based monitoring, on-the-job training and patient home visits by the mobile team is essential,” says Dr. Tun.

A second important component of this remote health care is a TB mobile team that screens for tuberculosis in the villages. Dr. Tun explains that 50 percent of patients are asymptomatic, or have atypical symptoms and are reluctant to travel for several days to reach a hospital. Many patients were identified with TB and referred to hospitals where they received treatment. The teams also identify family members of suspected TB patients and refer them to the hospital for treatment at the same time.

A new activity for the phase 2 project with L’Initiative will provide training to the village health workers in the remote areas to do counselling, testing for HIV and harm reduction services for drug users. According to the United Nations, Myanmar is now the world’s largest opium producer and there is a drug problem along the northern border with China. Dr. Tun’s team is now training the village health workers for the provision of harm reducation services, providing clean needles and syringes, HIV counselling, testing and referral for treatment among injecting drug users in remote areas. She says L’Initiative’s support to Medical Action Myanmar’s services in remote areas is extremely beneficial, despite the difficulties. She adds that L’Initiative’s support combined with Global Fund’s aid, is very important as “the project is able to address all the communities’ needs.”