Delegation members at Mandalay General Hospital          ©3DF

18 March 2011 - “It was clear to see that the clinic is responding well to an important need,” said Michael Wilson, the Australian Chair of the Three Diseases Fund (3DF) Donor Consortium, during a recent visit to the National Programme and the Union ART provision site in Mandalay. “We saw that the facility is much needed, well viewed and the money is well spent.”

The National Programme and the International Union against Tuberculosis and Lung Disease (the Union) have been working together within Mandalay General Hospital since 2005, implementing the Union’s Integrated Health Project. During their visit, Australian Government delegates saw the Union staff cooperating with government doctors on referral and care services. Members of the delegation commented on the welcoming atmosphere, well managed procedures, importance given to privacy and the quality of technical information.

Last year the Union mobilised 3DF funds to assist the scale up of ART provision for positive patients. “This is one of our busiest sites,” says Phillippe Clevenbergh, Country Manager for the Union. “We hold seven half- day consultation sessions per week and each is attended by at least 50 patients. Of course,” he adds,” these numbers are worrying.”

ART provision is gaining momentum in Myanmar. At the end of 2005 only 2,527 people were able to access and take the life saving drugs; today the Department of Health estimates the number to be 28,000, up from 21,138 people in 2009. Today 3DF funds 78 ART sites around the country, supporting around 50% of the country’s total provision. The Union and National Programme cooperation will scale up again in 2011, this time with assistance from the Global Fund, with four new ART sites opening in Monywa, Meiktila, Myingyan and Yangon.

The Australian group also visited the Multi-Drug Resistant Tuberculosis (MDR-TB) unit in Mandalay’s Patheingyi TB Hospital. 3DF is co-funding the country’s first ever pilot programme addressing this strain of tuberculosis, with wards in Patheingyi TB Hospital and in Yangon’s Aung San TB Hospital. “Seeing the MDR-TB ward is harrowing, simply because of the side effects of the drugs are so severe on the patients. These people need intensive support,” said Mr. Wilson.

Myanmar is one of the worlds 27 high burden MDR–TB countries, with high estimated rates of HIV/TB co-infection. The 2009-10 TB Prevalence Survey suggests that there are some 9,000 cases of MDR-TB per year. The disease is treatable with second-line TB drugs and conversion time of sputum smear tests to negative results is proving to take as little as three to six months. However, a drug package needs to be taken for a full two years, at the cost of approximately $3,000 per patient. Results from the pilot program will be available in 2012 from implementers, MSF Holland/AZG and WHO.