HIVAIDs in MyanmarMyanmar, formerly known as Burma, is one of 35 countries where 90% of HIV infections occur worldwide. As of 2017, the World Health Organization (WHO) found that Myanmar accounted for 224,026 HIV/AIDS cases, or 0.54% globally. This, though still considered prevalent, has declined at a steady pace. The new efforts began in 2016, with tremendous success resulting in the current year to lessen the effects of HIV/AIDS in Myanmar.

What Is Going On?

Myanmar has experienced ongoing civil conflict since gaining independence from British rule in 1948, with numerous constitutional changes ultimately leading to the establishment of a military-led (Junta) state. In 2021, the country descended into full-blown civil war after the military disputed the results of a general election in which the National League for Democracy won a majority. Claiming electoral fraud, the military carried out a coup, detaining elected leaders and seizing control of the government. Since then, the conflict has escalated and continues to this day.

The majority of Myanmar’s citizens support the pro-democracy resistance against the Junta, and that support has made an impact. Despite initiating the conflict, the military has gradually lost ground to opposition forces.

Poverty Rates

Before the civil conflict, Myanmar had a small but growing middle class, and the economy experienced rapid growth throughout the 20th century. However, in the 21st century, shifting government policies and international sanctions slowed this progress. Poverty is growing at an alarming rate. Today, nearly half of the Burmese population lives below the poverty line. This sharp rise in poverty has directly contributed to a range of serious health issues across the country. On top of these challenges, Myanmar follows an “out-of-pocket” healthcare system, which means individuals must cover their medical expenses themselves, making it even harder for those living in poverty to access the care they need.

Because the country is experiencing division and conflict, it has become nearly impossible for many Burmese people to afford or access proper health care. The ongoing unrest has made it even harder for everyday citizens to get the medical help they need. This shows just how urgent the need is for support, whether from the government or international aid organizations. While HIV/AIDS is already a serious health issue in Myanmar, it is not the only one. As poverty increases and the civil crisis continues, more and more diseases are beginning to spread, putting vulnerable communities at even greater risk.

What Is Stopping the End of HIV/AIDS in Myanmar?

Among those infected, 41% are female sex workers, 31% are queer men and 28% are people who inject drugs. Because of the criminalization of sex work, homosexuality and drug usage, many people with HIV/AIDS are scared to accept treatment. The Aids Datahub found that 7% of individuals who avoided going to treatment clinics were scared of punishment and the stigma surrounding HIV/AIDS.

If a person is found “guilty” of homosexuality, they can be sentenced to up to 10 years of prison. An individual found guilty of soliciting can serve up to 6 years in prison. Lastly, Myanmar is the leading source of opium and heroin, two injectable substances. The United Nations Office on Drugs and Crime (UNODC) predicts that up to 90,000 Burmese people inject drugs, or about 0.23%.

The UNODC has also found that overall drug use has declined steadily from 2020 to 2024. Programs that are working to limit drug use or encourage “safer” drug use in high usage areas in Southeast Asian countries (Myanmar, China and Bangladesh) are helping to reduce the usage of injectable drugs and the number of new HIV/AIDS infections in Myanmar.

What Is Going Right?

This downward trend is largely due to a renewed national HIV response strategy launched in 2016. These efforts focused on expanding access to antiretroviral therapy (ART), improving testing and counseling services and targeting high-risk populations through community-based outreach. By 2023, more than three-quarters of people living with HIV in Myanmar were receiving treatment, marking a major public health achievement despite ongoing political and social challenges.

Despite civil war breaking out in 2021, efforts to maintain access to antiretroviral treatment to minimize HIV/AIDS in Myanmar remain strong. According to the AIDS Data Hub, new infections have declined to fewer than 10,000 per year. Of the 280,000 suspected cases, 216,757 have been confirmed. All confirmed individuals are receiving antiretroviral therapy (ART).

Beginning in July 2020, Myanmar introduced Pre-Exposure Prophylaxis (PrEP), where people routinely take ART to reduce the chances of getting HIV. It is still implementing this preventative measure today. Many foreign aid programs, such as USAID, the Global Fund and the National AIDS program, are funding access to PrEP.

What to Takeaway?

Despite ongoing conflict and growing poverty within the country, national and international efforts to curb the spread of HIV/AIDS in Myanmar remain strong. The number of new infections continues to decline annually, bringing the country closer to the global 2030 goal of eliminating new HIV cases. Access to treatment has significantly improved, with antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) available to all individuals who seek it, regardless of background or risk group. 

– Abby Buchan

Abby is based in York, PA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

Vaccinations in Timor-LesteEast Timor, also known as Timor-Leste, shares its island with Indonesia in Southeast Asia. Despite possessing substantial oil and gas reserves, the European Commission classifies it as a Least Developed Country due to insufficient infrastructure and frequent food insecurity. The majority of Timor-Leste’s population relies on small-scale agriculture in rural areas, complicating vaccination efforts due to challenges in reaching these communities. Nevertheless, the country has made significant progress in immunizing its population against common, once-life-threatening diseases like polio and smallpox.

Challenges to Immunization in Timor-Leste

In East Timor, 75% of the population engages in small-scale farming in rural areas, making vaccination efforts challenging due to the sparse distribution of communities. The lack of robust infrastructure—from transportation to educational facilities—further complicates immunization initiatives. The COVID-19 pandemic significantly disrupted education, affecting 45% of East Timorese children. Moreover, the country’s inadequate infrastructure has left many areas difficult to access, hindering widespread vaccination coverage. Consequently, 8% of children in East Timor are ‘zero dose children,’ meaning they have not received any vaccinations. This issue was intensified by school closures in 2020 during the pandemic.

Vaccination Efforts

The East Timorese government boasts a commendable record of vaccination achievements. In the 1980s, it successfully eradicated smallpox, followed by polio in the 1990s, diseases from which Timor-Leste remains free currently. More recently, the country eliminated measles in 2018 and rubella in 2023. Health care workers, including WHO consultants, have been pivotal in ensuring comprehensive immunization coverage. They often conduct door-to-door visits in communities to administer vaccines directly to children who have not been previously immunized. Many children in Timor-Leste miss vaccinations because community health centers are kilometers away, requiring parents to take time off work—a luxury many cannot afford. This approach effectively reduces the logistical burden on parents and ensures children receive essential life-saving vaccines.

HPV Vaccinations

Timor-Leste introduced the HPV vaccine in July 2024, marking a significant achievement in public health. The Ministry of Health, in collaboration with WHO, UNICEF and other organizations, efficiently managed the vaccine rollout. By the 23rd of Sept., just three weeks into the program, health care workers had vaccinated 90% of the target population of school-aged girls, totaling 56,350 out of the 62,000 targeted. The HPV vaccine is crucial for preventing cervical cancer by protecting against various types of human papillomavirus. In addition to administering the vaccine, health care workers also engaged in community education efforts to emphasize the importance of vaccinations for eradicating cervical cancer in Timor-Leste.

A Bright Future

Timor-Leste has made remarkable progress in vaccination, despite its status as a Least Developed Country struggling with poor infrastructure and connectivity. Effective leadership has enabled widespread immunization, significantly improving the health of the East Timorese people. With continued efforts from the government and support from organizations like WHO and UNICEF, Timor-Leste is well-positioned to enhance the well-being and happiness of its citizens.

– Callum Bennett

Callum is based in Colchester, Essex, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

Afghanistan's Opium PoppiesFor decades, Afghanistan has been the world’s leading opium producer, supplying at least 70% of the global output. This vast industry, involving farmers, traffickers, warlords and authorities, has significantly funded the country’s conflicts with the United States (U.S.), particularly in southern Afghanistan, where farmers depend on cultivating Afghanistan’s opium poppies to sustain their livelihoods in an arid desert landscape where poppies thrive.

The Impact of the Taliban’s Opium Ban

Life changed dramatically in 2022 when the Taliban, after seizing power, banned opium farming nationwide on religious grounds. Since the ban, farmers in the former opium fields have struggled to sustain their livelihoods with alternatives like wheat and cotton, whose prices have plummeted due to market saturation. The options for growing other crops are extremely limited in this area because of the harsh climatic conditions that challenge agriculture.

Economic Consequences of the Opium Ban

The ban on opium farming has deeply impacted Afghanistan, creating a cycle of economic instability and underdevelopment showcasing its reliance on the Afghanistan economy.  A sharp decline in annual revenue occurred after the ban, from $1.3 billion in 2022 to just $110 million in 2023. Projections suggest a continued economic downturn, with an estimated 6.4% reduction in GDP in the first year and approximately 8% by 2026, assuming a sustained 70% reduction in opium production. Replacing the opium poppy industry is no small feat in Afghanistan and requires substantial investment in alternative livelihoods and drought-resistant agriculture.

UNDP’s Role in Transitioning Afghanistan’s Agriculture

The United Nations Development Programme (UNDP) and its supporters aim to guide Afghanistan toward an economically viable transition from opium production to alternative crops or industries that foster growth and create sustainable livelihoods. This objective requires supportive policies and strong foreign aid to ensure a sustainable transition.

Initiatives and Achievements of CBARD-ALL

The Community-Based Agriculture and Rural Development – Access to Licit Livelihoods (CBARD-ALL) initiative is central to these ongoing efforts, which aim to replace opium poppies with high-value crops in key production districts. CBARD-ALL aims to enhance livelihoods and incomes throughout the agricultural industry in Afghanistan by supporting farmers who are reliant on opium production. These goals are achieved through a comprehensive approach that includes providing essential farming supplies and knowledge, advisory support, building greater capacity within these farms through diverse training programs and establishing agriculture infrastructure to handle the transition.

The United States International Narcotics and Law Enforcement Affairs is a major supporter of this initiative, providing substantial resources. The project has achieved notable accomplishments, including surpassing the target for repurposing greenhouses previously used for opium poppy cultivation, developing tools to enhance crop productivity and constructing numerous small-scale irrigation channels. Scheduled to conclude by Sept. 2025, the project seeks to establish a more sustainable agricultural future for Afghanistan.

Looking Forward

The CBARD-ALL initiative plays a crucial role in fostering sustainable alternatives to Afghanistan’s opium poppies, showing notable progress. By providing viable options rather than enforcing prohibitive measures, CBARD-ALL aims to improve the livelihoods and incomes of those impacted by the opium ban. This strategy not only reduces economic reliance on opium cultivation but also promotes economic resilience and diversification, crucial for the stability and development of rural areas. In regions dependent on agriculture and challenged by poor infrastructure and limited connectivity to major cities, this ongoing project is vital for securing a sustainable and lasting agricultural future in Afghanistan.

– Mathieu Paré

Mathieuis based in Toronto, Canada and focuses on Business and Good News for The Borgen Project.

Photo: Flickr