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Historic US aid project

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A woman affected by flooding receives mosquito nets during a distribution effort last month.

A new USAID-funded malaria project in Myanmar will draw on prevention, treatment and containment models developed in Cambodia, and underscores the emergence of closer relations between Washington and Naypyitaw, health officials said yesterday.

The US$24 million project will expand the effort to contain drug-resistant malaria, which began on the Cambodian-Thai border late last year, to Myanmar, health officials told the Post yesterday. The project will be implemented by University Research Corp, which oversees USAID-funded projects in about 40 countries and is a partner in the malaria containment effort here, they said.

“This is our first USAID-funded project in Myanmar,” Dr Kheang Soy Ty, chief of URC’s malaria containment project in Cambodia, told the Post. The project will span five years and cover three countries – Cambodia, Myanmar and Thailand, he added.

It also follows a shift in funding by USAID to Myanmar announced in late September by the US embassy there. The embassy unveiled a five-year program called Shae Thot (the Way Forward) to deliver humanitarian assistance to communities in central Myanmar through the international NGO Pact.

Previously, USAID funding to Myanmar had been directed primarily to pro-democracy groups, humanitarian assistance to Burmese nationals in Thailand and containing “the spread of infectious diseases” along the country’s border with Thailand. USAID has also funded HIV prevention and treatment in Myanmar.

It had suspended funding to Myanmar in 1988, following the suppression of the pro-democracy movement there, but resumed targeted funding in 1998 in tandem with the US State Department. Health officials say the new funding for malaria signals greater willingness by the US to engage Myanmar.

URC’s malaria project was approved in the second week of October and some of its funding comes from the President’s Malaria Initiative, Kheang Soy Ty said. PMI was established in 2005 as a five-year project to increase funding for malaria prevention and treatment in sub-Saharan Africa. It was extended and expanded by President Barak Obama in 2009 as part of his Global Health Initiative. PMI staff visited the region, including Myanmar, to conduct a regional assessment last month, Khean Soy Ty said. 

URC staff will meet in Bangkok in the second week of December to discuss implementation of the project. Major concerns will include reaching populations in rebel-held areas, where malaria is endemic, Kheang Soy Ty said.

Malaria experts in Cambodia said that URC will draw on strategies developed in Cambodia to access “hidden” populations along its border with Thailand.

Dr Steven Bjorge, team leader of the malaria and vector-borne diseases department of the WHO in Cambodia, said “we definitely hope they can duplicate the success of our project here”.

He identified three components of the project for duplication in Myanmar. These are: mass distribution of insecticide-treated bed nets, engaging communities to create community surveillance systems, and gaining access to hard to reach and hidden populations.

The goal of URC’s project is to decrease the prevalence of malaria, deaths from malaria and to contain drug-resistant malaria, Kheang Soy Ty said. Funding from USAID would preclude working with the government, but once in Myanmar URC could tap other donors for funds that would allow it to train government officials on malaria prevention, treatment and containment, he said.

Drug-resistant malaria was first detected in 2009 along the Cambodian-Thai border, with Pailin identified as the epicenter of what epidemiologists saw as a potential global health nightmare. They were alarmed that the parasite that causes malaria was becoming resistant to the most effective drug they have for treating it, artemisinin. Testing conducted earlier this year found that in some villages along the border it was taking twice as long for the drug artemisinin to clear the parasite from an infected patient, and that in some clusters, more than one-third of those infected were showing resistance to the drug.

In January, the World Health Organisation launched a $175 million global containment plan in Pailin. Epidemiologists said they were most concerned that drug-resistant malaria could reach Africa, where it would pose the gravest threat due to the poor health of the population and lack of healthcare services there.

Robert Newman, director of the WHO’s Global Malaria Program, said in an interview in February that worries about drug-resistant malaria reaching Africa “wake me up in the middle of the night”.

Anecdotal evidence from clinics along the Thai-Myanmar border suggested that drug-resistant malaria was present in the country, but the lack of a national detection system has made it impossible to accurately assess the situation there, health officials said.

A failure to contain drug-resistant malaria could result in millions of deaths, the WHO has warned. It estimates that about 3.3 billion people are at risk of malaria. There are about 250 million malaria cases annually and nearly 1 million deaths, most of them in Africa, according to the WHO.

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