In Myanmar, only sickest HIV patients get drugs

Thein Aung has been trained not to show weakness, but he's convinced no soldier is strong enough for this.

He clenches his jaw and pauses, trying to will his chin to stop quivering and his eyes not to blink. But he's like a mountain that is crumbling. His shoulders shake, then collapse inward, and he suddenly seems small in the denim Wrangler shirt that's rolled up to his elbows and hanging loosely off his skinny arms. Big tears drip from his reddened eyes, and he looks away, ashamed.

As he sits outside a crowded clinic on the outskirts of Myanmar's biggest city, he knows his body is struggling to fight HIV, tuberculosis and diabetes - but he can't help wishing he was sicker.

Although Aung is ill enough to qualify for HIV treatment in other poor countries, there are simply not enough pills in Myanmar. Only the sickest of the sick are lucky enough to go home with lifesaving medicine here. The others soon learn their fate is ultimately decided by the number of infection-fighting cells found inside the blood samples they give every three months.

The World Health Organization recommends treatment start when this all-important CD4 count drops to 350.

In Myanmar, it must fall below 150.

Antiretroviral therapy, in the past considered a miracle only available to HIV patients in the West, is no longer scarce in many of the poorest parts of the world. Pills are cheaper and easier to access, and HIV is not the same killer that once left thousands of orphaned children in sub-Saharan Africa.

But Myanmar, otherwise known as Burma, remains a special case. Kept in the dark for so many decades by its reclusive ruling junta, this country of 60 million did not reap the same international aid as other needy nations. Heavy economic sanctions levied by countries such as the United States, along with virtually nonexistent government health funding, left an empty hole for medicine and services. Today, Myanmar is among the hardest places to get HIV care, and health experts warn it will take years to prop up a broken health system hobbled by decades of neglect.

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