At its height, the project provided treatment to more than 17,000 people, many from outside Yangon. The closure represents a milestone both for MSF and for Myanmar, marking the country’s growing capacity to provide antiretroviral (ARV) treatment for people living with HIV.
MSF was the first provider of ARV treatment in Myanmar and for some time ran the largest HIV treatment programme in the country. In recent years, as the capacity of the NAP and National Tuberculosis Programme (NTP) has grown, we have transferred patients to the care of the Ministry of Health and Sports for treatment in clinics closer to their homes.
A patient-centred approach
At the Insein clinic, we built a community where people received high quality treatment, in an environment free from stigma or judgement. The clinic exemplified a dignified standard of care, providing an example to follow and a standard for HIV care providers to meet.
Pavlo Kolovos, MSF’s head of mission in Myanmar
The care provided at MSF’s Insein clinic – as at all of MSF’s HIV treatment clinics in Myanmar – was comprehensive and patient-centred. Counselling was an integral part of it, particularly in the pre and post-testing phase. The counsellors also helped patients adhere to their treatment, especially vulnerable groups such as adolescents, sex workers and drug users. As discrimination against people living with HIV is widespread in Myanmar, counsellors also helped patients cope with social challenges and educated patients, their families and communities about HIV.
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A woman living with HIV attends a counselling session at MSF's Insein clinic in Yangon. Myanmar, June 2019. © Minzayar Oo
Overcoming stigma and integrated care
“When my HIV positive status was confirmed, I was depressed – I even thought about committing suicide,” says MSF patient U Myo Win.* “But the staff at the clinic showed me that I could stick to my treatment and have a normal, healthy life again. They were supportive and kind, encouraging me to stay strong and fight for life.”
At the Insein clinic, patients with HIV also received treatment for life-threatening opportunistic infections such as tuberculosis (TB), multidrug-resistant TB, hepatitis C, pneumonia and meningitis, all within the same clinic. This unique model for integrated care eased the burden on patients and made it easier for them to adhere to their treatment, in turn helping prevent the spread of HIV and other illnesses. MSF continues to advocate for these innovative approaches to care be taken up by other HIV providers.
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U Myo Win poses for a portrait at the MSF Insein clinic. HIV positif, he is the father of six children. This is his last visit to the MSF clinic, as he is transferred to another one closer to his home. Myanmar. June 2019. © Minzayar Oo
The closure of the Insein clinic marks the conclusion of one of MSF’s most significant projects since it began working in Myanmar in 1992. It also marks a significant step towards the NAP’s target of providing 75 percent of all ARV treatment in Myanmar by 2020. MSF will work with the NAP as it continues to scale up HIV care to standardise improved models of care and push for greater decentralisation of services.
MSF continues to provide comprehensive HIV care in Yangon, Kachin, Shan and Tanintharyi.
* Name has been changed
