Health Director for Asian Harm Reduction Network with 15 years experience in Harm Reduction. Responsible on strategic planning of health interventions, developing new healthcare programs, project proposals, agency growth and direction. In charge of technical resources, programming and quality control of medical interventions such as HIV/TB/Hepatitis B/C/drug treatment.

Issue:
Myanmar is exceptionally hardly hit by the COVID-19 pandemic. Myanmar is confronted with a profound political crisis, and civil disobedience movement by healthcare workers causing the near collapse of the country’s public health system. Prolonged conflicts and COVID-19 related restrictive measures increased barriers to access harm reduction, HIV and related services.

Setting:
Drug use is a rural phenomenon in Myanmar. Asian Harm Reduction Network (AHRN) and sister organization Best Shelter (BS) implement harm reduction programmes in a mix of sensitive hotspots with conflicts, jade, gold mining, poppy production, extreme poverty, high disease burden, cross-border drug trafficking and drug using labor migration.

Project:
AHRN, in collaboration with BS, strengthened community-based harm reduction activities through capacity building of local community prevention workers, peers and enhancing secondary needle distribution through dealers, and innovative community-based Needle Syringe Automatic Taking Machines (NSATMs) at grocery shops, that greatly increased access to free NS in remote-rural areas during COVID-19 lockdowns. While public health facilities were not fully functioning because of the political crisis, AHRN assisted National Programs in methadone provision, decentralized ART initiation and dispensing through a satellite clinic model in drop-in-centers. To mitigate COVID-19 transmission and potential roadblocks, AHRN advocated scaling up methadone take-home doses and multi-month dispensing of ART.

Outcome:
From 2019 to 2021, during the COVID-19-political dual crisis, NS distribution increased from 16,176,517 to 16,805,883 and 18,486,694 annually; secondary distribution contribution increased from 10% to 11% and 26% ensuring PWID access to sterile NS. People receiving methadone increased from 5,364 to 7,641 and 8,223 annually, with 6 months retention rate of 74%, 68% to 83% respectively. Average 21%, 70% and 83% of people took MMT take-home doses. People receiving ART increased from 1,737 to 2,180 and 3,455. Despite profound challenges, AHRN and BS developed and integrated efficient strategies to uphold harm reduction programming.