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Malaria as a Catalyst for Change in Myanmar | Commentary

By Myaing Myaing Nyunt and Christopher Plowe In Washington D.C., recently, more than a dozen senior officials and politicians from Myanmar, some from groups with histories of deep mutual distrust, joined together in an extraordinary effort: to eliminate malaria from their deeply fragmented country. This is move that could have a dramatic effect on the global fight against the deadly parasitic disease.  

This meeting was an unprecedented step. It took years of work, by us and by many others. The groups included the government — including the military — the main opposition party, and three of Myanmar’s many ethnic minorities afflicted by malaria, the Shan, Karenni, and Kayin. Some of these groups had never sat down together at the same table to discuss anything.  

The subject they discussed, malaria, is a major health and economic problem for Myanmar and for the world. About 300,000 people in the country are afflicted by malaria every year; Myanmar accounts for more than three-quarters of malaria deaths in Southeast Asia.  

For Myanmar, this meeting is truly historic, a model for how to use science and medicine not only to solve important health problems, but also as a way to foster wider social and political change.  

If the Burmese can elevate this urgent global health goal above politics, so should we.  

Some in Washington and elsewhere oppose working with Myanmar’s military, which has been linked to human-rights violations. Some powerful interests in Myanmar are also reluctant to work with opposition political parties and ethnic minorities who are fighting for autonomy.  

We understand these concerns. But malaria elimination can’t be held hostage to political change — even important and needed change, such as ceasefire agreements and fully democratic elections.  

Myanmar is emerging from 50 years of isolation and military rule. Although open national elections will be held in November, the country is struggling with entrenched poverty, compounded over the past few weeks by severe flooding, and the military still holds most of the power. After decades of violent ethnic and regional conflicts, Myanmar has as many armed groups as we have candidates for the Republican presidential primary.  

As public health clinicians and researchers, we have worked in Myanmar for years, trying to reduce and ultimately eliminate malaria in the country. We collaborate with everyone from village midwives and community health volunteers to physicians and disease experts from both the government and opposition groups. We work all over the country -- some of our field sites can only be reached by a combination of motorcycle, boat and ox-cart. Wherever we go, we find dedicated people ready to put aside their differences to fight malaria.  

Why? Malaria is powerful because it is something all sides agree on: it is everyone’s enemy. Mosquitoes are just as happy infecting government troops, the militias fighting against them and poor villagers caught in between. All sides have an interest in vanquishing this disease.  

Recently, Myanmar has seen a sharp increase in drug-resistant malaria, and there is a real danger that the disease will soon be untreatable. The World Health Organization recently warned that if not eliminated quickly, these resistant parasites could spread to surrounding countries and then to Africa, as happened in 1970s when resurgent drug-resistant malaria caused millions of deaths.  

We believe this meeting in Washington was a crucial step to ensuring that this doesn’t happen. The participants got to know each other, began to build trust and agreed to work together to attack the disease throughout the entire country, including conflict and post-conflict areas. If we follow through on this plan, we have a very good chance of reducing the toll of disease there, and of rolling back drug-resistant malaria.  

Opposition leader and Nobel Peace Prize winner Aung San Suu Kyi has signaled her support for this work. On a more personal level, one of us (Dr. Nyunt) was born in Myanmar, and was a student activist in 1988 during the military crackdown of a popular pro-democracy movement. She watched as her friends were shot down during street protests; then, like thousands of others, she had to flee the country or face prison.  

Yet in order to fight malaria, she has put aside this past to work hand-in-hand with government and military officials. Like so many people in Myanmar on all sides, we are convinced that to eliminate malaria we need everyone to be involved, and we must start now.  

Eliminating drug-resistant malaria is also an important U.S. interest that should be protected from shifting political priorities—not only because of the huge toll malaria takes in lives and economies in countries of strategic importance, but because it continues to threaten our troops and other global travelers.  

U.S. technical and financial support for malaria elimination in Myanmar and the Greater Mekong Subregion — including direct aid through USAID and the U.S. President’s Malaria Initiative, our contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and malaria research at the Centers for Disease Control and Prevention, the National Institutes of Health and Department of Defense labs at home and abroad — should be strengthened and sustained, irrespective of the pace of peace negotiations, human rights improvements and election outcomes in Myanmar.  

No one is predicting that Myanmar’s new coalition against malaria will produce a breakthrough in peace talks or a fully fair election. But there is no question that this alliance has the potential to become a catalyst for more dialogue, reconciliation and social change — in Myanmar now, and perhaps in other troubled places in the future.  

Myaing Myaing Nyunt and Christopher Plowe are public health scientists at the Institute for Global Health at the University of Maryland School of Medicine. Dr. Plowe is president of the American Society of Tropical Medicine and Hygiene.

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