Title: Deputy Director General for NCDs, Ministry of Health and Sports Partner
Country: Myanmar

Myanmar is known for its magnificent Buddhist temples, traditional crafts, and rich culture. It is also home to a diverse population comprised of more than 130 ethnic groups - speaking over 100 languages – who together have maintained the country’s traditions alive. However, a growing health problem is threatening the wellbeing of individuals, families and communities.

NCDs are the major causes of mortality and morbidity in Myanmar. They accounted for 40 per cent of all deaths in the country in 2010, 59 per cent in 2014 and 68 per cent in 2018. On top of that, up to a third of the population’s adults are estimated to be living with hypertension, but many are either unaware of their condition or unable to receive consistent care due to cost, availability, and other barriers to access healthcare. Dr Kyaw Kan Kaung, Deputy Director-General for NCDs at the Ministry of Health and Sports in Myanmar is working to overturn this reality.

Dr Kaung began his civil service career managing a state-level 200-bed hospital in Myanmar’s border region. His subsequent experience leading the country’s immunization roll-out and managing procurement and supplies for the entire public health sector made him an ideal leader for running their country’s NCD unit, a role he took up in 2018. Since then, he has been focused on achieving Myanmar’s vision stated at the National Strategic Plan for Prevention and Control of NCDs: to ensure that “everyone in Myanmar lives a healthy and productive life free of avoidable disability and death due to NCDs”. However, this is a tough task even for the most experienced ones.

As in many other countries, some of the main risk factors leading to the development of NCDs are tobacco and alcohol use, obesity, and insufficient physical activity. Although these might seem easily avoidable, designing public health strategies and policies to help prevent the causes behind NCDs are actually harder than one can think. “A ‘quick win’ in preventing NCDs in Myanmar would be a tax on tobacco and alcohol. This would have a high impact, but given the effect on these industries, there is much resistance within the country from them”, explains Dr Kaung. The diverse reality of Myanmar’s population also imposes a challenge.

There are differing attitudes related to NCDs across Myanmar’s various ethnic groups. Some are illiterate, awareness-raising material is not translated into some languages, and specific cultural beliefs are not addressed. Many in Myanmar have very limited communication with healthcare providers, there needs to be a lot of trust built with health centres, so many different approaches are required.

Fortunately, Dr Kaung and his team could count on the support of The Defeat-NCD Partnership, which provided technical assistance to Myanmar’s NCD unit through a programme coordinator and health economist. The specialist worked closely with Dr Kaung and his colleagues on building a multisectoral approach and provided the necessary financial modelling. This collaboration resulted in the development of a national cost-efficient operational plan for Myanmar covering 2021 and 2022. “Although we had a national strategy for NCDs already, it was not costed. Without a costed plan for service delivery, we were unable to mobilize domestic funding or secure money from donors”, Dr Kaung justifies.

When Dr Kaung started working on the plan, he and his team identified many gaps regarding tackling NCDs such as multi-stakeholder coordination. “Mobilizing collaboration and cooperation across and between government, civil society organizations and the private sector remain an ongoing challenge”, he says adding that their overwhelmed frontline health workers and a lack of NCD-related communications and advocacy are additional limitations to their efforts against such diseases. “This means that frontline workers, engaged with other priorities, are reluctant to screen for NCDs”, he clarifies.

Their recently developed two-year plan aims to support 11 million people until 2022, with a focus on screening and treatment for five NCDs in particular: CVDs, CRDs, diabetes, cancer and mental health. “If the rising trend of NCDs is not addressed now, the current burden will just continue to increase and the cost of this will be felt across all aspects of health care, across government and within local communities”, predicts Dr Kaung who has the ambition to improve healthcare access in the whole country. “There is currently no nationwide electronic medical registration system at community township-level in Myanmar. Introducing this would be extremely beneficial to trace and control NCDs. To be effective this must not be a parallel effort, but instead interoperable with existing mechanisms and integrate with health management information systems”. We cannot wait to see this happening!