Beating infectious disease in Myanmar

17 Oct 2018

UNSW Medicine and the Kirby Institute strengthen their commitment to medical education, research and collaboration in Myanmar in order to reduce the burden of infectious disease. 

“In Myanmar, there’s a crying need to do better with infectious diseases,” says Professor Tony Kelleher from UNSW Medicine. “Every time I go to there, I think it won’t be as bad as I remember.  But it is: up to 90 people in one hospital ward, where in Australia we’d have 20. I’ll see 30 or so people with complicated cases of tuberculous – something we don’t see here. The lack of resources is incredibly confronting, but then the doctors are amazing and committed. They know what to do but they don’t have the resources to do it.”  

Against this backdrop, the Kirby Institute, Insein General Hospital (IGH) and the University of Medicine 2 (UM2) are working closely to build the capacity of local Myanmar practitioners to address the high local burden of infectious diseases including HIV, tuberculosis, and malaria. 

Despite its limited resources, the Myanmar Government is committed to strengthening the country’s health system. The Kirby Institute and UNSW Medicine can help make a real difference in Myanmar.  “We can support their efforts and commitment through funding, education, collaboration and capacity building,” says Kelleher.  

Professor Aye Tun, the Rector of UM2 agrees. “The relationship between UNSW and UM2 has encouraged broad collaboration between our many departments, particularly clinical training, lab development and curriculum development. Our continued commitment will offer benefits to both universities and will ultimately impact the health of our community. I’m pleased with our successes thus far and look forward to our continued relationship.” 

Recent visit to Myanmar 

In August, Tony Kelleher, together with Associate Professor Philip Cunningham from St Vincent’s Hospital, and Dr Josh Hanson from the Kirby Institute, travelled to Myanmar. During this visit, they helped train local laboratory scientists and met the young clinicians who are performing clinical studies with the support of the Kirby Institute. The delegation also met with senior academics from UM2 to discuss local priorities and reaffirm UNSW’s commitment to the collaboration after the passing of Professor David Cooper, Director of the Kirby Institute, who initially led the partnership. A memorial plaque was unveiled in David’s memory and the MARCH (Myanmar Australia Research Collaboration for Health) laboratory was officially opened. 

Tony believes the collaboration’s biggest tangible success so far has been the quick establishment of a lab at UM2. “From a shell to a functioning space; overcoming the challenge of importing equipment; to now actually having the lab open and functional is a great achievement. The lab work is complemented by our regular visits and financial and academic support. We’ve earned their trust, and working in partnership we now need to further build capacity and grow the program”   

Professor Mar Mar Kyi, Head of Medicine at IGH, has seen the direct benefits of the research, with the work informing the care of patients with malaria, HIV and rheumatic heart disease on her ward.   

Dr Josh Hanson spends two weeks of every ten in Yangon to support the collaboration.  It is his work and commitment that underpins the success of the program so far.   

“Our research is examining how we can better manage infectious diseases in locations where resources are limited. We have focused particularly on training young local clinicians perform research which will tangibly improve the care of the patients on their sometimes-chaotic hospital wards. Work from the Masters project of one of our students, Dr Phyo Pyae Nyein, was presented at the Malaria World Congress in Melbourne this year and is expected to change the way we manage adults with severe malaria in developing countries globally.” 

Future challenges and sustaining growth 

The collaboration between the Kirby, Insein and UM2 was formally launched in June 2017.  The program aligns with the UNSW 2025 strategic objective of developing significant partnerships to address development challenges and inequality through research, education and practical initiatives. 

The program has received two Institute for Global Development seed grants in the last year.  One grant focuses on training medical students and developing medical curricula at both the undergraduate and postgraduate level. This aspect is being led by Dr Peter Harris from the Office of Medical Education and Liza Doyle from the Kirby Institute. The other has allowed the establishment of the laboratory at UM2 which will aid with the expansion of the UM2-Insein-Kirby program to address infections like hepatitis C and the human papillomavirus (HPV).  In addition, the team will work with David Peiris from The George Institute to introduce digitally-based algorithms to improve models of care in the HIV outpatient clinic at IGH.  

A future challenge will be how to sustain and grow the collaboration, and the Institute is exploring various mechanisms and funding sources.   

“In 2018, with the support of other researchers from the Kirby Institute, we are supervising three doctoral projects and one master’s project in subjects as diverse as tuberculosis, bacterial sepsis and viral encephalitis,” says Hanson.  

“In 2019, we plan to expand our program to support students to examine other infections that local clinicians have identified as a priority in Myanmar. We are very proud of what we have achieved in a few short years and are excited about producing even more high-quality work in the years ahead.”