Myanmar - Government crackdown prompts calls for reform as drug addicts suffer

A miner injects heroin at a jade mine in Hpakant township in Kachin state. (Photo: Htet Khaung Linn/Myanmar Now)

YANGON (Myanmar Now) - Several young men were standing near the entrance of Thingangyun Hospital in central Yangon on a recent July morning, waiting impatiently for a fellow drug addict to exit the facility.

They had just received their daily dosage of methadone, but one man was not coming out. After a few minutes, they concluded he must have failed the mandatory illegal drugs test and got detained. The group quickly left.

“One of the guys was arrested by police at the hospital,” an addict named Soe Maung said later. “Recently, a girl was arrested in the same hospital while getting methadone… she tried to run away but a policeman caught her by the neck.”

Like the others, Soe Maung, 28, is taking methadone to wean himself off heroin and fight its withdrawal symptoms. He is also a contact person for the Burnet Institute’s HIV Mitigation programme for drug-injecting users and he helps Yangon’s opiate addicts enter methadone therapy.

Drug users who register their addiction with police and health authorities can avoid criminal punishment from Myanmar laws, which set tough prison sentences for narcotics use, possession and sale. They can enter mandatory methadone maintenance therapy at 46 hospitals across Myanmar, including Thingangyun Hospital, to suppress withdrawal symptoms as they give up illegal drugs.

Health experts, representatives of drug users, and some politicians say methadone therapy, and other so-called harm reduction strategies for drug users, should be expanded to bring Myanmar’s rampant drug abuse problems under control.

They say the government should also change laws that penalise recovering addicts who test positive for illegal drugs, or punish those who fail to attend methadone therapy and regular police registration.

They warn, however, that the NLD government’s approach so far has only been punitive, as the Ministry of Home Affairs launched a nationwide drugs and crime crackdown that arrested many addicts, but did little to help them.

The ministry recently said it wants more money for its crackdown, while some MPs have called for tougher actions against drugs and crime.

GOVERNMENT CRACKDOWN NETS MOSTLY ADDICTS

Soe Maung said the NLD’s approach had raised fears among Yangon’s addicts, while police were more quick to arrest recovering users who failed the conditions of the methadone therapy programme.

“More addicts who are taking methadone have been arrested during the first 100-days plan of the new government,” he said.

Okkar Min, an Upper House NLD lawmaker from Tanintharyi Region, urged his government to abandon this repressive approach and introduce genuine reforms.

“The government needs to lay down a policy to open more rehab centres for drug addicts. If it keeps arresting all drug users, as it has been doing over the past few months, then they will fill up the prisons but the problem won’t be solved,” he said.

According to the Ministry of Home Affairs, police arrested 4,761 people in 3,197 drug-related cases between April 1 and July 31. Several hundred kilos of opium and heroin, and millions of methamphetamine pills were seized, but arrests of those running the drug rings remain rare.

“When I asked police officers about those arrested in the drugs crackdown they were just small dealers or users,” Okkar Min said. It would be more effective, he added, to fight government corruption and increase public education campaigns that warn youths about narcotics.

PLANS TO REFORM LAWS, EXPAND REHAB

Myanmar has long been a major producer of opium, its derivate heroin and methamphetamine, much of which originates from and passes through its poor, ethnic borderlands, where the government remains weak. Drug abuse in these areas and in Myanmar’s major cities has reportedly worsened sharply in recent years, prompting calls for a new approach to drug addiction.

The Drug Policy Advocacy Group, a network of health experts and NGOs, has worked with health officials on expanding harm reduction and rehabilitation programs, while it cooperated with law enforcement officials to develop plans for amending drug laws.

Dr. Hla Htay, senior technical manager at the Burnet Institute and a member of the group, said the government’s capacity to provide methadone therapy is hindered by current laws and limited due to a lack of resources and facilities.

He said there are now about 7,000 registered addicts seeking rehabilitation, but Thingangyun Hospital, for example, can only provide methadone for 400 addicts on a daily basis.

 An opiate detoxification centre at Yangon Mental Health Hospital in East Dagon Township, on the city’s outskirts, can treat only 50 patients at a time for a two-week treatment.

According to some estimates there are 81,000 drug users in Myanmar.

Dr. Hla Htay said methadone supplies at the Yangon Mental Health Hospital were often not sufficient for the detoxification treatment. “We cannot give addicts the amount of methadone they asked for, and every project needs good facilities and skilled staff,” he said. “But we have plans to expand this project”

The Thingangyun Hospital methadone service is limited to 8 a.m. to 11 a.m., another practical hindrance for addicts, who might relapse if they miss the methadone’s clinic opening hours, according to Win Min, a Burnet Institute staffer who counsels addicts.

Dr. Hla Htay said drug reform advocates have worked together with police officers of the Central Committee for Drug Abuse Control (CCDAC) to draft amendments to the 1993 Narcotic Drugs and Psychotropic Substances Law, which would remove penalties for drug users.

Police Colonel Myint Aung, who heads the International Department of the CCDAC, confirmed the draft amendments had been completed. “We are going to send this bill to the Union Attorney General’s Office and later it will be discussed in parliament,” he said.

“Drug users are now arrested, but this bill would enforce steps that would make it a health issue, rather than a criminal one,” he added.

Dr. Hla Htay said he hoped the bill could be brought to the attention of the NLD government and parliament within the next few months so that it could begin reforms.

“Drug addicts should not be imprisoned, instead they need opiate detoxification treatment,” he said. “If they were found to be using drugs, police should urge them to go to hospital.”

Phyo Thiha Cho

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Myanmar - Health assistants want changes to the system

Health assistants want more opportunities for promotion, better education and a new name, the Blue Ribbon campaign committee announced at an event in Nay Pyi Taw’s Sky Palace hotel on August 13 and 14.

Health assistants working in villages can prescribe medicine and provide health education. When someone gets very sick, health assistants direct them to the appropriate doctor or hospital.

Health assistants would like to be addressed as “public health officers”, committee members said at the event. They want more transparent and specific policies surrounding the transfer of health assistants.

And as soon as possible, they want the government to enact rules that protect public health workers, and they would like access to post-graduation courses.

The committee’s chair, U Aung Cho, said their demands will be sent to Union Minister for Health and Sport U Myint Htwe.

“After the submission of the outcome of this meeting, we will negotiate,” he said.

Ko Tun Myo Aung, who is participating in the campaign, said the committee was not bringing up new ideas but was focusing on things that needed to be addressed.

“We health assistants have tried to provide the best service we could,” he said. “But we did not get the opportunities we deserved because of bad management.”

Myanmar’s healthcare service was ranked 190th in the world last year, according to a report from the World Health Organisation.

“We are waging the campaign not because we want to get an official post in our department, but because we want to see changes there,” said Ko Tun Myo Aung.

When they tried to address problems within the system, bureaucracy and bad management put a stop to progress, he said.

“We are not given the rights to make decisions,” he said.

“But those who can make decisions never take responsibility. And there is no transparency in the decision-

making. If someone complains about these issues, they are persecuted for it.”

Health assistants face threats from supervisors when they try to improve the system, Ko Tun Myo Aung said.

“When someone points out the errors of a supervisor, they are punished,” he said. “For example, they are transferred from our department to another department or ordered to work in a remote area and they lose their chance to improve their skills.”

The campaign, which is being waged by health assistants across the country, started on July 25.

Pyae Thet Phyo

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Myanmar - Naga slam slow response to measles deaths

Naga tribeswomen and children gather in the grounds of Lahal Township in Sagaing Region, December 2014. (Phyo Hein Kyaw / AFP)

The deaths of more than 40 people, most of them children, from a measles outbreak in a remote, mountainous area of northwestern Sagaing Region was partly because of a slow response from the local authorities, a Naga community group said.

“The government blames communication and transportation [problems], but another problem is the slow response by the local government that has made the situation worse,” Naw Aung Sann, the general secretary of the Council of Naga Affairs, told Frontier on August 8.

His comment came as a spokesperson for the World Health Organization told Frontier that tests at a Yangon laboratory on August 5 had confirmed measles as the cause of the outbreak. Most of the fatalities are reported to have been children aged under five.

The WHO spokesperson said a rapid response and investigation team from the Ministry of Health and Sports, supported by WHO regional surveillance officers, was in the area supervising investigation, treatment and control measures.

The areas worst affected by the outbreak are the isolated townships of Lahe and Nanyun, in the Naga Self-Administered Zone adjoining the border with India, one of least inaccessible areas of Myanmar, where poor road conditions are made worse by monsoon weather.

The death toll from the outbreak stood at 41, of whom 21 were females, the Council of Naga Affairs said on August 8.

Dr Than Htun Aung, deputy director general of the Department of Public Health, told Frontier on August 8 that the outbreak had mainly been confined to Htan Thaw Lama, a village about 64 kilometres (40 miles) from Lahe.

“We were delayed in receiving the information”, Than Htun Aung said when asked about the response to the outbreak.

“The first case was reported on June 6, but we did not hear anything until July 28. This is for many reasons; because of very bad weather in the area, a lack of manpower and many people in these villages do not have access to cell phones,” he said.

A measles vaccination program was conducted in Lahe Township in January 2015, Than Htun Aung said.

“The reported coverage was 94 percent but I don’t think that can be correct. If that figure was correct, then we would not have the outbreak that we are having now,” he said.

A statement issued by the Council of Naga Affairs on August 6 said health concerns had begun rising in mid-June when a 10-year-old girl in Lahe Township died of a “strange disease”.

The government’s slow response had exacerbated the situation, said Aung Sann, who acknowledged that poor communications was a factor.

Phone coverage was available only in Lahe and other villages were unable to communicate with the authorities, he said, adding that another contributing factor was a lack of healthcare facilities in the region.

Aung Sann rejected claims by the government that the situation was under control.

“The government says that the situation is under control but this morning [August 8] we found out that two more girls have died, so I don’t agree that the situation is under control,” he said.

The WHO says measles is a leading cause of death among young children despite the availability of a safe and cost-effective vaccine. Young, malnourished children are most vulnerable to the highly contagious disease.

Although Myanmar has increased health spending in recent years, it still has one of the lowest health budgets in Southeast Asia, and access to healthcare is limited in many parts of the country, particularly remote areas.

Oliver Slow

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Myanmar - Measles behind Myanmar outbreak

This photograph taken on December 24, 2014 shows a Naga ethnic woman bathing her child in Lahal township in the remote Sagaing region located in northern Myanmar. (AFP photo)

YANGON - Myanmar health officials have confirmed that a measles outbreak is behind the deaths of more than 30 people, mostly children, in a remote part of the country as authorities rush to treat victims.

The outbreak has struck the far corner of Myanmar's northern Sagaing region, a remote and mountainous area which borders eastern India and is populated by people from the Naga tribes.

The deaths began in June and highlight how vulnerable Myanmar's more isolated populations are in a country where health care was never prioritised under decades of brutal and inept junta rule.

It is one of the many crippling legacies that the newly installed civilian government of Aung San Suu Kyi is trying to tackle.

Than Tun Aung, deputy director general of the disease control department at Myanmar's health ministry, said labwork from the worst hit town of Lahal had come back positive for measles.

"It's measles," he told AFP late Friday. "So we are sending more team members and cooperating with medical doctors from the military as well."

Local Naga representatives had previously accused the central government of being slow to act.

The region is impoverished and very remote, a mountainous border area where roads and electricity are scant.

out six days to reach the villages. Communication there is also difficult," Than Tun Aung said.

He said they had confirmed a total of 31 deaths in Lahal region, half of whom were under 15.

The Council of Naga Affairs gave a higher toll of 39 dead in nine villages with all the deceased children.

Although health budgets slightly increased in the last few years of outright army rule -- which ended with last November's elections -- Myanmar is still one of the lowest spenders in the world on healthcare as a share of GDP.

Last year, with the help of the World Health Organization and the UN, Myanmar embarked on a mass vaccination programme with the aim of eradicating measles and rubella by 2020.

AFP

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Myanmar - Emerging Myanmar discovering it pays to insure

It was only when Aye Aye Nge's pharmacy burned down for the second time that she thought about taking out insurance, a novelty in impoverished Myanmar where most people either can't afford to buy premiums or don't trust those selling them.

The two blazes -- one in 2010 and then in January this year -- gutted much of the bustling Mingalar market in downtown Yangon, taking with it two shops and valuable stock belonging to the 73-year-old.

"I thought there couldn't be a fire accident again after the first one," she told AFP from her tiny new store on the fourth floor of a nearby building where the market has moved. "I am going to buy insurance," she added. "I must do it. I have lost (everything) twice already and am afraid of losing it all again."

Decades of brutal, corrupt and economically inept military rule left Myanmar's people with a deep distrust of state-run institutions.

Many people chose to hide or bury their savings rather than deposit them in a bank.

For 50 years until 2013, the only insurance company in the country was a state-run monopoly after the junta closed down all rivals.

But the country's dramatic transformation from military to civilian-led rule, capped by last November's elections that spurred Aung San Suu Kyi's party to power, has begun to shift the fortunes of the economy. The values and aspirations of Myanmar's people are also changing.

Insurance firms are gambling that as people get richer, they eventually will do more to protect themselves -- and their assets -- in a country prone to natural disasters and with near non-existent health and safety standards.

Investment has flooded in and the country's largest city Yangon is now filled with cranes and cars plying traffic choked streets.

But according to the government, just five percent of the country's 600,000 drivers have any sort of insurance.

Likewise, few of the shop owners around the bustling Shwe Mingalar market have taken out protection measures, despite losing thousands of dollars in the recent fires.

After decades of junta rule, insurance is simply not a priority to the public. "They are not interested at all," admits Htay Paing, the deputy managing director of Grand Guardian Insurance Public, one of a host of new insurance companies.

Management consulting giant McKinsey believes the economy, if managed properly, could quadruple from $45 billion in 2010 to $200 billion by 2030. That should be a boon to insurers. "The (potential) market is very big, it's true that it's a virgin market," Htay Paing said.

Until 2013 the only insurer allowed to operate in the country was Myanma Insurance, which offered a limited number of products -- including protection against snake bites in a country where the mortality rate from such incidents is twice as high as the world average.

Competitors have since been allowed in alongside a handful of foreign companies.

"There's absolutely huge potential in Myanmar, it's a nearly untapped market," an employee of a large western insurance broker who regularly travels to Myanmar told AFP, asking not to be named.

"But there's currently very little culture of taking out insurance and the state still dominates the industry," he added.

Under current rules, private insurers are still limited to offering just 11 products, largely life, health and car insurance. Myanma Insurance is able to offer more products, often at a cheaper premium.

But companies are nonetheless jostling to get a head start in the hopes that regulations will be further relaxed. So far 22 foreign firms have been granted licences with Japanese companies leading the way -- three have been granted concessions to sell products inside a newly opened special economic zone.

The rewards for those who get in early could pay off.

Asia Insurance Review, a website monitoring the regional market, believes Myanmar's sector could be worth as much as $2.6 billion by 2030. Meanwhile, US giant MetLife, which opened up a Myanmar office in 2013, has estimated that the life cover market alone could grow from just $1 million in 2012 to $1 billion in 2028. Car insurance is one area already seeing growth.

AFP

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Myanmar - Disease kills over 30 children in remote Myanmar

Adults and children in Myanmar's northern Sagaing district have both been struck since the first outbreak of the disease emerged in June, a local MP said ©Ye Aung Thu (AFP/File)

An undiagnosed disease has killed more than 30 children in a remote part of Myanmar, officials said Thursday, with health authorities struggling to treat victims.

The illness, with measles-like symptoms, has hit the far corner of Myanmar's northern Sagaing region, a remote and mountainous area which borders eastern India and is populated by people from the Naga tribes.

Adults and children have both been struck since the outbreak first emerged in June, a local MP said, but the illness appears to be particularly deadly to children under the age of five.

"Altogether 23 children were have been killed in Lahal township and 13 killed in Nan Yon township since June because of this unknown disease," Law Yon, a regional MP from Naga self-administrative region told AFP.

"Rashes came out on their bodies, they have a fever and difficulty breathing because of coughing. Blood also comes out while coughing," he said.

Some 200 people so far have come down with the disease, he said, adding that central authorities have been slow to react.

A health ministry official in the capital Naypyidaw confirmed the outbreak, including more than 30 deaths, and said tests were being carried out.

"We assume at an initial stage it's a measles outbreak or strong influenza. But we can definitely say only when we get the result from laboratory," the official said, requesting anonymity.

The outbreak highlights how vulnerable Myanmar's more remote populations are in a country where healthcare was never prioritised under decades of brutal and inept junta rule.

It is one of the many crippling legacies that the newly installed civilian government of Aung San Suu Kyi is trying to tackle.

Although budgets slightly increased in the last few years of outright army rule -- which ended with last November's elections -- Myanmar is still one of the lowest spenders on healthcare as a share of GDP.

According to the latest World Bank figures health spending increased from 0.2 percent to just over 1 percent of GDP from 2009 to 2013 despite being one of the world's fastest growing economies.

In contrast 4.3 percent of GDP in 2014 went to the military, according to the Stockholm International Peace Research Institute.

AFP

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Myammar - 40% of health jobs filled: minister

The Public Health Department needs more than 58,000 staff but only 40 per cent of that number has been employed, Minister for Health and Sports Dr Myint Htwe has told the Lower House.

MP Dr A Zin Latt proposed a reorganisation of the department to extend and improve public health care. 

"The department is allowed to appoint 58,554 people, but we have been able to appoint only 40 per cent. We are now trying to recruit more staff," said Myint Htwe.

Too little expertise in the ministry and too few practitioners on the ground were holding health care back, he said.  

The minister unveiled a plan to reconstitute the department, including the appointment of about 2,000 doctors next year.

"We are planning to reconstitute the department to promote public health-care services such as vaccinations, school health, educational talks, effective health-care services and the elimination of infectious and chronic diseases," said the minister. 

Phochan

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Myanmar - Lawmakers debate expanding rural healthcare

A patient sleeps on her bed in a ward at Yangon General Hospital in Yangon. Photo: AFP

Debating the National Health Policy in the Pyithu Hluttaw yesterday, most members of parliament advocated for adding more public health staff around the country, particularly in rural areas.

Dr Aye Zin Latt, a National League for Democracy MP for Sagaing Region, submitted the proposal in the first regular session.

Daw San San Ei, an NLD MP for Kachin State’s Mohnyin township, said the death toll for infants and mothers is increasing in rural areas because of insufficient health staffing and inadequate medicine.

She suggested that the government open more rural-based pharmacies and assign more midwives and general health staff.

U Maung Maung, another NLD MP, from Htigyaing township in Sagaing Region, said improved health education is needed.

“I run a hardware shop. One day, a girl came in and bought a yellow powder used for polishing furniture,” he said. “When I asked her why she needed to buy it, she said she was going to use it to make pork sticker. She wanted to use the polish to colour food.”

Daw Wint War Tun, an NLD MP for Kayah’s Shardaw township, said remote areas of her state are especially in need of healthcare services.

The services cover the urban areas while neglecting the rural areas, said Daw Khin Saw Wai, an Arakan National Party MP for Rathedaung township in Rakhine State.

“Because of the lay of the land, three or four villages cannot have a midwife,” she said. “It means we are neglecting mothers from rural areas who cannot go to urban areas for medical treatment.”

One-third of the country’s children under five years old are malnourished, said Dr Aung Khin, an NLD MP from Mandalay Region’s Pyin Oo Lwin township. About 29 percent do not meet the standard height for children their age. The malnourishment leads to physical and developmental issues when they grow up, he said.

Staffing of the country’s health sector is just over 40pc of what it should be, he said.

U Thet Naung from Lahe township in Sagaing Region said health workers’ salaries need to be increased.

In his township, only 26 health workers are assigned to a department that should have a staff of 94.

“They say they are thrown away into the distant areas,” he said, explaining how health workers respond when they are assigned to the township.

Responding to the MPs, Union Minister for Health and Sport U Myint Htwe said that in two months 2000 doctors and medical staff will be assigned to meet the needs of the hospitals.

However, the deputy director of the medical care department has previously admitted to The Myanmar Times that the ministry is direly short on doctors. The new recruits barely begin to staunch the vacancies, with 2000 to 3000 new doctors needed annually just to fill the gaps.

According to the World Health Organization, Myanmar has just six doctors for every 10,000 people, with a rural and urban disparity exacerbating the shortage outside of city centres. According to a parliamentary session last month, only 37,710 medical officers and staff serve the entire country’s 51 million people.

Parliament’s debate on the National Health Policy is scheduled to continue today.

Htoo Thant

mmtimes

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Laos - S. Korea to help modernize Laos' medical service, education

SEOUL, Sept. 9 (Yonhap) -- South Korea and its top university have agreed to provide support for modernizing medical services and education provided by their counterparts in Laos, the Seoul government said Friday.

A memorandum of understanding (MOU) for cooperation was signed by the Seoul National University and Laos' state-run medical college, under which the South Korean school's medical college and hospital will provide their Laotian counterparts with various support, including free training programs, according to the Ministry of Health and Welfare.

The agreement was signed on the sidelines of a summit between South Korean President Park Geun-hye and her Laotian counterpart Bounnhang Vorachith. Park is currently on a visit to Laos for the G20 summit.

Under the new agreement, the Seoul National University's college of medicine and university hospital will invite school faculty and hospital staff from their Laotian counterparts for free training programs here, while they will also dispatch their medical personnel to work as special medical advisors in Laos.

In a separate MOU signed by the countries' health ministries, the South Korean government also agreed to provide support for developing Laos' medical sector, as well as enhancing the country's disease control and prevention capabilities.

Meanwhile, the government said it has invited four Laotian children to South Korea for free medical treatment of their physical disabilities or injuries that is currently unavailable in Laos.

The four included a boy who suffered severe bite wounds to his face by a dog, the ministry said.

yonhapnews

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Laos - Joint Declaration between the United States of America and the Lao People’s Democratic Republic

Joint Declaration between the United States of America and the Lao People’s Democratic Republic

1. On the occasion of his historic state visit to Lao P.D.R., President Barack Obama and President Bounnhang Vorachit held talks today in Vientiane where they officially inaugurated the Comprehensive Partnership between the Lao P.D.R. and the United States of America.  Through this partnership, the United States and the Lao P.D.R. are opening a new era of bilateral relations based on mutual respect, common interests and a shared desire to heal the wounds of the past to build a foundation for the future.

2. President Obama and President Bounnhang Vorachit decided to form a U.S.-Lao P.D.R. Comprehensive Partnership for advancing the relationship.  They underlined the principles of the U.S.-Lao P.D.R. Comprehensive Partnership, including respect for the United Nations Charter, international law, and each other’s political systems, independence, sovereignty, and territorial integrity.  They stated that the Comprehensive Partnership is intended to contribute to peace, stability, cooperation, and prosperity in each country, in the region, and in the world.  The new Comprehensive Partnership will create mechanisms for cooperation in areas including political and diplomatic relations, trade and economic ties, science and technology, education and training, environment and health, humanitarian cooperation, war legacy issues, security, protection and promotion of human rights, and people-to-people ties. 

Political and Diplomatic Cooperation

3. As part of the U.S.-Lao P.D.R. Comprehensive Partnership, the two sides committed to increase high-level exchanges as well as contacts at all levels, and to intensify dialogue and cooperation mechanisms.  President Obama affirmed the United States’ support for Lao P.D.R.’s independence, sovereignty, prosperity, and integration into the international community.  President Bounnhang Vorachit welcomed the United States’ enhanced cooperation in the Asia-Pacific region, which contributes to the peace, stability, and prosperity of the region.

4. The two leaders welcomed the establishment of a regular dialogue between their foreign ministries, and encouraged dialogues and exchanges between entities associated with political parties in both countries. 

5. President Obama and President Bounnhang Vorachit committed to enhance cooperation at regional and international fora including the Association of Southeast Asian Nations (ASEAN), the ASEAN Regional Forum (ARF), the East Asia Summit (EAS), and the ASEAN Defense Ministerial Meeting Plus (ADMM+) to support peace, stability, cooperation, and development in the Asia-Pacific region.  The two leaders reaffirmed their support for the settlement of disputes by peaceful means in accordance with international law.  They also reaffirmed their support for not resorting to the threat or use of force in resolving disputes.

6. Both leaders welcomed the progress made under the Lower Mekong Initiative (LMI) and Friends of the Lower Mekong (FLM) in recent years.  Therefore, the two presidents reaffirmed their governments’ commitment to work closely together, along with other LMI and FLM members, to further strengthen cooperation through the effective implementation of projects and programs under the LMI Master Plan of Action 2016-2020 and the Sustainable Infrastructure Partnership, to enhance regional connectivity and narrow the development gaps among member countries as well as promote sustainable socio-economic development and the well-being of people in the Mekong region. 

War Legacy Issues

7. President Obama and President Bounnhang Vorachit confirmed that comprehensive cooperation in addressing war legacy issues to deepen mutual trust has allowed both countries to develop a relationship that looks to the future.  To address the impact caused by unexploded ordnance (UXO) in Laos, President Obama announced that the United States intends to contribute $90 million over three years for a national UXO survey and clearance of UXO in Laos.  President Bounnhang Vorachit welcomed the U.S. government’s continued commitment to clear UXO, assist UXO victims, prevent future casualties, and develop local capacity to ensure sustainability of this work.

Humanitarian Cooperation

8. President Obama expressed his appreciation for the Lao P.D.R.’s continued cooperation in providing for the fullest possible accounting for U.S. personnel missing from the war, including its recent steps to increase the efficiency of joint search efforts.   The two sides would continue to meet semi-annually for technical discussions on mission planning and strive to complete the mission in a timely and efficient manner. 

Trade and Economic Ties

9. President Obama and President Bounnhang Vorachit welcomed the signing earlier this year of a Trade and Investment Framework Agreement between the two countries.  The Agreement will strengthen trade ties and form a basis for expanding streams of commerce between the two nations. 

10. The two leaders recognized the importance of protecting the most vulnerable populations while pursuing economic development and upholding international labor standards, including combatting child labor, forced labor, and human trafficking.

11. President Obama welcomed President Bounnhang Vorachit’s commitment to pursuing steps to uphold international labor standards that could pave the way for the United States to grant the Lao P.D.R. benefits under the Generalized System of Preferences.

Education Cooperation

12. President Obama and President Bounnhang Vorachit affirmed the need to enhance educational, cultural, and people-to-people ties between the United States and Lao P.D.R.  President Obama announced an initial basic education program, which focuses on improving early grade reading outcomes, and that Laos would be a Let Girls Learn Challenge Fund country, which would make Laos eligible for additional U.S. government funding for adolescent girls education.  The two leaders noted the positive outcomes of the ongoing U.S. Government-funded School Feeding Program, for which the U.S. Government is currently providing over $27 million in funding over five years.  They remarked on the rapid growth of English language programs in Lao P.D.R. and confirmed that close cooperation on education and training are critical elements to the next phase of the relationship.  The leaders noted that robust English language instruction would contribute to the Lao P.D.R.'s effective collaboration with other ASEAN nations for their mutual educational, cultural and social development as well as its competitiveness in the 21st century global economy.  President Obama and President Bounnhang Vorachit noted the success of bilateral education and exchange initiatives, especially the Fulbright program.  The leaders noted the need for continued discussions on a Peace Corps program in Laos.

Health and Nutrition

13. The two leaders welcomed the establishment of the Lao-American Nutrition Institute, which will align with Laos’s efforts to meet its Sustainable Development Goals, and ensure Lao children receive the nutrition they need for healthy lives.  They also took note of a new three-year, $6 million USAID program that will improve community sanitation and mother and infant feeding practices in targeted districts, in line with the Lao government’s Multi-Sectoral Food and Nutrition Security Action Plan. President Obama reaffirmed the United States’ commitment to providing further medical and other care and assistance for persons with disabilities, regardless of cause.  President Bounnhang Vorachit expressed his appreciation for the U.S. government’s continued support through the President's Emergency Plan for AIDS Relief (PEPFAR) for Lao P.D.R.’s efforts to build sustainable systems for HIV/AIDS prevention, treatment, and care.

14. President Obama and President Bounnhang Vorachit made a commitment to jointly advance the Global Health Security Agenda (GHSA), including formally endorsing the GHSA and through bilateral efforts to develop a five-year roadmap to bolster national capacity in Laos to prevent, detect, and respond to biological threats and to fully implement the International Health Regulations.  As part of this commitment, Laos will join the GHSA multilateral effort in 2016 and will undergo and publish a Joint External Evaluation (JEE) of its national capabilities.  The United States has recently undergone and publically shared the results of its JEE.

Environment

15. President Obama and President Bounnhang Vorachit affirmed the importance of addressing climate change and resolved to support robust and transparent implementation of the historic Paris Agreement.  Following the United States formally joining the Paris Agreement, President Bounnhang Vorachit stated that the Lao P.D.R. has completed its domestic procedures to ratify the Paris Agreement and will formally join the Agreement this year.  Both leaders called on all nations to support the Agreement’s rapid entry into force in 2016.  Both leaders affirmed their commitment to adopt an ambitious and comprehensive hydrofluorocarbons (HFCs) phase-down amendment in 2016 within the Montreal Protocol, and support the adoption of a global market-based measure at the upcoming Assembly of the International Civil Aviation Organization for implementation from 2020.

16. President Obama and President Bounnhang Vorachit welcomed increasing bilateral cooperation to promote sustainable development and management of hydropower and forestry resources, as well as adaptation to climate change and response to natural disasters.  The two countries pledged to promote a low greenhouse gas development pathway, including clean power sources that minimize environmental and climate impacts.

17. The two leaders also committed to work together, along with their LMI partners, to promote scientific research, capacity-building, investment, and dialogue to ensure the sustainable development of the Mekong River.  They committed to increase cooperation to reduce wildlife trafficking and other environmental crimes, in accordance with the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES).

Security

18. President Obama and President Bounnhang Vorachit confirmed that the United States and Lao P.D.R. would continue to cooperate on defense and security through annual Bilateral Defense Dialogues and associated working groups.  The two Presidents committed to expand mutually beneficial cooperation to enhance capabilities such as UXO clearance, search and rescue and disaster response.  The two sides also underscored the importance of enhanced cooperation in non-traditional security matters and confirmed that they would work more closely to counter terrorism; combat transnational crime including narcotics, human, and wildlife trafficking; and address high-tech crime and cyber security. 

Promotion and Protection of Human Rights

19. President Obama and President Bounnhang Vorachit took note of the benefits of a candid and open dialogue to enhance mutual understanding and narrow differences on human rights.  They emphasized the importance of protection and promotion of human rights, the rule of law, and the rights of religious believers.  In this regard, President Obama noted the crucial role of civil society.  Both sides reaffirmed their commitment to uphold the United Nations Charter and the Universal Declaration of Human Rights.  The United States and Lao P.D.R. also committed to include informal consultation on human rights within the annual Comprehensive Bilateral Dialogue.

People-to-People Ties

20. President Bounnhang Vorachit and President Obama highlighted the importance of enhanced cooperation through strengthening people-to-people ties.  They took note of the positive contributions that the people of the Lao P.D.R. and the United States, including the Lao-American community, can make to the strengthening of bilateral ties.  The two leaders encouraged more people-to-people exchanges that focus on solving shared global challenges, with particular focus on encouraging youth leadership and entrepreneurship.

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