Editorial BMJ Mil Health: first published as 10.1136/bmjmilitary-2021-001871 on 21 May 2021. Downloaded from

Nonetheless, Min Aung Hlaing, the new ’s coup d’état and its impact de facto head of the government, reported that Myanmar has permitted the import of on COVID-19 response: a collapsing COVID-19 vaccines from Russia, and India for both public and private healthcare system in a state of turmoil health institutions as approved by the Food and Drug Administration, with the 1,2 1 2,3 goal of inoculating everyone.11 12 Ian Christopher Rocha ‍ ‍ , T D Cedeño ‍ ‍ , M G Pelayo ‍ ‍ , Just when the people needed their 1 4 K Ramos ‍ ‍ , H O H Victoria government to address the COVID-19 situation in the country, this very unfor- tunate scenario happened. Aside from the Myanmar, a country in Southeast Asia, is As of 23 April 2021, there have been documented and undocumented COVID- currently in a state of turmoil after the 142 687 total cases of COVID-19 in the 19-­related deaths, hundreds of civilians military took control of all operations.1 country with 3206 deaths. Among the total were also killed, making the military coup With the added COVID-19 pandemic, the cases, only 7560 are active cases with a a disruption to the country’s COVID-19 country’s situation has totally become a very few and almost unchanging daily new response. This devastating situation in chaos. As a former pariah state under an 7 cases since the coup started. Before the the country has alarmed the international almost 50-year­ rule of an oppressive mili- coup, there were thousands and hundreds community, including the tary junta, known as the ,2 of daily new cases registered every day. (UN) and the Association of Southeast Myanmar seemingly had a déjà vu of mili- 1 3 13 Surprisingly, a few days after the coup, Asian Nations (ASEAN). The UN tary dictatorship since the country the daily new cases abruptly dropped to Security Council convened an emergency returned into a military state from a quasi-­ 7 one or two digits every day. The strange meeting in reaction to the coup, at which democratic political system on 1 February epidemiological report is attributed to a draft resolution calls for the resto- 2021,1 3 in the midst of an ongoing public the hampered COVID-19 testing in the ration of democracy in Myanmar, thereby health emergency, after 10 years of a series country as a result of the turmoil. Due 2 condemning the country’s military actions of political reforms and civilian rule. 1 to the coup and the collapsed healthcare and calling for the release of its detainees. Due to the increasing friction between system, the real COVID-19 situation in However, Russia and China are impeding the civilian government and the Tatmadaw 3 the country is thought to be unreliably a united international response. over alleged election irregularities, Aung reported. The ASEAN has also condemned this San Suu Kyi, the re-elected­ state counsellor copyright. The coup has indeed significantly situation and called out for an emergency of Myanmar, was arrested, along with affected the country’s healthcare summit among all leaders of the member other key officials, in a morning raid.1 3 system. For instance, at least 19 govern- states, including the new de facto leader Despite the ongoing pandemic, the mili- ment doctors from Naypyitaw, Yangon, of Myanmar on 24 April 2021 to discuss tary declared a coup, putting Myanmar 13 14 Mandalay and other areas in Myanmar a dialogue with the military junta. under a 1-year­ .3 Subse- have been charged by the junta for their However, protesters have been calling out quently, the state power was transferred support in the civil disobedience move-

ASEAN to not meet Min Aung Hlaing as http://militaryhealth.bmj.com/ to the commander-­in-­chief of the Armed ment, along with a committee of ousted 1 this might mean that they have recognised Forces, Min Aung Hlaing. 3 13 lawmakers. In fact, there have been his junta’s rule in Myanmar. Despite the The coup d’état in Myanmar has caused reports of doctors being dismissed from protests, the recent ASEAN Summit 2021 severe damage on the COVID-19 response their posts, being arrested and hiding in pushed through. The ASEAN leaders of the country, and the action has been fear for their lives—signifying a grave agreed that the violence in Myanmar condemned by various world leaders due 4 8 breach of humanitarian . More- should stop immediately, that all parties to the continuing escalation of violence over, health infrastructures have also been should engage in meaningful dialogue among its people.3–5 Despite several mass affected. The Grand Hantha International to find a peaceful solution that benefits protests, the country has failed to achieve Hospital, for example, which is situated the people, that humanitarian aid will solidarity in a time where health and safety near a police station in Yangon, exploded be provided in Myanmar and that the 6 3 should have been given greater focus. on September 26, 2021 by guest. Protected last 17 April 2021. COVID-19 ASEAN response fund will be This has therefore hampered the ability In addition to the collapsed COVID-19 used in procuring vaccines for all member of the country and its people to tackle the 14 testing and response, the COVID-19 states including Myanmar. issues brought about by the COVID-19 vaccination progress in Myanmar has Faced with the double threat of global pandemic, especially with the infection trickled down since the ousting of Aung health crisis and military coup, not only rates being underestimated since the start San Suu Kyi’s government, as frontline is Myanmar’s healthcare system facing of the coup.7 health workers refused to get vaccinated collapse but also, more importantly, its unless there is no involvement from the 1 pursuit of a more democratic government School of Medicine, Centro Escolar University, Manila, military junta.8–10 The healthcare system Philippines has been shattered. It is a grave human 2Behavioral Sciences Department, De La Salle has been disorganised as some health rights violation to jeopardise people’s University, Manila, Philippines sectors in Myanmar continue to strike lives in their fight for survival against 3 International Studies Department, Ateneo de Davao along with the uneven boycott system COVID-19 while continuing to repress University, Davao City, Philippines from the public.9 Consequently, the them through military bloodshed. There is 4English Department, East Yangon University, Thanlyin, Yangon, Myanmar trust in the vaccination process has also indeed a pressing concern in the interna- declined as a result of the widespread tional community as to whether there is a Correspondence to Mr Ian Christopher Rocha, anger at the Myanmar regime, with more need for foreign intervention in Myanmar. School of Medicine, Centro Escolar University, Manila, 9 Philippines; rocha1750018@​ ​ceu.edu.​ ​ph of its people refusing to get vaccinated. Under international law, a state has a duty Rocha IC, et al. BMJ Mil Health Month 2021 Vol 0 No 0 1 Editorial BMJ Mil Health: first published as 10.1136/bmjmilitary-2021-001871 on 21 May 2021. Downloaded from to refrain from intervening in the internal Contributors ICR planned and conceptualised cabinet, 2021. Available: https://​asia.nikkei.​ com/​ ​ and external affairs of any other state the manuscript. ICR, TDC, MGP and KR wrote the Spotlight/​Myanmar-​Coup/​Myanmar-​coup-Week-​ ​ manuscript with important contribution from HoHV. from-March-​ 30-​ to-​ ​April-​17-Opponents-​ of-​ junta-​ ​ or, for that matter, the relations between unveil-Suu-​ Kyi-​ led-​ ​unity-​cabinet [Accessed 18 Apr 15 All authors read and approved the final version of the other states. Nonetheless, in the case of manuscript. 2021]. Myanmar, instead of the term humani- Funding The authors have not declared a specific 4 Mahase E. Covid-19: military coup in Myanmar sees tarian intervention, it is more apt to use grant for this research from any funding agency in the virus response crumble as doctors are arrested. BMJ ‘responsibility to protect’. This implies public, commercial or not-­for-­profit sectors. 2021;372:n704. 5 Goldman R. Myanmar’s coup and violence, explained. that when a state fails to discharge its Competing interests None declared. New York Times, 2021. Available: https://www.​ responsibility to the people, the residual Patient consent for publication Not required. nytimes.com/​ ​article/myanmar-​ ​news-protests-​ ​coup.html​ responsibility lies with the broader [Accessed 18 Apr 2021]. Provenance and peer review Not commissioned; community of states. 6 Ebbighausen R. Myanmar coup: mass protests fail to internally peer reviewed. attract global solidarity. DW news, 2021. Available: With the current military atrocities in This article is made freely available for use in https://www.dw.​ ​com/en/​ ​myanmar-coup-​ ​protests-​ Myanmar amidst the COVID-19 pandemic accordance with BMJ’s website terms and conditions solidarity/​a-​56950349 [Accessed 18 Apr 2021]. and the unwillingness or inability of the for the duration of the covid-19 pandemic or until 7 Coronavirus: Myanmar. Available: https://www.​ current military rule to halt its violations, otherwise determined by BMJ. You may use, download worldometers.info/​ ​coronavirus/country/​ ​myanmar/ [Accessed 24 Apr 2021]. the principle of non-­intervention yields and print the article for any lawful, non-­commercial purpose (including text and data mining) provided that 8 Reuters. Coronavirus testing collapses in Myanmar to the principle of international responsi- all copyright notices and trade marks are retained. after coup, 2021. Available: https://www.​reuters.​ com/article/​ ​us-health-​ ​coronavirus-myanmar-​ ​coup-​ bility to protect. This means that the inter- © Author(s) (or their employer(s)) 2021. No commercial idUSKBN2A90CK [Accessed 18 Apr 2021]. national community can safeguard the re-­use. See rights and permissions. Published by BMJ. 9 Frontier Myanmar. Anti-­military defiance slows lives of the people of Myanmar especially COVID-19 vaccination to a trickle, 2021. Available: from the military’s exploitation of the https://www.frontiermyanmar.​ ​net/en/​ ​anti-military-​ ​ COVID-19 crisis. Hence, the UN Human defiance-slows-​ ​covid-19-​ ​vaccination-to-​ ​a-trickle/​ Rights Council called for influential states To cite Rocha IC, Cedeño TD, Pelayo MG, et al. [Accessed 18 Apr 2021]. BMJ Mil Health Epub ahead of print: [please include 10 Soe ZW, Oo MM, Wah KS, et al. Myanmar’s to have an immediate concerted pressure Day Month Year]. doi:10.1136/ health leaders stand against military rule. Lancet towards the military of Myanmar in order bmjmilitary-2021-001871 2021;397:875. to halt the gross human rights violations in Accepted 28 April 2021 11 Eleven Media Group. Private hospitals, clinics allowed 16 to import COVID-19 vaccines, 2021. Available: https://​ the country. BMJ Mil Health 2021;0:1–2. The violations include the pitiless elevenmyanmar.com/​ ​news/private-​ ​hospitals-clinics-​ ​ doi:10.1136/bmjmilitary-2021-001871 allowed-to-​ ​import-covid-​ ​19-vaccines​ [Accessed 18 Apr violence against the people using military-­ 2021].

ORCID iDs copyright. grade weaponry; indiscriminate killing, 12 Chern KW. Private sector permitted to import Ian Christopher Rocha http://orcid.​ ​org/0000-​ ​0002-​ COVID-19 vaccines in Myanmar, 2021. Available: including that of women and children; 8775-6876​ https://www.mmtimes.​ ​com/news/​ ​private-sector-​ ​ and the way too obvious power grabbing T D Cedeño http://orcid.​ ​org/0000-​ ​0002-5005-​ ​9065 permitted-import-​ ​covid-19-​ ​vaccines-myanmar.​ ​html M G Pelayo http://orcid.​ ​org/0000-​ ​0002-9817-​ ​8784 through leveraging COVID-19 pandemic [Accessed 18 Apr 2021]. K Ramos http://orcid.​ ​org/0000-​ ​0002-2675-​ ​5765 towards their personal interests. The 13 Japan Times. Myanmar junta leader set to ASEAN global community, therefore, needs to Summit, drawing outcry, 2021. Available: https:// take decisive action to curb military REFERENCES www.japantimes.​ ​co.jp/​ ​news/2021/​ ​04/18/​ ​asia-pacific/​ ​

myanmar-​-​meeting/ [Accessed 19 Apr 2021]. http://militaryhealth.bmj.com/ manslaughter and to restore the collapse 1 Yeung J. Myanmar’s military has detained leader in a coup: here’s what you need to know, 14 Jakarta: ASEAN Secretariat. Chairman’s statement of democracy and COVID-19 response 2021. Available: https://edition.​ ​cnn.com/​ ​2021/02/​ ​01/​ on the ASEAN leaders’ meeting. Available: http://​ in Myanmar. Without this commitment asia/myanmar-​ ​military-coup-​ ​explainer-intl-​ ​hnk-scli/​ ​ asean2021.bn/​ ​Theme/news/​ ​news-24.​ ​04.21-​ ​csalm.​ to uphold the rights of the citizens and index.html​ [Accessed 15 Apr 2021]. aspx [Accessed 24 Apr 2021]. 15 Schraeder PJ. Intervention in the 1980s: U.S. foreign to protect them from both the domestic 2 Stokke K, Vakulchuk R, Overland I. Myanmar: a political economy analysis. Oslo: Norwegian Institute policy in the third World. Boulder (CO): Lynne Rienner strife and the global health warfare, the of international Affairs, 2018. Available: https://​ Publishers, 1989. very fabric of human rights is relentlessly nupi.brage.​ ​unit.no/​ ​nupi-xmlui/​ ​bitstream/handle/​ ​ 16 Office of the United Nations High Commissioner for shaken. Until then, Myanmar remains 11250/2483349/​ ​NUPI_rapport_​ ​Myanmar_Stokke_​ ​ Human Rights. Intensifying widespread, systematic at the crossroads of surviving both the Vakulchuk_%C3%​ ​98verland.pdf?​ ​sequence=1 slaughter by Myanmar military must be halted - [Accessed 15 Apr 2021]. Bachelet, 2021. Available: https://www.​ohchr.org/​ ​ civil unrest and the health danger that is 3 Nikkei Asia. Myanmar coup: week from March 30 to EN/NewsEvents/​ ​Pages/DisplayNews.​ ​aspx?NewsID=​ ​ COVID-19. April 17, opponents of junta unveil Suu Kyi-­led unity 26989&​LangID=E [Accessed 19 Apr 2021]. on September 26, 2021 by guest. Protected

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