1. Overview
Tuberculosis (TB) is one of the oldest and most lethal infectious diseases in human history. Caused by the bacterium Mycobacterium tuberculosis, it primarily attacks the lungs, yet it is capable of affecting virtually any organ. Despite the existence of effective vaccines, diagnostics, and treatments for decades, TB continues to claim more than one million lives every year — the vast majority in low- and middle-income countries.
Every year on 24 March, the global health community marks World Tuberculosis Day. The date honours the 1882 announcement by German physician Dr Robert Koch, who identified M tuberculosis as the causative agent of TB — a discovery that fundamentally shaped modern medicine. In 2026, the World Health Organization (WHO) and the Stop TB Partnership set the theme: “Yes! We Can End TB: Led by Countries, Powered by People.” This theme signals a decisive shift from global aspiration to concrete, country-owned, community-powered action.
TB is preventable, diagnosable, and curable. Yet it remains the world’s second deadliest infectious disease after COVID-19 during pandemic years. The paradox of a curable disease killing over a million people annually is a moral, political, and public health failure — one that World TB Day 2026 calls every nation to correct.

2. Global Prevalence
According to the WHO Global Tuberculosis Report 2025, approximately 10.7 million people developed TB globally in 2024 — the fourth consecutive year of elevated incidence following the disruptions caused by the COVID-19 pandemic. Of these, an estimated 1.23 million people died: roughly 1.08 million HIV-negative individuals and 150,000 people living with HIV. Drug-resistant TB (DR-TB) remains a critical challenge, with an estimated 150,000 new DR-TB cases recorded in 2024.
Global reduction in TB incidence from 2015 to 2024 stands at only 12.3 per cent — far short of the WHO End TB Strategy milestone target of a 50 per cent reduction by 2025. South-East Asia alone, home to less than a quarter of the global population, accounts for more than one in every three new TB cases worldwide. Encouragingly, coordinated global TB control efforts have saved an estimated 83 million lives since 2000, demonstrating the transformative impact of sustained international action. However, COVID-19 disruptions reversed hard-won progress and accelerated undetected transmission, making the recovery period of 2022–2026 critically important.
TB is fundamentally a disease of inequity, driven by poverty, overcrowding, malnutrition, and limited access to healthcare. Ending it will demand not only medical interventions but comprehensive, multisectoral strategies that address these upstream social determinants.

3. Tuberculosis in Myanmar
Myanmar carries one of the heaviest TB burdens in the world and is designated as one of the WHO’s 30 high-TB-burden countries. According to the WHO South-East Asia Regional Office, Myanmar’s TB incidence rate in 2024 was approximately 480-500 cases per 100,000 population — far above the regional average of 201 and the global average of 131 per 100,000. In absolute terms, an estimated 263,000 people developed TB in Myanmar in 2024. Approximately 50,000 deaths annually are attributed to the disease
Myanmar faces what public health experts describe as a “triple burden” — drug-susceptible TB, drug-resistant TB, and HIV-associated TB — making its TB response among the most complex in the region. The fourth National TB Prevalence Survey conducted between 2017 and 2018 found a bacteriologically confirmed TB prevalence of 468 per 100,000 adults, though this represented a notable 51 per cent reduction from the 2009-2010 survey, reflecting an average annual decline of 7.6 per cent. This steady progress demonstrates that Myanmar’s National TB Programme, with international support, has been making significant gains.
The COVID-19 pandemic severely disrupted that trajectory. In 2020, case detections fell by approximately 40 per cent compared to the prior year, reversing years of achievement and leading to increased rates of undiagnosed and untreated TB — particularly among vulnerable populations in urban slums, and hard-to-reach communities. Recovery since 2022 has been notable, and a 2025 hybrid WHO review commended the Ministry of Health for maintaining essential TB services under exceptionally difficult conditions. Myanmar is now in the process of developing its National Tuberculosis Strategic Plan 2026-2030, which aims to close detection gaps, scale up preventive treatment, and restore the downward trend in incidence.

4. Signs and Symptoms
The clinical presentation of TB varies by the site of infection and the immune status of the individual. Pulmonary TB — the most common form — primarily manifests with respiratory and systemic symptoms. Extrapulmonary TB, in which the bacterium spreads beyond the lungs, can affect virtually any organ and may present with diverse, organ-specific features.
Pulmonary TB
The hallmark of pulmonary TB is a persistent productive cough lasting two weeks or more, sometimes with blood-streaked sputum or frank haemoptysis. Chest pain, tightness, and progressive shortness of breath are also common. Systemic symptoms accompanying pulmonary TB include prolonged low-grade fever (often worse in the evenings), drenching night sweats, significant unexplained weight loss, loss of appetite, and persistent fatigue. The combination of these symptoms in a patient from a high-burden country like Myanmar should prompt immediate TB evaluation.
Extrapulmonary TB
When TB disseminates beyond the lungs, it may present as painless cervical lymph node swelling (scrofula), back pain and spinal deformity in Pott’s disease, severe headache and neck stiffness in TB meningitis, joint pain and swelling in musculoskeletal TB, abdominal pain and ascites in abdominal TB, or haematuria and flank pain in genitourinary TB. In young children under five and immunocompromised individuals — including people living with HIV — TB may present atypically, and severe disseminated or miliary TB can develop rapidly, with non-specific systemic features that may not suggest the diagnosis without a high index of suspicion.

5. Risk Factors
TB infection and disease progression are shaped by a complex interplay of host vulnerability, pathogen exposure, and environmental conditions. The following groups carry the highest risk and are priority targets for screening and preventive intervention.
Immunocompromised states markedly increase the risk of progression from TB infection to active disease. HIV infection remains the single most powerful individual risk factor for TB — a person living with HIV is up to 18 times more likely to develop active TB than an HIV-negative individual. Diabetes mellitus is an increasingly significant risk factor in Asia, where its prevalence is rising rapidly. Other immunosuppressive conditions and treatments — including renal failure, malnutrition, corticosteroids, and tumour necrosis factor-alpha inhibitors — similarly elevate risk.
Beyond medical vulnerabilities, social and environmental determinants are equally critical. Poverty, overcrowding, poor housing, food insecurity, and incarceration create conditions in which TB spreads readily and goes undetected. Smoking and alcohol use disorder are independent risk factors. Healthcare workers exposed to active TB cases, miners at risk of silicosis, and migrants or displaced persons from high-burden settings are among the occupational and demographic groups requiring particular attention. In Myanmar’s specific context, populations in urban slums and individuals in hard-to-reach communities are among the most vulnerable.

6. Diagnosis
Early and accurate diagnosis is the cornerstone of TB control. Delayed diagnosis sustains transmission, worsens outcomes, and drives drug resistance. Multiple modalities are available, and their appropriate use depends on available resources and clinical context.
Sputum smear microscopy — examining sputum for acid-fast bacilli — is rapid and widely available but offers limited sensitivity, particularly in HIV-positive patients and children. Sputum culture on Lowenstein-Jensen or liquid MGIT media remains the diagnostic gold standard, detecting TB and drug susceptibility with high accuracy, but takes two to eight weeks. The Xpert MTB/RIF and Xpert MTB/RIF Ultra assays represent a transformational advance: these WHO-recommended rapid molecular tests detect M. tuberculosis and rifampicin resistance within two hours and are now widely used in Myanmar’s TB diagnostic network. Line probe assays provide additional drug resistance profiling.
Chest X-ray is an indispensable screening and diagnostic tool, identifying pulmonary infiltrates, cavitations, and pleural effusions characteristic of TB. CT scanning offers higher resolution for complex or atypical presentations. For the detection of latent TB infection, the Tuberculin Skin Test (Mantoux) and Interferon-Gamma Release Assays (IGRAs) are used, with IGRAs offering greater specificity in BCG-vaccinated populations such as Myanmar’s.
A landmark development for World TB Day 2026 is the WHO’s Call to Action, urging Member States to fast-track the rollout of the first-ever WHO-recommended near point-of-care diagnostic tests. These tests are designed to be deployed at health centres and community-level facilities, dramatically reducing diagnostic delays that fuel transmission and preventable deaths — a critical development for high-burden settings like Myanmar.

7. Treatment
TB is curable. Treatment success depends on timely initiation, accurate drug susceptibility testing, and full adherence to the prescribed regimen. Myanmar’s National TB Programme delivers treatment through the directly observed therapy, short-course (DOTS) strategy.
Drug-Susceptible TB
The standard first-line regimen for drug-susceptible TB is a six-month course: two months of Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol, followed by four months of Isoniazid and Rifampicin (2HRZE/4HR). When completed as prescribed, treatment success rates exceed 85 per cent. HIV-positive TB patients require concurrent antiretroviral therapy — initiated within two to eight weeks of starting TB treatment — alongside cotrimoxazole preventive therapy.
Drug-Resistant TB
Multidrug-resistant TB (MDR-TB), resistant to at least isoniazid and rifampicin, and extensively drug-resistant TB (XDR-TB) represent the most challenging treatment scenarios. New all-oral regimens — BPaL (Bedaquiline, Pretomanid, Linezolid) and BPaLM (with Moxifloxacin) — have transformed the management of MDR/XDR-TB, reducing treatment duration from 18-24 months to as little as six months with improved outcomes. WHO recommends these regimens as priority options, and their rollout in Myanmar is a strategic priority.
TB Preventive Treatment
For individuals with latent TB infection — those infected but not yet ill — TB Preventive Treatment (TPT) is a proven strategy to prevent progression to active disease. Recommended regimens include six months of daily isoniazid (6H), three months of weekly rifapentine plus isoniazid (3HP), or one month of daily rifapentine plus isoniazid (1HP). Scale-up of TPT for household contacts and PLHIV is central to Myanmar’s 2026-2030 strategic plan.

“Health is wealth” is a saying that people all over the world widely accept and believe. This proverb clearly explains the importance of good health in human life. A person may work hard to earn a great deal of money, gain a high social position, and enjoy luxury and comfort. However, if that person does not have good health, all the wealth and status in the world cannot bring true happiness. Without health, a person cannot fully enjoy life, no matter how rich or successful he or she may be. Therefore, good health is considered one of the greatest blessings in life.
Health is the foundation of a happy and meaningful life. When people are healthy, they feel energetic, confident, and ready to face the challenges of daily life. A healthy person can work productively, learn effectively, and contribute positively to society. In contrast, when people suffer from illness or poor health, their ability to perform daily tasks becomes limited. They may feel weak, tired, and discouraged. This is why maintaining good health is extremely important for every individual.
In order to live a long and happy life with family members and loved ones, everyone must pay attention to their health. A healthy body and mind allow people to enjoy their lives more fully. They can spend quality time with their families, pursue their dreams, and participate actively in social and community activities. Good health also helps people remain independent and self-reliant as they grow older.
Unfortunately, many people today do not give enough attention to their health. In modern society, people often lead very busy lives. They spend most of their time working, studying, or dealing with various responsibilities. Because of these busy schedules, they sometimes forget to take proper care of their bodies. Some people skip meals, sleep too little, or rely too much on fast food and unhealthy snacks. Others spend long hours sitting in front of computers or using their mobile phones without engaging in physical activity.
Another problem is that many people only begin to think about their health after they become sick. When they are young and strong, they may believe that health problems will never happen to them. As a result, they develop unhealthy habits that may later cause serious health issues. However, prevention is always better than a cure. It is much easier to maintain good health than to recover from illness. Therefore, people should develop good health habits before their health begins to decline.
Healthy living includes several important aspects such as balanced nutrition, regular exercise, sufficient rest, and a positive lifestyle. First, proper nutrition plays a vital role in maintaining good health. People should eat a balanced diet that includes fruits, vegetables, grains, protein, and other essential nutrients. Eating too much oily, salty, or sugary food can lead to various health problems such as obesity, heart disease, and diabetes. Drinking enough clean water is also essential for keeping the body hydrated and functioning properly.
Second, regular physical activity is necessary for maintaining a strong and healthy body. Exercise helps improve blood circulation, strengthen muscles, and maintain a healthy weight. Activities such as walking, jogging, cycling, swimming, or playing sports can help people stay physically fit. Even simple daily activities such as climbing stairs, doing household chores, or stretching can contribute to better health. Regular movement also reduces the risk of many diseases and improves overall well-being.
Third, adequate sleep and rest are important for both physical and mental health. The human body needs enough sleep to recover from daily activities and restore energy. Lack of sleep can cause fatigue, stress, and reduced concentration. Therefore, people should maintain a regular sleep schedule and ensure they get enough rest each night.
In addition to physical health, mental health is also very important. Stress, anxiety, and negative emotions can affect a person’s overall well-being. People should try to maintain a positive attitude and manage stress in healthy ways. Spending time with family and friends, practising relaxation techniques, and engaging in hobbies can help improve mental health.
In today’s world, technological devices such as smartphones, computers, and televisions have become an important part of everyday life. While these technologies offer many benefits, excessive use can also lead to health problems. Spending too much time on screens can cause eye strain, poor posture, and a lack of physical activity. Therefore, people should try to balance their use of technology with healthy outdoor activities and social interactions.
Good health is not only important for individuals but also for the development of a nation. When citizens are healthy and strong, they can work more efficiently and contribute to the economic growth and stability of their country. Healthy people can participate actively in education, industry, agriculture, and other sectors that support national development. Moreover, a healthy population helps ensure a brighter future for the next generation.
Governments and national organizations also recognize the importance of public health. Many countries implement policies and programmes to improve healthcare services, promote healthy lifestyles, and prevent diseases. These efforts aim to ensure that people can live longer, healthier, and more productive lives.
Education also plays a key role in promoting health awareness. Schools and communities should encourage people to learn about healthy living and develop good habits from an early age. Children who grow up with proper knowledge about nutrition, exercise, and hygiene are more likely to maintain healthy lifestyles throughout their lives.
In addition, health is one of the most valuable treasures a person can have. Without good health, wealth, success, and comfort lose their true meaning. Therefore, everyone should take responsibility for maintaining their own health. By eating nutritious food, exercising regularly, getting enough rest, and maintaining a positive lifestyle, people can protect their health and enjoy a longer and happier life.
For these reasons, it is important to encourage all people to be aware of the value of health and to practice healthy habits in their daily lives. By doing so, individuals, families, and society as a whole can achieve a healthier, stronger, and more prosperous future.

gnlm

1. Overview
Every year on 4 March, the global health community observes World Obesity Day (WOD) — a day dedicated to raising awareness, driving policy change, and empowering individuals to take action against one of the most pressing non-communicable diseases (NCD) challenges of our era. Established by the World Obesity Federation, WOD 2026 carries the theme “Breaking Barriers to Healthier Lives,” calling on governments, healthcare professionals, communities, and individuals to dismantle the systemic, social, and behavioural obstacles that perpetuate obesity worldwide.
Obesity is no longer a problem confined to high-income countries. It is a global epidemic that transcends borders, affecting low- and middle-income countries (LMICs) with equal – and often greater – ferocity. Myanmar, like many of its Southeast Asian neighbours, is experiencing a rapid nutrition transition characterized by rising rates of overweight and obesity, particularly among urban adolescents and adults. Data from Myanmar’s Global School-based Student Health Survey (GSHS 2016) provide valuable national benchmarks and underscore the urgent need for targeted intervention.
This article aims to educate communities – from individual households to healthcare providers and policymakers — about the nature of obesity, its burden in Myanmar and globally, its multifactorial causes, its serious health consequences, and the practical, evidence-based steps all of us can take to prevent and manage it.

2. Definition of Obesity
a. Clinical Definition
Obesity is defined as abnormal or excessive fat accumulation that presents a health risk. The most widely used clinical measure is the Body Mass Index (BMI), calculated as weight in kilograms divided by the square of height in metres (kg/m²).

Table 1. BMI Classification — WHO Global vs. WHO Asian cut-offs.
For children and adolescents (aged 5–19 years), the WHO uses age- and sex-specific BMI-for-age z-scores: overweight is defined as >+1 SD and obesity as >+2 SD above the median of the WHO Growth Reference 2007.
Waist circumference (WC) is an important complementary measure of central (abdominal) adiposity, which is particularly associated with metabolic risk. For Asian populations, action thresholds are: ≥ 90 cm for men and ≥ 80 cm for women.

b. Beyond BMI
Obesity is now increasingly understood not merely as a numerical threshold but as a chronic, relapsing, multisystem disease with a strong biological basis. The Edmonton Obesity Staging System (EOSS) recognizes that the metabolic, mechanical, and mental health impact of excess adiposity is equally — if not more — important than BMI alone. This shift in framing is central to the World Obesity Federation’s advocacy: obesity deserves the same clinical respect and resource allocation as other chronic diseases.

3. Global Prevalence
Obesity has reached pandemic proportions. According to the World Obesity Federation’s 2023 Atlas and WHO 2024 estimates:
• More than 1 billion people worldwide are living with obesity — exceeding one in eight of the global population for the first time in history.
• In 2022, 2.5 billion adults (aged 18+) were classified as overweight (BMI ≥ 25), of whom 890 million had obesity.
• Adult obesity has more than doubled since 1990, and adolescent obesity has quadrupled over the same period.
• If current trajectories continue, the World Obesity Federation projects that by 2035, over four billion people — roughly half the global population — will be living with overweight or obesity.
• The annual economic cost attributable to overweight and obesity is projected to reach US$4.32 trillion by 2035, equivalent to nearly three per cent of global GDP — surpassing the economic burden of smoking.
• Low- and middle-income countries now bear a disproportionate share of the global obesity burden, with obesity rates rising fastest in South Asia, Southeast Asia, and Sub-Saharan Africa.
• Among children and adolescents aged 5-19 years, approximately 390 million were overweight in 2022, of whom at least 160 million had obesity.
The Asean Region – home to Myanmar – has seen particularly sharp increases. Rapid urbanization, nutrition transition toward energy-dense ultra-processed foods, reduced physical activity linked to sedentary lifestyles, and inadequate health literacy are driving forces across the region.

4. Prevalence in Myanmar
a. Adult Data
Nationally representative data on adult obesity in Myanmar remain limited, but available evidence points to an accelerating trend. The WHO STEPwise survey and multiple nutrition reports indicate that:
• The prevalence of adult overweight (BMI ≥ 23 using Asian cut-offs) is estimated at approximately 22– 30 per cent in urban areas and lower in rural settings.
• Urban women, particularly in Yangon and Mandalay, demonstrate higher rates of overweight and obesity compared to their rural counterparts.
• Central adiposity (waist circumference ≥ 80 cm in women, ≥ 90 cm in men) is increasingly prevalent and is a recognized risk factor for cardiovascular disease and type 2 diabetes in the Myanmar population.

b. Adolescent Data — GSHS Myanmar 2016
The Myanmar Global School-based Student Health Survey (GSHS) 2016, conducted among students aged 13– 17 years in government secondary schools, provides the most comprehensive nationally representative dataset on adolescent health behaviours and nutritional status in Myanmar to date. Key findings relevant to obesity include:

Table 2. Selected GSHS Myanmar 2016 indicators related to overweight, obesity, and associated risk behaviours.
These data are alarming: more than 70% of adolescent boys and nearly 80 per cent of girls fail to meet the minimum recommended physical activity levels. Over half do not consume adequate fruits or vegetables. These behavioural risk factors, combined with rising consumption of calorie-dense foods and sugary beverages, are setting the stage for a significant rise in adult obesity in Myanmar in the coming decade if no action is taken.

5. Causes of Obesity
Obesity is the result of a complex interplay between genetic, physiological, behavioural, social, environmental, and economic factors. No single cause explains the epidemic; it is the product of an “obesogenic environment” that makes energy-dense food widely available while systematically reducing opportunities for physical activity.

a. Energy Imbalance
At its simplest, obesity results from a sustained positive energy balance — consuming more calories than the body expends. However, this simplification obscures the many biological and environmental drivers that influence both energy intake and energy expenditure.

b. Dietary Factors
• High consumption of ultra-processed foods (UPFs) rich in refined carbohydrates, saturated fats, and added sugars.
• Increased portion sizes and frequency of eating out at restaurants and street stalls.
• Easy availability and low cost of calorie-dense, nutrient-poor snacks and sugary beverages, including carbonated drinks and sweetened teas.
• Reduced consumption of whole grains, fruits, vegetables, and legumes.
• Marketing and advertising of unhealthy food products, particularly to children and adolescents.

c. Physical Inactivity
• Sedentary occupations and desk-based work are exacerbated by urbanization.
• Increased screen time (smartphones, television, social media) — a major concern for Myanmar’s youth as smartphone penetration rises rapidly.
• Inadequate infrastructure for active transport (cycling lanes, safe walking paths).
• Lack of accessible, affordable recreational facilities and green spaces.
• Reduced physical education time in schools.

d. Biological and Genetic Factors
• Genetics account for 40-70 per cent of the variation in BMI within populations. Certain gene variants (eg, FTO, MC4R) predispose individuals to weight gain.
• Hormonal dysregulation (e.g., leptin resistance, insulin resistance) disrupts satiety signalling and fat metabolism.
• Gut microbiome composition influences energy harvest from food and inflammatory pathways.
• Epigenetic influences: prenatal exposures to maternal obesity, gestational diabetes, and malnutrition programme offspring for later metabolic disease.

e. Social and Economic Determinants
• Poverty: calorie-dense foods are often cheaper and more filling than nutritious alternatives – the “food insecurity paradox”.
• Low educational attainment limits health literacy and the ability to make informed dietary choices.
• Urbanization and rural-to-urban migration disrupt traditional diets and activity patterns.

• Cultural norms: In some Asian contexts, being slightly overweight is culturally associated with prosperity and good health, delaying help-seeking.
• Food environments in urban areas of Myanmar are dominated by street food high in oil, sugar, and refined carbohydrates.

To Be Continued

gnlm

Myanmar’s Comprehensive Ban on E-Cigarettes for Public Health

Continued From yesterday
The Ministry of Health of the Republic of the Union of Myanmar issued Order 8/2026 on 18 February 2026 (3rd Waxing Day of Taboung, 1387 ME) to impose a comprehensive ban on electronic cigarettes. Exercising the authority conferred under Section 4 (a) of the Essential Supplies and Services Law, the Ministry enacted this notification in accordance with Section 9 of the said Act. The order strictly prohibits the importation, exportation, sale, possession, storage, distribution, and consumption of e-cigarettes, e-shisha, and related accessories to protect public health and prevent toxic substance addiction among young people.
The order 8/2026 now completes the architecture of Myanmar’s ENDS prohibition, adding a clear, enforceable import and export ban that gives customs officers unambiguous authority to seize prohibited products at borders and ports of entry.

Essential Contents of Myanmar’s Order 8/2026
The scope and technical precision of the order No. 8/2026 distinguish it from many earlier bans globally. Rather than a broad definitional prohibition susceptible to definitional loopholes, the Order enumerates in granular detail every product category and component part subject to the ban:
Category (a) — Electronic Cigarettes and ENDS: Mouthpieces; e-liquid containers (reservoirs, cartridges, tanks, pods); atomizers; microprocessors; batteries; chargers; charging cables; pre-filled and refillable e-liquids, including natural organic substitutes; carrying cases; cleaning tools; and all related accessories.
Category (b) — Heated Tobacco/Smoking Devices (HTPs): Holders containing heating elements and their casings; batteries; microprocessors; heating blades; heating coils; heating ovens; e-liquids and natural organic substitutes; carrying cases; cleaning tools; chargers; charging cables; and all related accessories.
Category (c) — Electronic Shisha: Mouthpieces; hoses; vases; grommets; e-liquid containers; pre- filled and refillable e-liquids, molasses, and natural organic substitutes; atomizers; microprocessors; flow sensors; batteries; chargers; charging cables; carrying cases; cleaning tools; and all related accessories.
The Order prohibits all listed items from: importation, exportation, transit, transhipment, re- exportation, storage, display, and sale — encompassing the full range of customs-related commercial activities at all border entry points throughout Myanmar.

Benefits for Myanmar’s Youth and General Public
Protecting Brain Development and Preventing Addiction
The most profound benefit of Myanmar’s e-cigarette ban is the protection it offers to the developing brains of adolescents and young adults. Nicotine is acutely neurotoxic during the critical period of brain development that extends into the mid-twenties. Nicotine exposure during adolescence permanently alters the architecture of the prefrontal cortex — the region governing decision-making, impulse control, and executive function — through its action on nicotinic acetylcholine receptors. Studies have demonstrated measurable reductions in attention, learning capacity, working memory, and impulse regulation among adolescent nicotine users. These are not temporary effects; they are permanent structural changes that disadvantage affected individuals throughout their lives.
By removing the primary supply channel of affordable, appealing nicotine products from the market, the ban directly reduces the probability that Myanmar’s young people will initiate nicotine use — and therefore protects the cognitive development and academic potential of the next generation of Myanmar’s citizens.

Preventing the Gateway to Conventional Smoking
The gateway effect of e-cigarettes is among the most robustly evidenced phenomena in tobacco research. Young people who use e-cigarettes are approximately three times more likely to transition to regular cigarette smoking than non-users. For Myanmar — already carrying a conventional tobacco burden that kills nearly 57,000 people annually — this pipeline effect would compound an existing crisis. The ban interrupts this pathway at the point of initiation, protecting Myanmar from a future in which the brief e- cigarette epidemic creates a new generation of long-term conventional smokers.

Respiratory and Cardiovascular Health Protection
The aerosol produced by e-cigarettes causes measurable respiratory and cardiovascular harm even in the short term. Ultrafine particles in the aerosol penetrate to the deepest airways, triggering inflammatory responses that, with repeated exposure, can lead to chronic bronchitis, decreased lung function, and increased susceptibility to respiratory infections, including influenza and COVID-19. Nicotine’s acute cardiovascular effects — elevated heart rate, increased blood pressure, endothelial dysfunction — elevate cardiovascular risk with every puff. The removal of these products from Myanmar’s market will prevent a cohort of respiratory and cardiovascular diseases that would otherwise have materialized in the coming decades.

Economic and Social Benefits
The economic burden of tobacco-related disease on Myanmar’s healthcare system and economy is already substantial. Every person who never initiates nicotine use through e-cigarettes represents savings in future healthcare expenditure, preserved workforce productivity, and reduced family suffering. For a health system with limited resources, prevention through supply restriction is among the most cost- effective public health interventions available. The social benefits of denormalizing vaping — reversing the re-glamorization of nicotine use that the industry engineered — are equally significant, as social norms powerfully shape youth behaviour.

Making the Ban Effective: What Must Follow
The issuance of Order 8/2026 is a necessary but not sufficient condition for effective e-cigarette prohibition. The experiences of Thailand, Singapore, and India — countries that have operated comprehensive bans for a decade or more — provide clear lessons on what transforms a policy declaration into an on-the-ground reality.

Comprehensive Legislation
The order governs border entry and exit but does not explicitly address domestic manufacture, internal trade, possession, or use. Myanmar needs dedicated ENDS legislation — ideally as an amendment to the existing Control of Smoking and Consumption of Tobacco Products Law — that covers the complete product lifecycle within the country. This legislation should specify criminal penalties, establish clear enforcement responsibilities across multiple agencies (customs, police, health inspectors, local authorities), and include provisions for asset forfeiture in large-scale trafficking cases.

Enforcement Capacity Building
Myanmar’s borders — particularly informal crossing points with China, Thailand, and India — represent the most vulnerable points for contraband vaping product entry. Investment in customs officer training, detection equipment, and intelligence-sharing arrangements with neighbouring countries’ enforcement agencies is essential. The Ministry of Commerce and the Customs Department should establish dedicated ENDS enforcement units with clear key performance indicators. Market surveillance in urban retail and online environments must be systematic, not reactive.

Online Platform Regulation
The primary marketplace for e-cigarettes in Myanmar is not the physical shop but Facebook, TikTok, Telegram, and other social media platforms. A ban that does not address online sales and promotion will be substantially undermined. Regulatory authority must be extended to require platform operators to remove ENDS listings and advertising, with penalties for non-compliance. This requires both legal authority and the technical capacity to monitor and enforce.

Public Education and Demand Reduction
Supply restriction through border control addresses availability but not demand. A comprehensive public health communication campaign — designed specifically for adolescents and young adults, delivered through the channels they actually use, and employing messages that resonate with youth values of autonomy, authenticity, and peer respect — is essential to reduce demand. The campaign should specifically counter the industry’s marketing narratives: that vaping is harmless, that it is a lifestyle choice rather than an addiction, and that it is socially desirable. Schools, universities, monasteries, community health workers, and healthcare providers all have roles to play in this communication effort.

Cessation Support for Existing Users
An unknown but significant number of Myanmar residents are already nicotine-dependent through e- cigarette use. A ban without parallel investment in cessation services will either drive these individuals towards conventional cigarettes or towards the contraband market — outcomes that undermine the public health rationale for the ban. Evidence-based cessation support — nicotine replacement therapy, brief behavioural counselling, and telephone quitlines — must be made accessible through the existing township health system.

Monitoring and Accountability
The effectiveness of the ban must be measured, not assumed. A national surveillance system — building on the existing STEPS and Global Youth Tobacco Survey frameworks — should be established to track ENDS prevalence annually among youth and adults, monitor contraband market activity, and evaluate the impact of enforcement and education interventions. This evidence base will be essential for adaptive management and for reporting to the WHO FCTC Secretariat.

Conclusion
Myanmar’s Order 8/2026 is a landmark public health measure — a decisive, comprehensive, and technically thorough prohibition on the importation, exportation, and trade in all forms of electronic smoking devices and their components. It places Myanmar firmly alongside India, Thailand, Singapore, Cambodia, and Laos in the most protective tier of global e-cigarette regulation, fulfilling Myanmar’s obligations under the WHO FCTC and acting on the urgent call of COP11.
The order arrives after years in which Myanmar’s young people were exposed to an unregulated flood of nicotine products, and after a period in which Myanmar’s robust achievements on conventional tobacco control — its globally-ranked pictorial health warning requirements and its progression towards plain packaging — were undermined by the absence of ENDS-specific measures. The ban corrects this inconsistency and restores the integrity of Myanmar’s comprehensive tobacco control framework.
But as this article has argued, the order is the beginning of a journey, not its destination. Thailand, Singapore, and India demonstrate that comprehensive bans are most effective when supported by strong domestic legislation, well-resourced enforcement, targeted public education, and accessible cessation services. Myanmar now has the policy declaration. The measure of success will be whether the institutions, resources, and political will are marshalled to make that declaration real.
E-cigarettes are not an escape from nicotine addiction. They are its newest and most seductive gateway. Myanmar has taken the right step in closing that gateway. Let us ensure the door remains firmly shut — for the health, the futures, and the freedom of Myanmar’s next generation.
The author is a public health specialist and WHO Guest Adviser who attended the WHO FCTC COP11 Conference in Geneva, November 2025.

References
1. World Health Organization. WHO Framework Convention on Tobacco Control (WHO FCTC) — Report of the Conference of the Parties, Eleventh Session (COP11). Geneva: WHO; November 2025. Available at: https://fctc.who.int/
2. World Health Organization. The global prevalence of e-cigarettes in youth: A comprehensive systematic review and meta-analysis. Geneva: WHO; 2025.
3. Myint HS, Hlaing SH, Htay N. Prevalence of e-cigarette use among tobacco smokers in six states and regions of Myanmar. Myanmar Health Sciences Research Journal. 2020.
4. Global Youth Tobacco Survey (GYTS) 2016 Data. Prevalence and determinants of tobacco use among youth in Myanmar. Atlanta: CDC/WHO; 2016.
5. Singapore Ministry of Health. FAQs on E-Cigarettes, Vapourizers and Heat-Not-Burn Tobacco Products. Singapore: MOH; 2018.
6. Republic of the Union of Myanmar, Ministry of Health, Order 8/2026: Nay Pyi Taw: 18February 2026.
7. The author. E-Cigarette Danger: A Growing Global and National Burden. Global New Light of Myanmar. Yangon: GNLM; 20 December 2025.

gnlm

What Is an E-Cigarette?
Electronic cigarettes — commonly known as e-cigarettes, vapes, vapourizers, or Electronic Nicotine Delivery Systems (ENDS) — are battery-powered devices that heat a liquid solution to produce an aerosol that is inhaled by the user. Unlike conventional cigarettes, which generate smoke through the combustion of tobacco leaf, e-cigarettes operate through an electrical heating mechanism that vapourizes a chemical liquid, commonly called e-liquid or e-juice. This fundamental distinction — vapourization rather than combustion — was the cornerstone of the industry’s early marketing claim that e-cigarettes are ‘safer’ than traditional smoking. That claim, as the global scientific community has firmly established, is dangerously misleading.
E-cigarettes come in numerous forms: cigarlike devices that resemble conventional cigarettes, pen-style vapourizers, tank-based mods, and the increasingly ubiquitous pod systems and disposable single-use devices. Heated tobacco products (HTPs) such as IQOS, and electronic shisha or e-hookah devices fall within the broader category of emerging tobacco and nicotine products regulated under international frameworks.

Core Components
All e-cigarette devices share three essential components: a battery providing the power source; an atomizer (heating coil) that converts e-liquid to aerosol; and the e-liquid reservoir — a cartridge, tank, pod, or bottle containing the consumable solution. The e-liquid itself contains a mixture of propylene glycol and vegetable glycerin as the base carrier, nicotine in concentrations ranging from zero to over 50 milligrammes per millilitre in some products, flavouring agents — which may number in the thousands across products — and additional chemical additives.
Crucially, the e-liquid and the aerosol it generates are not inert. Heating these compounds produces new chemical species not present in the original liquid. At high temperatures, propylene glycol and glycerin decompose to form formaldehyde, acetaldehyde, and acrolein — substances classified as known or probable human carcinogens by the International Agency for Research on Cancer (IARC). The flavouring compound diacetyl, widely used in buttery and creamy flavour variants, is firmly linked to bronchiolitis obliterans — a severe, irreversible obliterative lung disease colloquially known as ‘popcorn lung.’ Heavy metals, including nickel, tin, and lead, have been detected in e-cigarette aerosols, leached from heating coil components.

Global and Myanmar Prevalence
The Global Vaping Epidemic
The global growth of e-cigarette use has been extraordinary in both scale and speed. From a niche consumer product a decade ago, the global e-cigarette market had attracted an estimated 82 million users by 2021, up from 68 million in 2020 — a 20.6 per cent increase in a single year. The South-East Asia region alone accounted for approximately 14.3 million users in 2021. Market analysts project the global ENDS industry to exceed US$55 billion in annual revenue by 2030, driven by aggressive expansion into low- and middle-income markets across Asia, Africa, and Latin America.
The demographic profile of e-cigarette uptake is perhaps its most alarming feature. According to the World Health Organization’s 2025 systematic review and meta-analysis on global youth e-cigarette prevalence, at least 15 million children aged 13 to 15 years currently use e-cigarettes worldwide. Children are, on average, nine times more likely to use e-cigarettes than adults in surveyed countries. Among youth aged 16 to 19 years, current usage rates range from 7.7 to 9.4 per cent across countries — figures that represent an unprecedented epidemic of nicotine addiction initiation among a generation that had never smoked conventional cigarettes.
The tobacco industry’s strategy is explicit in its internal documents: recruit a new generation of nicotine- dependent consumers to replace adults who quit or die from smoking-related diseases. The instrument of this recruitment is the e-cigarette — packaged in child-friendly designs, available in thousands of sweet and fruity flavours, priced at pocket money levels in disposable form, and promoted through social media platforms where young people spend the majority of their leisure time.

Myanmar’s Burden
In Myanmar, e-cigarette use has expanded rapidly against an already concerning backdrop of conventional tobacco use. National STEPS survey data recorded an adult smoking prevalence of approximately 26 per cent, and an estimated 56,841 people die annually in Myanmar from smoking- related diseases — a figure that will grow as the downstream health consequences of the emerging vaping epidemic materialize.
A 2020 study of tobacco smokers across six states and regions of Myanmar found that 11.6 per cent of respondents reported ever having used an e-cigarette. Use was significantly concentrated among males, students, youth aged 18 to 29 years, and residents of Mandalay Region — the demographic groups most targeted by the industry’s marketing. Data from the 2016 Global Youth Tobacco Survey showed that smoking prevalence among students aged 13 to 15 in Myanmar had already risen from 6.8 per cent in 2011 to 8.3 per cent in 2016, before the explosive growth of affordable disposable vapes in subsequent years.

WHO FCTC: The International Call for Action
The World Health Organization Framework Convention on Tobacco Control (WHO FCTC), which entered into force in 2005 and to which Myanmar acceded in 2004, remains the world’s first international public health treaty and the cornerstone of global tobacco control. It’s 182 Parties collectively represent over 90 per cent of the world’s population, making it one of the most widely adopted treaties in United Nations history.
The 11th Conference of the Parties (COP11) to the WHO FCTC, held in Geneva, Switzerland from 16 to 22 November 2025, placed ENDS and emerging nicotine products at the centre of its deliberations. I attended COP11 as a WHO Guest Advisor. The consensus of COP11 was unambiguous: e-cigarettes represent a dangerous gateway that leads young people towards conventional cigarette use through nicotine addiction, and the protection of youth must be the paramount priority for all Member States.

Key COP11 Resolutions and Positions
• All Member States resolved to prioritize protective measures for youth against e-cigarettes and to establish strict regulations, treating the issue as an urgent public health emergency rather than a commercial regulatory matter.
• The Conference reaffirmed that e-cigarettes are not an approved smoking cessation therapy — the WHO does not recommend ENDS for cessation — and that framing them as harm reduction tools plays into the tobacco industry’s strategy of delay and deception.
• Member States were called upon to implement the full range of FCTC provisions — particularly Articles 5.3 (protection from industry interference), 8 (protection from secondhand exposure), 11 (packaging and labelling), and 13 (advertising, promotion and sponsorship bans) — as applied to ENDS products.

• Countries that had not yet enacted ENDS-specific legislation were urged to do so without delay, citing the accelerating youth epidemic and the industry’s deliberate targeting of unregulated markets.
• The Conference strongly emphasized that the tobacco and vaping industries must be excluded from all policy-making processes relating to tobacco and ENDS control, in line with Article 5.3.
The FCTC framework provides Myanmar — and all Parties — with both the legal mandate and the technical guidance to act decisively. Myanmar’s Customs Order 8/2026 is a direct response to these international obligations and the conclusions of COP11.

Global Situation: How the World Has Responded
The international policy landscape on e-cigarettes is now clearly bifurcating into two camps: countries that have enacted comprehensive bans or severe restrictions, and those that have opted for regulatory frameworks. The trend among public health leaders — particularly in Asia — is decisively towards prohibition.

Comprehensive Prohibition Countries
More than 35 countries have enacted comprehensive bans on the sale, importation, and/or use of e- cigarettes. India’s 2019 Prohibition of Electronic Cigarettes Ordinance — subsequently enacted as permanent legislation — banned production, manufacture, import, export, transport, sale, distribution, storage, and advertisement of all ENDS products, with penalties of up to 3 years imprisonment for repeat offences. Brazil’s ANVISA has maintained a ban since 2009, one of the earliest in the world. Thailand’s ban, enacted under the Customs Act in 2014, carries penalties of up to 10 years imprisonment. Singapore’s prohibition under the Tobacco (Control of Advertisements and Sale) Act has been comprehensively enforced since 2016. Cambodia and Laos both prohibit ENDS, meaning every one of Myanmar’s neighbouring countries to the east and south had acted years before Myanmar’s 2026 order.

Strict Regulatory Frameworks
The European Union’s Tobacco Products Directive (TPD) and its 2024 revisions represent the most detailed regulatory framework for ENDS globally, limiting nicotine concentrations to 20 milligrammes per millilitre, restricting tank volumes, mandating health warnings covering 30 per cent of packaging, and prohibiting characterizing flavors in many member states. The United Kingdom, following its post-Brexit regulatory divergence, has adopted a ‘regulated authorization’ approach while pursuing stricter youth protection measures, including a generational tobacco ban. Australia, after a period of prescription-only access, moved in 2024 toward a phased ban on commercial disposable vapes.

The Industry’s Preferred Markets
Indonesia, the Philippines, and several Central Asian and African nations remain as relatively permissive markets where the tobacco industry has concentrated its promotional efforts. This deliberate targeting of unregulated markets is a well-documented industry strategy: when one market restricts access, the industry redirects resources toward the next available jurisdiction. Myanmar’s 2026 ban removes the country from this category.

gnlm

Cancer of the Body: Malignancy Without Contagion
Cancer of the body evokes profound fear because it has structure, location, and measurable progression. It arises when cells lose their regulatory discipline and begin to multiply for their own survival rather than for the organism they belong to. Yet despite its destructive potential, cancer possesses one important limitation: it is not contagious. It does not spread through proximity, touch, or communication. It originates from within the individual’s own biological system, representing a failure of internal regulation rather than invasion by an external agent. Its threat is intimate, but not transmissible.

Cancer of the Mind: Malignancy of Thought
The mind can develop an analogous form of malignancy, not in tissue but in patterns. Certain thoughts – fear, despair, self-negation – may initially serve adaptive purposes but later become self-perpetuating. Fear that protects becomes anxiety that imprisons. Reflection that enlightens becomes rumination that paralyzes. These cognitive patterns, like malignant cells, escape normal regulatory mechanisms. They replicate automatically, shaping perception and narrowing psychological flexibility. In conditions such as depression or trauma, these patterns operate with a form of autonomy, sustaining themselves even in the absence of immediate threat.

Psychological Contagion: Transmission Without Pathogens
Unlike cancer of the body, cancer of the mind exists within a social and communicative environment. Human beings are inherently receptive to one another’s emotional and cognitive states. Through emotional contagion, observational learning, and shared narratives, maladaptive mental states can propagate across individuals. Neuroscientific research demonstrates that mirror neuron systems and empathic processes allow one person’s despair, fear, or cynicism to influence another’s neural and emotional equilibrium. In this sense, psychological malignancy becomes transmissible – not through cells, but through ideas, symbols, and repeated exposure.

Collective Mind: When Malignancy Becomes Cultural
When such patterns spread widely, they may become embedded in collective consciousness. Traumatized communities often internalize persistent narratives of helplessness or threat. These narratives replicate across generations, shaping expectations and behaviour independently of present reality. The pathology is no longer confined to individual psychology but becomes systemic, sustained by social reinforcement. What begins as an internal dysregulation can evolve into a shared psychological environment.

Awareness as Regulation and Remedy
The mind, however, possesses a unique protective capacity: awareness itself. To observe a thought is to interrupt its automatic authority. Neuroplasticity allows new cognitive and emotional pathways to emerge through reflection, connection, and meaning. Just as maladaptive states can spread, so can resilience, hope, and stability. Psychological health is therefore not static but dynamic, continuously shaped by both internal regulation and external influence.

Conclusion: The Ecology of Mental Health
Cancer of the body threatens the organism but remains biologically contained. Cancer of the mind, while originating internally, exists within a network of minds and meanings. It can propagate through unexamined beliefs and shared despair, but it can also be contained through awareness and understanding. This dual reality reminds us that mental health is not merely an individual condition but an ecological one, sustained by the quality of both inner regulation and collective consciousness.

gnlm

In today’s fast-paced world, the human mind is constantly exposed to information, stress, and distractions. Maintaining mental clarity and emotional balance has become increasingly important. One simple yet powerful habit that supports mental well-being is reading articles. Whether they are related to health, education, culture, or everyday life, reading articles regularly is an effective mental exercise that strengthens the mind, improves thinking ability, and enhances overall quality of life.
Reading articles is good for the mind because it gives your brain a regular workout, kind of like a mental gym session. The following are the reasons why it helps so much:
 Improves focus and attention: When you read an article, you’re training your brain to concentrate on one thing at a time. Over time, this strengthens attention span, which is especially helpful in a world full of notifications and distractions.
 Expands knowledge and perspective: Articles expose you to new ideas, cultures, research, and viewpoints. This broadens how you think about the world and helps you see issues from multiple angles instead of just your own.
 Strengthens critical thinking: Reading encourages you to analyze arguments, question assumptions, and evaluate evidence. Your brain practices sorting what makes sense from what doesn’t, which is a powerful everyday skill.
 Boosts vocabulary and language skills: The more you read, the more words and sentence structures you naturally absorb. This improves writing, speaking, and even how clearly you think.
 Reduces stress and mental fatigue: Getting absorbed in an article can calm the mind and provide a healthy mental break. It shifts your focus away from worries and helps you reset.
 Supports memory and brain health: Following ideas, facts, and narratives strengthens memory pathways. Regular reading is linked to better long-term cognitive health.
 Encourages curiosity and lifelong learning: Reading sparks questions and motivates you to keep learning. That curiosity keeps the mind active, flexible, and engaged over time.
First, reading articles plays a vital role in expanding knowledge and understanding. Each article introduces new ideas, facts, and perspectives. This continuous exposure to information stimulates the brain and keeps it active. When the mind learns something new, neural connections are strengthened, helping the brain remain flexible and alert. Over time, this habit improves general intelligence and intellectual curiosity, encouraging lifelong learning.
Second, reading articles significantly improves concentration and memory. In a digital age, reading articles trains the mind to concentrate for longer periods. At the same time, remembering key points, arguments, or examples enhances short-term and long-term memory. This mental training is especially beneficial for students, professionals, and older adults alike.
Another important benefit of reading articles is the development of critical thinking skills. Many articles present problems, explanations, or different viewpoints. Readers are encouraged to analyze information, evaluate evidence, and form their own opinions. This process strengthens logical reasoning and decision-making abilities. As a result, people who read regularly tend to think more clearly and respond to daily challenges more effectively.
Reading articles also supports emotional and psychological well-being. Engaging with meaningful content can reduce stress by shifting attention away from worries and mental fatigue. Informative and inspirational articles, especially those related to health or personal growth, can provide reassurance, motivation, and emotional comfort. This calming effect helps maintain mental balance and resilience in stressful situations.
Furthermore, reading articles improves language and communication skills. Regular exposure to well-written content enriches vocabulary, enhances comprehension, and improves writing and speaking abilities. Clear communication is closely linked to clear thinking, and both are essential for personal and professional success.
In addition, reading articles promotes mental independence and awareness. It helps individuals stay informed about social, scientific, and health-related issues, enabling them to make better decisions in daily life. A well-informed mind is less vulnerable to misinformation and more capable of thoughtful judgement.
Moreover, reading articles is highly beneficial for the mind. It strengthens memory, sharpens concentration, enhances critical thinking, reduces stress, and supports emotional well-being. As a simple, affordable, and accessible mental exercise, reading articles should be encouraged as a daily habit for people of all ages. By dedicating even a short time each day to reading, individuals can encourage a healthy, active, and resilient mind.

gnlm

Introduction
World Cancer Day is observed every year on 4 February to raise global awareness about cancer prevention, detection, and treatment. The theme for 2025-2027 is “United by Unique”, which recognizes that everyone’s cancer experience is different, but we are all connected in the fight against cancer.
Cancer is one of the leading causes of death worldwide. According to the World Health Organization (WHO), cancer caused approximately 10 million deaths in 2020. The good news is that many cancers can be prevented, and others can be successfully treated if detected early.
In Myanmar, cancer is a growing health problem affecting thousands of families each year. By understanding cancer better and taking preventive measures, we can reduce the burden of this disease in our communities. This article explains the cancer situation in Myanmar and what we can do to prevent it.

Common Cancer Types
Cancer is not just one disease – there are over 100 different types. The most common cancers worldwide include breast cancer, lung cancer, colorectal cancer, liver cancer, stomach cancer, and cervical cancer. Different cancers affect different parts of the body and have different causes and treatments.
Some cancers are linked to infections (like liver cancer from hepatitis B and cervical cancer from HPV), some are caused by tobacco use (like lung cancer), and others are related to lifestyle factors such as diet and physical activity. Understanding these causes helps us prevent cancer.

The Global Cancer Situation
Worldwide, there were about 19.3 million new cancer cases in 2020. This number is expected to increase to 28.4 million cases by 2040 due to ageing populations and lifestyle changes. More than half of all cancer cases and deaths occur in developing countries like Myanmar.
The good news is that progress is being made. Many countries have successfully reduced cancer deaths through prevention programmes (like tobacco control), vaccination (against hepatitis B and HPV), screening programmes (for cervical and breast cancer), and improved treatments. However, making these advances available to everyone remains a challenge, especially in low- and middle-income countries.

Cancer in Myanmar
According to 2020 data, there were approximately 76,690 new cancer cases and 54,285 cancer deaths in Myanmar. The four most common cancers in Myanmar are:
1. Lung Cancer: This is the most common cancer in Myanmar, mainly caused by smoking and tobacco use. Myanmar has one of the highest smoking rates in Southeast Asia – about 44 per cent of men smoke. Most lung cancer patients are diagnosed late, when treatment is difficult. The best prevention is to avoid all tobacco products and stay away from secondhand smoke.
2. Liver Cancer: The main cause of liver cancer in Myanmar is hepatitis B virus infection, which affects 6-10 per cent of our population. Other causes include hepatitis C, alcohol, and contaminated food (aflatoxin in mouldy grains). Prevention includes hepatitis B vaccination (now included in the national immunization programme), avoiding alcohol abuse, and proper food storage to prevent mould.
3. Breast Cancer: This is the most common cancer among Myanmar women. Many women are diagnosed late because they don’t know the warning signs or are afraid to seek medical care. Early detection through self-examination and regular check-ups greatly improves survival chances. Women should be aware of any breast lumps or changes and seek medical advice immediately.
4. Cervical Cancer: This cancer is caused by human papillomavirus (HPV) infection. The good news is that cervical cancer can be prevented through HPV vaccination and screening. Myanmar has started HPV vaccination programmes in some areas. Women should undergo screening tests starting from age 30. When detected early through screening, cervical cancer can be prevented or cured.

Main Cancer Risk Factors
Many cancers can be prevented by avoiding known risk factors. The most important risk factors in Myanmar are:
Tobacco use is the single biggest cause of preventable cancer, responsible for about 25 per cent of all cancer deaths. This includes cigarettes, cigars, chewing tobacco, and betel quid (Kunya).
Infections such as hepatitis B and C (causing liver cancer) and HPV (causing cervical cancer) are major causes in Myanmar. These can be prevented through vaccination and safe practices.
Alcohol consumption increases the risk of liver, mouth, throat, and other cancers. The risk increases with the amount consumed.
An unhealthy diet and obesity raise cancer risk. Eating too much processed meat and red meat, too few vegetables and fruits, and consuming contaminated food (mouldy grains) all contribute to cancer risk.
Physical inactivity increases the risk of several cancers. Regular exercise helps maintain a healthy weight and reduces cancer risk.
Other factors include excessive sun exposure (skin cancer), workplace exposures to harmful chemicals, and pollution. While we cannot change factors like age and family history, we can control many of these risk factors through our choices and behaviours.

Cancer Control in Myanmar and Global Action
World Cancer Day 2026 Theme: The 2025-2027 campaign “United by Unique” reminds us that while everyone’s cancer journey is different, we share a common goal: to reduce cancer’s impact on individuals, families, and communities. This theme calls for unity in action while respecting each person’s unique experience with cancer.
Myanmar has developed a National Cancer Control Programme working with WHO guidance to address cancer through prevention, early detection, treatment, and palliative care. Key initiatives include:
The Expanded Programme on Immunization (EPI) has provided hepatitis B vaccination to all infants since 2002, which will prevent liver cancer in future generations. HPV vaccination for girls has started in selected areas to prevent cervical cancer.
Tobacco control measures following WHO’s Framework Convention on Tobacco Control include smoke-free public places, health warnings on tobacco products, and restrictions on tobacco advertising. However, stronger enforcement is needed.
Cancer treatment centres operate in Yangon, Mandalay, and Nay Pyi Taw General Hospitals, providing radiotherapy, chemotherapy, and surgery. However, these facilities face challenges with equipment, staff shortages, and overwhelming patient numbers.
Cervical cancer screening using visual inspection with acetic acid (VIA) has been introduced in some areas, allowing early detection and treatment of precancerous conditions.
The Myanmar Cancer Registry collects data to help plan cancer control programmes and monitor progress.
WHO’s call for action includes implementing comprehensive tobacco control (the single most important cancer prevention measure), providing vaccination against cancer-causing infections (hepatitis B and HPV), establishing screening programmes for cervical, breast, and colorectal cancer, ensuring access to early diagnosis and treatment, making essential cancer medicines available and affordable, and integrating palliative care to relieve suffering.
World Cancer Day 2026 reminds governments, health systems, and communities to take concrete steps toward these goals. Myanmar’s National Cancer Control Strategic Plan aligns with WHO recommendations, but full implementation requires sustained commitment, adequate funding, trained health workers, and support from all sectors of society.
Everyone has a role to play – from government officials implementing policies to health workers providing care to individuals making healthy choices. Together, we can reduce cancer’s burden on Myanmar.

How to Prevent Cancer: 15 Important Actions
While not all cancers can be prevented, you can significantly reduce your risk by following these evidence-based recommendations:
1. Don’t use tobacco in any form: Avoid cigarettes, cigars, chewing tobacco, and betel quid. If you currently use tobacco, quit immediately. Avoid secondhand smoke by staying away from smoky environments. Quitting tobacco at any age reduces your cancer risk.
2. Get vaccinated: Ensure children receive the hepatitis B vaccine according to the national schedule (given at birth and during infancy). Girls should receive the HPV vaccine when available (typically ages 9-14). These vaccines prevent liver cancer and cervical cancer, respectively.
3. Maintain a healthy weight: Obesity increases the risk of several cancers. Eat a balanced diet with plenty of vegetables, fruits, whole grains, and beans. Limit processed foods, sugary drinks, and excessive meat consumption. The traditional Myanmar diet of rice, vegetables, and fish is healthy.
4. Exercise regularly: Aim for at least 30 minutes of moderate physical activity most days of the week. This can include walking, farming work, cycling, or traditional sports. Physical activity helps maintain a healthy weight and reduces cancer risk.
5. Limit or avoid alcohol: Alcohol increases the risk of several cancers. If you drink, do so in moderation or not at all. There is no completely safe level of alcohol consumption regarding cancer risk.
6. Protect yourself from the sun: If you work outdoors, protect your skin by wearing a hat, long sleeves, and seeking shade during peak sun hours (10 AM – 4 PM). This is especially important for farmers, construction workers, and fishermen.
7. Store food properly: Keep grains, peanuts, and other foods in dry, cool places to prevent mould growth. Discard mouldy or discoloured food. Aflatoxin from mouldy food increases liver cancer risk.
8. Get screened for cancer: Women should undergo cervical cancer screening (VIA test) starting at age 30. Women over 40 should have regular breast examinations. Follow your doctor’s recommendations for other screening tests based on your age and risk factors.
9. Know your body and watch for changes: Women should check their breasts monthly for lumps or changes. Everyone should be alert for unusual bleeding, persistent cough, unexplained weight loss, changes in bowel habits, or lumps anywhere on the body. See a doctor promptly if you notice these signs.
10. Practice safe behaviours: Use condoms to prevent sexually transmitted infections, including HPV and HIV. Avoid sharing needles or other sharp instruments. Choose licensed facilities for tattoos, piercings, or medical procedures.
11. Breastfeed if possible: Breastfeeding reduces breast cancer risk in mothers and provides the best nutrition for babies. WHO recommends exclusive breastfeeding for 6 months.
12. Be aware of workplace hazards: If your job involves exposure to chemicals, dust, or other harmful substances, follow safety procedures, use protective equipment, and ensure good ventilation. This includes agricultural workers using pesticides.
13. Don’t delay seeking medical care: If you have persistent or unusual symptoms, see a doctor immediately. Many people delay care due to fear or cost concerns, but early detection saves lives and often costs less than treating advanced cancer.
14. Don’t rely only on traditional medicine for suspected cancer: While traditional medicine has its place, cancer needs modern medical evaluation and treatment. Delays in seeking appropriate care allow cancer to progress to advanced stages when it’s harder to treat.
15. Learn accurate cancer information: Get information from reliable sources like health professionals and official health agencies. Don’t believe myths such as cancer being contagious or always fatal. Accurate knowledge helps you make good decisions about prevention and care.
Conclusion
World Cancer Day 2026 reminds us that we are “United by Unique” in the fight against cancer. While each person’s cancer experience may be different, we all share the goal of preventing cancer, detecting it early, and supporting those affected.
Cancer is a serious health challenge in Myanmar, but it is not a hopeless one. Many cancers can be prevented through simple actions like avoiding tobacco, getting vaccinated, eating healthy foods, exercising regularly, and avoiding harmful substances. Other cancers can be detected early through screening and awareness of warning signs, making them easier to treat successfully.
The Myanmar government, working with WHO and other partners, has developed cancer control programmes including vaccination, screening, and treatment services. However, these programmes need continued strengthening and expansion to reach all communities, especially in rural areas.
Every person has a role to play in cancer prevention and control. By making healthy choices, participating in screening programmes when available, seeking early medical attention for concerning symptoms, supporting cancer patients with compassion rather than stigma, and advocating for stronger cancer control policies, we can reduce cancer’s burden on our families and communities.
Let us use World Cancer Day 2026 as an opportunity to renew our commitment to cancer prevention and control. Together – united in our diversity and strengthened by our shared purpose – we can create a healthier future for Myanmar where fewer people develop cancer, more cancers are detected early, and all those affected by cancer receive the care and support they need.
The fight against cancer begins with each of us. Take action today to protect yourself and your loved ones. Your choices matter, your actions count, and together we can make a difference.
References
1. World Health Organization. (2020). Global Health Estimates 2020: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2019. Geneva: WHO.
2. Sung, H, Ferlay, J, Siegel, RL, et al (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71(3), 209- 249.
3. World Health Organization. (2022). WHO Report on Cancer: Setting Priorities, Investing Wisely and Providing Care for All. Geneva: WHO.
4. International Agency for Research on Cancer. (2020). Myanmar Fact Sheet – GLOBOCAN 2020. Lyon: IARC.
5. Ministry of Health and Sports, Myanmar. (2019). National Cancer Control Strategic Plan 2019-2023. Nay Pyi Taw: Ministry of Health and Sports.
6. World Health Organization. (2017). Guide to Cancer Early Detection. Geneva: WHO.
7. Union for International Cancer Control (UICC). (2024). World Cancer Day 2025-2027: United by Unique Campaign Toolkit. Geneva: UICC.

gnlm