Human immunodeficiency virus and acquired immune deficiency syndrome in Burma (or Myanmar) is recognised as a disease of concern by the Ministry of Health and is a major social and health issue in the country. In 2005, the estimated adult HIV prevalence rate in Burma was 1.3% (200,000–570,000 people), according to UNAIDS, and early indicators show that the epidemic may be waning in the country, although the epidemic continues to expand in parts of the country. Four different strains of HIV are believed to have originated from Burma, along heroin trafficking routes in northern, eastern and western Burma. Intravenous drug users (43%), along with miners (who often become infected through drug use) and sex workers (32%), are along the most likely to be infected with HIV. At least half of the 300,000 to 500,000 drug users (according to conservative estimates) in Burma are intravenous drug users, and Burma (Shan State and Kachin State) is a major regional supplier of heroin (with a major domestic shift from opium consumption to heroin consumption occurring in the late 1980s) and methamphetamines. The most common form of heroin is a highly refined injectable product, colloquially known as "Number 4". The national government, in 2005, spent US$137,120 (K150,831,600) on HIV, while international donors (the governments of Norway, the Netherlands, United Kingdom, and Sweden) donated US$27,711,813 towards HIV programmes in Burma. Burma (ranked 51 out of 166 countries) has one of Asia's highest adult HIV prevalence rates, following Cambodia and Thailand. An estimated 20,000 (range of 11,000 to 35,000) die from HIV/AIDS annually. In geographic terms, the lowest rates of HIV were in the West (Rakhine and Chin State), while intermediate rates were in the central region (Ayeyarwady, Mandalay, Magway, Sagaing, Yangon and Bago Regions), and the highest infection rates were in the North (Kachin State), East (Shan and Kayin State), and South (Mon State, Tanintharyi Region). Government action The Ministry of Health began surveying for HIV/AIDS in Burma in 1985. The first HIV case in Burma was reported in 1988, and the first AIDS patient in Burma was reported in 1991. Surveillance for HIV began the following year, and a prevention of mother-to-child transmission programme subsequently began in 2000. In 2005, antiretroviral therapy was introduced to the public sector, although only 3% of HIV/AIDS patients currently receive such treatment. Currently, AIDS is one of the priority diseases in the National Health Plan. On 18 August