Paper short abstract:

This paper examines power and politics in vaccination programmes in Myanmar. It highlights the role of local actors in reaching the Sustainable Development Goals, whilst also challenging dominant development paradigms in which the state is ultimately deemed responsible for community 'development'.

Paper long abstract:

Myanmar's National Health Plan (NHP) promises to achieve universal health coverage by 2030, in line with SDG Target 3.8. Both the NHP and the new government's endorsement of the SDGs are widely seen by international actors as progress, in a country where a many still lack access to healthcare. However, there is significant debate within Myanmar about how universal health coverage should be achieved, and what role state and non-state actors should play. In the country's south-eastern borderlands, decades of conflict have resulted in the development of parallel systems for health, with local health workers providing services under the umbrella of the ethnic nationalist groups. These health workers question the vision underlying Myanmar's NHP - one where power remains centralised in the Bamar-dominated state. In recent years, health workers in Kayah and Kayin States have worked in partnership with government health workers to implement an Expanded Programme for Immunization in the borderlands. These local health workers have capitalised on the impetus provided by the NHP and the state's commitment to the SDGs, in order to achieve greater health coverage in their areas. Yet through these programmes, the health workers are also challenging the assumption underlying both the NHP and the SDGs, that the state is ultimately responsible for 'development' in local communities. By examining questions of power and politics in vaccination programs in Kayah and Kayin States, this paper highlights the role of local actors in redefining dominant development paradigms.