Myanmar, also known as Burma, is ranked at the very bottom of 190 countries for overall health system performance, according to the World Health Organization.

The per-capita income is approximately $1,300, which places Myanmar at 205 out of 226 countries studied by the Central Intelligence Agency, but this is just part of the story. The people are not only poor; they also suffer from a cultural fabric that has been disrupted terribly over time. In addition, the current government is both unwilling and unable to invest the resources needed to improve the health status of its citizens.

As the country begins to open up, it will be affected by the global health industry, which is now eyeing a relatively untouched market of 60 million people.

This is a two-edged sword. If multinational firms are left unbridled, health care will improve for some, but it will be neither uniform nor comprehensive. Health disparities among Myanmar’s citizens will increase, and the changes will be profit-driven.

Instead, change should be the result of a comprehensive public health strategy in which the government has the will and the capacity to serve its people, foremost by developing necessary internal resources and, secondarily, by skillfully orchestrating the entrance of the global health industry into the country.

During its peak, between 200 and 400 years ago, the Burmese civilization was the largest and among the most literate states in the history of Southeast Asia. Its last kingdom fell in its entirety to the British by 1885 and was then ruled from India. It was taken briefly by the Japanese in World War II, and its independence was secured from Britain in 1948, negotiated by Burmese Gen. Aung San. Since that time the country has been dominated largely by a military junta. It has also suffered from a perennial civil war driven by ethnic strife.

The country was on the verge of returning to a true democracy when Aung San’s daughter, Aung San Suu Kyi, won the general election of 1990, but the military junta was unwilling to relinquish power. She spent 15 of the next 21 years under house arrest.

Her release in November 2010 was a sign the country has slowly begun to open up. In 2015, once again, her party, the National League for Democracy, plans to contest elections.

Last month Suu Kyi traveled to Qatar to speak at the World Innovation Summit for Health. Among Myanmar’s many pressing health concerns, she is focused on HIV/AIDS — which is rampant with 1.3 percent of its 60 million citizens now infected, including more than 40 percent of IV drug users and more than 30 percent of sex workers. In 2005, the last year for which data are available, the government spent a nominal $137,120 on management.

Myanmar has among the worst health indicators on the globe. Forty percent of all children under the age of 5 are small for their size because of malnutrition. Myanmar is also home to more than 50 percent of all malaria-related deaths in Southeast Asia, according to the Lancet medical journal. All told, life expectancy in Myanmar is 56 years.

Historically, health care spending has comprised only approximately 2 percent of the country’s total budget, among the lowest in the world. Government spending amounts to a mere 12 percent of total dollars spent on health care. In 2013 the country raised spending to 3.9 percent.

In contrast, military spending remains greater than 20 percent. Myanmar is the only developing country where the military spending is higher than health care and education combined, according to Reuter’s.

The country needs far more than access to diagnostics and medications. It needs to graduate 1,500 physicians per year but is only producing roughly 1,200. The paucity of resources, however, also has seriously compromised the quality of medical education. In addition, physicians are so poorly compensated they have little motivation to remain in the country, according to Forbes. Specialists are even harder to come by: There are only 61 oncologists in the country, which equates to one per 1 million citizens.

At the health summit in Qatar, Suu Kyi said the problem is not one of economic resources alone, but also is a question of mismanagement of existing funds. She said a health care system that will suit the people of Myanmar depends upon core values as much as it depends on wealth. Finally, in her view, spiritual health is also of vital importance and that without it, simply treating the body with medications and procedures is but a half-measure.

(Note: Zunin is currently in Yangon where he is evaluating strategies for humanitarian and medical service.)

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Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.