The general state of health care in Myanmar is poor. The government spends anywhere from 0.5% to 3% of the country's GDP on health care, consistently ranking among the lowest in the world. Although health care is nominally free, in reality, patients have to pay for medicine and treatment, even in public clinics and hospitals. Public hospitals lack many of the basic facilities and equipment. The 2010 maternal mortality rate per 100,000 births for Myanmar is 240. This is compared with 219.3 in 2008 and 662 in 1990. The under 5 mortality rate, per 1,000 births is 73 and the neonatal mortality as a percentage of under 5's mortality is 47. According to the report named "Preventable Fate", published by Doctors without Borders, 25,000 Burmese AIDS patients died in 2007, deaths that could largely have been prevented by antiretroviral therapy drugs and proper treatment.