It is close to the Chad and Sudan border so there is some trade going on. But mostly the place suffers from lack of government attention and -money. Besides they are overrun by rebels, poachers and other villain type characters. So everytime they built up something others break it down again.
The airstrip is no longer usable, but ten kilometers south of Birao - just where the laterite soil turns into sand - there is a big airstrip, so connection with the capital Bangui is a matter of hours. However, fuel for the airplanes is rare (often months on end not available) and very costly (3,60 euro per liter).