C AMBODIA'S HIV/AIDS epidemic will soon spin out of control and devastate the country
unless the government soon takes effective measures to control the disease, according
to the World Health Organization (WHO).
"The HIV/AIDS problem in Cambodia is dramatic - the general population is facing
a situation which, in terms of deaths, will be just like the Pol Pot regime,"
said Dr Annie Macarry of WHO's Global Program on AIDS.
"If the government is unable to take effective measures within two years, the
epidemic will run away and never be controlled - it will destroy this country,"
Statistics compiled by Cambodia's Ministry of Health from an ongoing nationwide testing
program reveal that at least 100,000 Cambodians are HIV-positive and that the cumulative
death toll between now and the year 2000 will exceed 40,000.
In the year 2000 alone, according to ministry figures, at least 12,000 people are
expected to die from the disease.
Macarry said, however, that the figures were likely understated and the total number
of infections to date could conceivably be as high as 130,000, adding the Cambodian
government had not yet imposed measures similar to those in neighboring countries
like Thailand which have helped slow the spread of the virus.
"This problem requires political commitment at the highest level, but at this
stage there is little evidence of the necessary political support," she said.
"There is no structure of coordination between the various ministries involved
[in combating HIV/AIDS], the Council of Ministers cannot even decide on the basic
structure of the Ministry of Health," Macarry said, adding the National AIDS
Program's structure, funding base and future remained unclear.
She said there was no coherent strategy in place to deal with the epidemic and local
health authorities confirmed they are worried Cambodia's health system will collapse
under the pressure.
"Only 56 percent of the population has access to health services and we are
not able to cope with problems like tuberculosis, malaria and war injuries. How can
we manage to cope with a problem like this? The system will be overwhelmed,"
said the ministry's National AIDS Program manager, Dr Tia Phalla.
He said 2% of Cambodia's adult population is now HIV-positive, giving it the second
highest level of infection in Southeast Asia after Thailand.
He said high risk groups like commercial sex workers, where infection rates appear
to have peaked at around 40%, had been educated about the risk of HIV, but the next
big surge in infections would occur among married women.
"Our figures show that condom use in brothels is still only 60 percent - in
our culture women do not have the power to insist on condoms," Phalla said.
"It is very difficult for us to intervene at this stage of the epidemic when
it enters the home. Men will go to the brothels, then sleep with their wives. Our
latest figures show the infection rate among pregnant women has increased from 1.7
to 3.2 percent in the last year," he said.
"Now the ratio of infection is three men to every women, but the ratio will
soon be one to one."