T HE AIDS epidemic could cost Cambodia almost $3 billion and leave up to one million
people infected with HIV/AIDS over the next nine years, according to a major report
by the government and the United Nations.
The figures are among the most startling in an overall grim picture of the country's
health, education and human welfare sectors painted by the "National Human Development
Report 1997", released Oct 17 by the United Nations Development Program (UNDP)
and the Ministry of Planning.
"The AIDS epidemic is the most serious in Asia," said UNDP resident representative
"Not only does this spell enormous suffering and loss but it also has a very
significant economic impact. Many of the victims of HIV/AIDS will be educated people
living in the cities, people who are in the most productive periods of their lives,"
According to the report, Cambodia has the highest per capita HIV positive rate among
sex workers in Asia. It estimated that up to 120,000 Cambodians are now infected
and that the country could a pay a price of between $1.97 to $2.82 billion in lost
earnings by 2006 as a result of the as yet incurable disease.
"What this tells us about the HIV/AIDs epidemic is really very, very worrying.
Of course the government is very aware of this and a lot has been done in terms of
awareness raising. But some of the figures in here are extremely disturbing and would
indicate that this has to be tackled on almost an emergency basis if the epidemic
isn't to get out of hand," said Matthews.
"I think the implications are clear and it is up to the government and the people
of Cambodia to read this and draw their conclusions," he said.
The report, which is the country's first national poverty survey and is intended
to provide socioeconomic data for government planning, elaborates a dismal array
of facts about contemporary Cambodian life.
Nearly four out every ten Cambodians lives below the poverty line - pegged at 35,500
riel (close to $11) per person per month - with the vast majority of these living
in rural areas, according to the report.
Cambodia is among the poorest 20 countries in the world and among its Asian neighbors
ranks above only Bangladesh and Nepal in terms of the Human Development Index - a
ranking derived from life expectancy, education, and income figures.
Half of the nation's children are stunted, largely as a result of long-term, chronic
undernutrition rather than short term food deficits, the report said.
"It does not necessarily mean that they have not had enough food but they may
have the wrong sort of food," Matthews said.
Ignorance as much as food shortages contributes to the problem, according to the
report, which also found that as many as 40% of the children among the wealthiest
strata in society are stunted.
"This suggests that, while poverty is certainly a contributing factor in child
malnutrition in Cambodia, it is not the only factor," said the report. "Cultural
and social factors may play a more important role than economic status in causing
Child malnutrition is exacerbated by a predominance of rice in the Cambodian diet
as well as a cultural custom of delaying the onset of breast-feeding until several
days after birth.
The survey also handed down a poor score card on Cambodia's education system, which
has high rates of repetition and drop-out.
Of every 1,000 pupils who enter primary school, only 27 graduate from upper secondary
school, according to the UN.
The report pinned much of the blame for the level of poverty and human development
in Cambodia on the country's long history of armed conflict.
The state-sponsored havoc wreaked on the population and social institutions during
the Pol Pot era had left the country with a disproportionate number of women to men,
as well as a shortage of educated people.
In addition, the long years of turmoil - and the prominent role played by landmines
- had left a legacy of displaced people, a large proportion of the population disabled
and a high number of households headed by women.
While the report does not make specific policy recommendations on how to improve
Cambodia's socio-economic plight, Paul Matthews said that economic growth is not
the sole answer.
"As important is where that growth takes place and how its fruits are used and
distributed," the UNDP official said.
"Even with low economic growth, achievements in human development and the reduction
of human poverty are possible. The success of any human development strategy will
depend on the level of political will.
"As to what will be done, that's up to Cambodians. [The report] speaks for itself."
Kao Kim Hourn, director of the Cambodian Institute for Cooperation and Peace, said
that the report spoke for the "silenced majority of Cambodian people" and
put the issue of poverty squarely on the national agenda.
"Unless we really start to address poverty now, it will be too late. The increasing
disparity between the rich and the poor... it is widespread, it is apparent."
Kim Hourn said Cambodia had sufficient natural resources to draw on in the fight
against poverty, but he warned of the mismanagement of the country's abundant natural
"If we were to have many free riders in our society, people who take these public
resources for their own personal enrichment, then the opportunity for progress against
poverty is definitely constrained," he said.
Finding the will and the funds to combat the alarming scenario of misery presented
in the report remains a thorny question for the government, which has begun cutting
into health and education spending in a bid to tackle substantial budget deficits.
"We have a lot of poverty in the country. It's a problem of allocating resources,"
said Dr Tea Phalla, head of the Ministry of Health's National Aids Program.
According to Minister of Planning Chea Chanto, a mere $18 per capita annually would
be enough to ensure that all Cambodians live above the poverty level.
"This amount represents only 40 percent of the external assistance that Cambodia
received in 1995," said Chanto.
But even with sufficient funds, it is "vision and leadership" which are
called for in the struggle to improve the lives of ordinary Cambodians, according
to the UNDP head.
"It is now up to Cambodians to take up the challenge, to show the will and determination
to stop fighting each other in a cycle of self-destruction and to join together to
fight poverty which is the real common enemy," said Matthews.