Since the beginning of the century, TB has been on the retreat in the rest of
Yet, Cambodia has nearly double the rate of infection of other high-risk areas as
Africa or Vietnam. Here, TB affects 500 out of every 100,000 inhabitants.
In the case of Cambodia, there are three main reasons for its spread. The long years
of warfare and its effect on infrastructure, the destruction and subsequent neglect
of the primary health system, and the ending, for budgetary reasons, of after-care
facilities for TB patients.
As a result, Cambodia continues to hold the sad world record of having the greatest
number of TB cases per annum as well as per inhabitant.
Victims usually recognize the symptoms - they cough and they hurt inside as more
and more bodily tissues become affected. They also lose weight and feel as if they
Either they go to a hospital to seek help, or they stay at home when they are told
they cannot be treated because there are no medicines.
Yet TB is easily curable with antibiotics. Why the scandalous lack of concern on
the part of the international community?
The Ministry of Health, together with the World Health Organization (WHO), has instituted
a program which hopes to control TB in Cambodia.
The amount needed to fund this program is a mere drop in the ocean compared to the
amounts pledged for other projects. Nevertheless, the money has not been forthcoming
despite repeated appeals.
Yet treating the sick, so that they are completely cured and no longer infectious,
is a relatively simple matter.
If Cambodia is to rid itself of TB, the disease cannot be attacked on a piece-meal
basis; it must first be tackled at the public sector level.
Only this way can a high-quality health service be developed nation-wide with appropriately
trained personnel. This obviously implies establishing a specific program.
Thanks to the World Health Organization such a program exists. Moreover, its' worth
has been proven in Tanzania, Benin, Costa Rica and Vietnam.
All that is required here is money. The $1m per year needed is in stark contrast
to the $44m spent every month by UNTAC during the first half of this year.
To do nothing now, even if it implies a small increase in overall funding requirements,
would be criminal. TB programs may be low profile but TB is Cambodia's number one
AIDS is newsworthy; it catches the media's attention. But TB can trigger off HIV.
The public may be unaware of the connection but the medical profession is not. Does
the international community need to have a full-blown epidemic before it reacts?
The French Red Cross, having supported Cambodian efforts for the last decade, has
an anti-TB program already. The Minister of Health is expected to announce a new
five-year program using the most modern treatment.
Donors of bilateral aid, in collaboration with WHO, are to launch a new, more effective
attack against TB next year.
The cost/benefit calculations are highly favorable. All it needs is adequate funding.
But this is still not forthcoming.
TB was long-considered "shameful" and incurable but that is no reason for
indifference on the part of the international community today.
Such a project may not make great TV coverage nor the photo-opportunities so necessary
to politicians. The reason why it must be given urgent priority is simple: more than
1,000 Cambodian lives could be saved each month.