Statistics from the Ministry of Health (MoH) show that less than 10 percent of the
budget had been disbursed to central and provincial health services by mid-year.
The head of the ministry's budget division said the money was instead being used
to aid "election campaigns".
Several health professionals said the result is that the country is now suffering
a dengue outbreak far worse than last year. Figures from the government's dengue
control center show the number of new cases has jumped 56 percent, while deaths have
Te Kuy Seing, the secretary-general of finance and budget at the MoH, said the reason
for the delay in disbursements was that the government was focused on the election.
"The government has to contribute to the election campaign. We have to have
our priorities," he said, adding that the six-month delay to several ministry
programs was normal. Seing added that another reason spending was low was that half
of the budget goes on drugs, an item that normally picks up towards the year end.
But a doctor with a prominent international health NGO, who did not want to be named,
said such reasoning was flawed. He agreed that some delay was inevitable and could
be managed: "But this is not a delay. It is a lack of disbursement," he
told the Post. "They use the money for other purposes, and they're killing people."
Only 9 percent of the ministry's budget-$4.4 million from a budget of $50.5 million-has
been doled out. Much of that is for medical staff and other expenses. The amount
spent on medicine and health care is far lower-less than 7 percent of the $41.6 million
allocated has been spent on basic health services.
One consequence of the delay was that the annual campaign against dengue was postponed
for a lack of funding. The first round of larvicide and anti-dengue education was
meant to begin in mid-April, but was delayed one month.
Dr Ngan Chantha, manager of the dengue control program at the National Malaria Center,
said the second part of the program scheduled for mid-July might also be delayed
for a month.
"We need to start immediately. We'd like to start in August," Dr Chantha
Dengue cases are substantially higher than in 2002. The National Dengue Control Program
reported 5,212 dengue cases across the country with 80 deaths, mostly children. In
the same period last year the country suffered 3,343 cases with 41 deaths. Phnom
Penh, Kampong Cham, Kandal, and Siem Reap have seen the highest numbers.
The $150,000 for the dengue control program is provided by the US Agency for International
Development through the World Health Organization. Dr Chantha said that money is
funneled through the MoH.
Health NGO Médecins Sans Frontières (MSF) cautioned that the delay
in starting the program was not the sole reason for the rise in cases. Vietnam and
Thailand have also seen dramatic rises in the number of dengue cases.
But Dr Kheang Soy Ty, the deputy medical coordinator for MSF Belgium, agreed that
the delay in implementing the program was partly to blame for the rise in dengue
cases in urban areas.
"Because they started a month late, the mosquito population is denser,"
Most of the Ministry of Health's budget comes from international donors. The Asian
Development Bank (ADB) approved a $20 million loan to the MoH in November 2001. An
ADB representative said the bank had not heard of money being diverted from that
"It's loan money, so we generally have a say in how it is spent," he said.
"I'm not aware of any of our money being diverted."
And some health professionals are horrified at the government's use of its funds.
The anonymous doctor said he was unable to sleep because of the government's actions.
"People are dying, and they don't care," he said.