CAMBODIA has the highest prevalence of tuberculosis in Asia and the Pacific, according to a new Asian Development Bank report - a fact that has come as no surprise to civil society actors, who say the disease has increasingly afflicted residents of poor rural areas as well as HIV-positive patients.

The 2009 version of Key Indicators for Asia and the Pacific cited a tuberculosis prevalence rate of 665 per 100,000 people. The Philippines had the second-highest rate at 500.

The Cambodia figure has dropped significantly from 1990, when it stood at 928, but other countries that had previously reported similarly high figures have experienced more dramatic drops in the past two decades.

Mao Tan Eang, director of the National Centre for Tuberculosis and Leprosy Control (CENAT), said Wednesday that the government was working to address the problem by expanding access to drugs, adding that nearly 2,000 drug outlets had been established.

Kek Galabru, president of the Cambodian rights group Licadho, acknowledged that the government, and CENAT in particular, had tried to lower the rate, but said access to drugs and proper medical care was inadequate, particularly in rural areas. Many public and private health care providers are "incompetent", she said.

She said the situation was particularly "fragile" for HIV/AIDS patients. Citing figures from Medecins Sans Frontieres, she said the prevalence rate for that group had risen from 2.5 percent in 1995 to 7.8 percent in 2007, and could be as high as 15 percent today.