EVERY day in Cambodia, 100 people become infected with the deadly HIV virus - the
highest infection rate in Asia. The spiraling epidemic could eventually take more
lives than even the KR killing fields, health experts warn.
ONE OF MANY: A Cambodian AIDS victim.
Developing and coordinating a national strategy to face the epidemic was the theme
of the First National Conference on HIV/AIDS, held in Phnom Penh on March 30 and
31. Over 700 participants - from government, NGO, religious, and UN sectors - heard
lectures, participated in working groups, and discussed strategies. The conference
was sponsored by the National Aids Authority and the Ministry of Health, with advice
and technical assistance from UNAIDS.
"Taking this event as a starting point, we will continue to make our effort
in reducing the spread of HIV/AIDS," said Prime Minister Hun Sen in his closing
He said AIDS funding from national and international sources was $3.5 million in
1997, but noted the commercial sex industry generates up to $22 million per year.
He said an education campaign was crucial to reduce the spread of HIV, and urged
media to include HIV/AIDS educational messages free of charge.
National AIDS Authority vice-president Dr. Narong Rith Dy said his institute was
"Never enough," he lamented of his $700,000 budget for 1999.
The HIV infection rate of sexually active adults has skyrocketed since the first
case was recorded eight years ago. Today, the rate is 3.7 percent. By comparison,
Thailand took ten years to reach the 2 percent level. At the current rate, Cambodia
will have nearly 200,000 infected persons by next year.
Hun Sen added a message of tolerance to AIDS victims, who are often shunned in Cambodia.
"I would like to talk to all infected people and emphasize that you remain an
important part of the society and you should take part in the fight against HIV/AIDS,
and in the education campaign," the Prime Minister said.
"Each day, 20 to 30,000 men seek extramarital sex," said Dr. Tia Phalla,
Deputy Director of the National Center for HIV/AIDS. He said a recent survey showed
only 53 percent of sex workers consistently get their clients to wear a condom -
while roughly 40 percent of sex workers are HIV positive.
"Men are the driving force of this epidemic, men have to change their behavior;
women are the most vulnerable," said UNAIDS Executive Director Dr. Peter Piot.
Different sections of the conference addressed strategies for different sectors of
the population; one special workshop, organized by the Ministry of Women's Affairs,
dealt specifically with Women and AIDS. Experts say that the infection rate in married
women is over 2 percent.
"We have learned that there is no magic bullet for prevention; a mix of approaches
and interventions is needed," said Piot.
He estimated the cost of the epidemic at up to $2-3 billion in lost revenue and productivity.
"The impact [if there is no slowdown in the rate] will be enormous," he
said. "It is not only a tragedy for individuals ... it is also a real problem
for the development of the country."
The conference was welcomed by many in Cambodia's health sector who have complained
that the fight against HIV/AIDS has been poorly coordinated and patchy.
"I was really impressed with the conference, because it did bring a lot of diverse
groups together," said Caroline Francis, a representative from Medicam HIV/AIDS.
"It was illuminating to see what other groups were doing, and to share ideas
and resources. . . I have a much better idea of how different programs and organizations
are tackling the issue."
She added that informal chats with people between sessions were easily as valuable
as the lectures and seminars. "To periodically bring people together like this
- it's a massive undertaking, but it's well worth it."
Meanwhile, a Health Ministry project is spreading education about HIV/AIDS and birth
spacing in a novel way: a boat trip through three provinces, with informational films
and shows presented every evening along with traditional dance and theater.
"The cultural aspect of the show is the candy, the educational aspect is wrapped
around the candy; you have to look at the wrapper before you get to the candy,"
explained Cedric Jancloes, a consultant with ACTION, a local NGO implementing the
project. "We can do more with education if we add culture ... that really works."
The boat trip, which kicked off Mar 27 and continues through Apr 11, will pass through
Kandal, Kampong Cham, and Kratie provinces. Audiences are averaging about 3500 per
night, with about 5000 condoms being sold or given away every day, Jancloes said.
Provincial health officials are also on hand at every stop to answer questions.
The "Journey for Education and Culture", brainchild of Chheng Daravuth
Kosal, is run by the National Reproductive Health Program and supported by the Information
and Culture Ministries and UNFPA, along with the reproductive-health NGOs Marie Stopes
International, and PSI.