Since the beginning of the century, TB has been on the retreat in the rest of

the world.

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

are suffocating.

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

killer.

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.