THE medical NGO Medicines Sans Frontieres France (MSF) has for the second time pushed back the handover of its HIV/AIDS programme to the government, in part due to uncertainty surrounding the future of salary supplements for civil servants, the organisation’s head of mission said this week.
The free programme, based at Phnom Penh’s Cambodian-Russian Friendship Hospital, serves up to 3,700 patients, making it the largest HIV/AIDS centre in the country. It is also the Kingdom’s longest-running programme offering antiretroviral treatment, which MSF introduced in Cambodia in 2001, and which drastically improves the quality of life and lifespan for people living with HIV/AIDS.
MSF began discussing the handover of the programme with the Ministry of Health’s National Centre for HIV/AIDS, Dermatology and STDs (NCHADS) in 2008, said MSF Head of Mission Dr Emmanuel Lavieuville. He added that the handover was originally scheduled for December 2009, but was pushed back to March 2010 at the urging of the national centre, which requested a second extension sometime last month. The handover is now expected to take place in June.
“The real problems in the handover are financial. There are a number of financial gaps that the [programme] and the [ministry] are still trying to bridge,” Lavieuville said. “We’re talking here about the incentives that we’re providing to the [ministry] staff to do their job.”
In December, Minister of Finance Keat Chhon announced that salary supplements – payments coming from development partners and the government to bolster the salaries of civil servants – would be terminated effective January 1, citing the need to promote equitable compensation arrangements and spur broader public administrative reform.
After members of the development community raised concerns about how the termination would be implemented, however, the government in January announced a stopgap arrangement under which straightforward supplements would be allowed to continue while the government formulates a new compensation scheme.
Lavieuville, like others in the development community, said there was much confusion over whether supplements would be allowed in the future.
“There is still uncertainty about how much of what we’re providing is going to be sustained, is going to be continued, after we depart – is it going to be 100 percent or just a fraction of it; is it going to be the whole staff or just a fraction of it?”
He added, though, that he was not entirely surprised by the delays. “These kinds of projects are always difficult to hand over. It’s always a complicated process.”
NCHADS Director Dr Mean Chhi Vun said Thursday that MSF had ceased supplementing the salaries of ministry staff since at least January, but declined to say whether salaries were being supplemented by another organisation.
He said NCHADS would work with the AIDS Health Care Foundation to provide a free service, adding that he was confident the programme would continue following the MSF pullout.