Cambodia’s capacity to prevent, detect and respond to health threats remains limited by an array of challenges and deficiencies, according to a World Health Organization report based on an external evaluation of the country’s systems.

The Kingdom was the first in the region to undergo a new kind of evaluation a Joint External Evaluation last August and September. The main findings in the report include significant funding gaps and insufficient human resources, formalisation and documentation of procedures, as well as a lack of coordination.

Dr Ly Sovann, spokesman for the Ministry of Health and director of the ministry’s Department of Communicable Diseases, didn’t respond to requests for comment yesterday.

“While Cambodia has enjoyed great success in improving health outcomes in recent decades, many technical capacities that relate to detecting, preventing and rapidly responding to emerging diseases and public health emergencies remain under development,” the report reads.

For example, in terms of prevention, Cambodia has developed various infection prevention guidance documents, such as the National Strategic Plan for Infection Prevention and Control in Health-Care Facilities, but components of the plan have not been fully implemented.

Additionally, “there is currently a lack of infection prevention and control professionals in the country and no system to evaluate the effectiveness of infection prevention and control measures in the health-care setting”, the report reads.

When it comes to reporting and responding to animal-to-human diseases, animal health and human health professionals are not communicating with each other. The country also lacks a culling compensation policy, which discourages people from reporting animal health events, such as avian flu outbreaks in poultry.

The report recommends the country to consider a compensation policy for culling animals. However, Dr Sen Sovann, deputy secretary-general at the Ministry of Agriculture, Forestry and Fisheries, said such a policy is very unlikely to be developed.

“I don’t think we are going to have the cash for compensation,” he said, adding that such a policy could also be “harmful” because it might encourage farmers to infect their animals to get government money.

But at a time when animal-to-human diseases pose a threat to Cambodia, the country is currently facing an acute shortage of veterinarians, according to the report.

“While there are currently about 850 individuals available with animal health training, most of them would not be considered qualified veterinary doctors,” the report says.

The report also found shortcomings in the country’s response preparedness. For example, although the director of the Communicable Disease Department has the authority to activate the emergency operations centre, it’s not clear what criteria are used for the activation or what authorities the centre has, if any, upon activation.

Chum Sopha, executive director of the Health and Development Alliance, said that was concerning. That finding comes in the wake of experts at the Pasteur Institute last year saying that Cambodia is at high risk of experiencing a Zika outbreak this year.

“I’m not confident for Cambodia to be able to handle [such outbreaks] by itself,” Sopha said, adding that if a health emergency arose, the country would need international assistance.

Vicky Houssiere, WHO communications officer in Cambodia, said all recommendations were reviewed and agreed to by Cambodia, and were integrated in the National Workplan on Emerging Disease and Public Health Emergency to Achieve International Health Regulation Core Capacities.