The Kingdom of Cambodia can take pride in its efforts to control tuberculosis (TB), with
case-finding doubling in 10 years from 20 000 in 2001 to more than 40 000 in 2011 cases
annually. This was achieved through basic TB control measures and the involvement of local
communities. The National Tuberculosis Programme (NTP) has achieved consistently high cure
rates, with documented evidence of the effectiveness and health impact of the NTP. National
prevalence surveys in 2002 and 2011 showed a 45% reduction in bacteriologically positive
cases over 15 years, with significant and rapid reduction, especially in young, wage-earning
adults. The potentially disastrous impact of HIV on TB has been significantly reduced and the
levels of multidrug resistance kept low. Cambodia has pioneered the banning of ineffective
serological tests for TB, and the commercial importation and sale of anti-TB drugs. The NTP
has prepared a comprehensive National Health Strategic Plan for Tuberculosis Control in the
Kingdom of Cambodia 2001–2015. The majority of the recommendations made during the
previous Joint Programme Review (JPR) in 2006 have been carried out.
These results were made possible through strong leadership of the National Center for
Tuberculosis and Leprosy Control (CENAT) and continued funding from the Cambodian
Government, which at all levels consulted articulated TB as a priority. Significant external
financial support, notably from the Global Fund to Fight AIDS, Tuberculosis and Malaria
(Global Fund) and the United States Agency for International Development (USAID), has been
essential.
This review concludes that the improvements in the epidemiology of TB in Cambodia have
been largely the result of TB control efforts. To accelerate the decline in the TB burden in
coming years and achieve levels closer to that of neighbouring countries, such as Thailand
and Viet Nam, core programme implementation needs to be strengthened further. Good,
motivated staff at central, provincial and operational district (OD) levels needs to be retained.
The NTP should continue to emphasize community DOTS and boost routine surveillance
and the analysis and use of data. It should regularly review its work through internal joint
programme reviews, and joint monitoring and evaluation with effective dissemination of
findings, including the challenges that such findings pose to the NTP and country. A new
national strategic plan, with multi-year operational and budget plans, for TB control in
Cambodia should be developed, mainstreaming project activities and, to the extent possible,
benefiting from pooled funding.