Ebola is grabbing world headlines. How is it affecting Cambodia’s fight against AIDS? Khmer Times sat down with Ieng Mouly, who took over last year as chairman of the National AIDS Authority. Mr. Mouly, a veteran politician with senior minister ranking, reflected on the priority that Cambodia and international donors place on fighting HIV / AIDS.
KT: Health funds are finite. How is AIDS faring in the fight over the health dollar with a sexy new virus like Ebola?
Mouly: “This is my concern. We are successful, and now people try to reduce the funding to us, and then turn their attention to, as you say, the sexy disease. This kind of situation makes us very concerned about the future of the fight against HIV /AIDS.”
KT: Is Cambodia’s anti-AIDS program a victim of its own success?
Mouly: “Yes, the fight against HIV /AIDS in Cambodia can be called a successful one. We have take down the prevalence rate in the general population from 2 percent to 0.6 percent. We have about 70,000 people living with HIV / AIDS. About 55,000 come to receive treatment.”
KT: What is the prevalence rate among sex workers in places like Street 51?
Mouly: “Our most successful case was with entertainment workers, who were high risk in the past. Of 30,000 entertainment workers, we had a prevalence rate of 14 percent. But recent surveys indicate the rate is going down, from 4 percent to 0.4 percent. It is a tremendous accomplishment.
KT: How did Cambodia do it?
Mouly: “Karaoke dancers, beer girls, entertainment workers, the owners of establishments – we work with everyone to provide them with education about sex, and to encourage them to use condoms all the time. Compared to other countries we are now the lowest in the region, lower than Thailand, even more among entertainment workers.”
KT: How do you get the word out?
Mouly: “Through the involvement of every level of government, from the civil society, from private sector – all encouraging 100 percent use of condoms…. You go to Kratie Province for example, and in a gas station you can buy condoms. Before some people were ashamed, especially Cambodian men. When they go to buy condoms, it meant that you were going to have sex with prostitute.”
KT: And on the legal side?
Mouly: “We tell police and judges not to use condom as proof of human trafficking. Before they would arrest manager of karaoke establishment and charge them with human trafficking if they found condoms.”
KT: It sounds like Cambodia is winning the battle against AIDS?
Mouly: ‘We have to be cautious, have to take precautions, because the second wave can come at any moment.
Especially among the youth, the young people, the factory worker. With the progress of information technology, the contact between boy and girl women and man are very easy – there is no barrier like before. You can send email, you can send message via Facebook, you make contact and have sex very easily.
We are going to distribute condoms at the Water Festival, educate people who come for the boat races.”
KT: So you have educate a whole new generation of sexually active young people?
Mouly: “We don’t object that they have sex, that they love each other, that they have contact. Just use condoms, prevent disease and prevent contamination.”
KT: And people who use needles to inject drugs?
Mouly: “This is one of the hotspots we must pay attention to. HIV prevalence is highest – 24 percent – among the people who do drugs…. My concern is also about the disappearing cases of people living with HIV / AIDS, who are supposed to receive treatment.
Of 70,000 living with HIV, only 55,000 come for treatment. So you have 15,000 who we don’t where they are. We identify they have HIV, but the didn’t come for treatment. Whether they die, whether they hide somewhere, whether they transmit their disease to others, we don’t know.”
KT: To close the circle, how strong is the foreign commitment to the Global Fund to fight AIDS in Cambodia?
Mouly: “The Global Fund was to give us to $148 million for two years. Now they tell us to use the same for the amount of money for four years. So we stretch the same money from two years to four years.”
KT: Is that a warning about the future of AIDS funding in a time of Ebola?
Mouly: “If we don’t join hands, Ebola will prevail because it is a new disease and it gets all the funding.”
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