The World Health Organization (WHO) has been a trusted collaborating partner of the Royal Government of Cambodia (RGC), specifically the Ministry of Health (MoH), for more than a decade during which the country invested in its core health security system. In January 2020, Cambodia recorded its first case of SARS-CoV-2: the RGC, with WHO support, promptly implemented an effective whole-of-government and whole-of-society response that included proactive local preparedness and maintenance of essential health programmes and services. As a consequence, the country reported less than 500 cases and zero deaths as of 1 February 2021. With WHO’s technical support, the response effort shifted towards vaccination campaigns and health care delivery, resulting in 70% of the country's population being vaccinated by September 2021, eight months ahead of the global target. By December 2022, over 91% of the population had received primary vaccine doses, with a third dose administered to 73% of people aged 60 and over, and fourth dose to 100% of health workers.
Key WHO Contributions
Developing the national preparedness and response plan
Adapting global and regional policies, guidelines and standard operating procedures on COVID-19 detection and treatment to the local context
Leading on partner coordination with health and non-health partners across local, national and international levels
Working with local governments on local preparedness, including joint MoH-WHO field missions to all provinces
Developing a multisource surveillance and risk assessment framework, including advice on border measures
Developing and updating the National Deployment and Vaccination Plan
Providing technical and operational support for capacity building
Developing and implementing a Risk Communication and Community Engagement (RCCE) strategy, including technical advice on public health and social measures
Creating and adapting guidance on health care readiness, patient pathways, and clinical management and treatment
Providing support to laboratory capacity, and technical advice, reagents and training to enable whole genome sequencing.
How did Cambodia, with the support of the WHO Secretariat, achieve this?
WHO provided technical expertise to the RGC to tailor global and regional frameworks, policies, guidelines and standard operating procedures to the local context. This included developing Cambodia’s COVID-19 master plan: a national preparedness and response plan that guided the country’s COVID-19 response efforts. To help Cambodia transition out of the early emergency response phase, WHO provided technical expertise to develop a multisource surveillance and risk assessment framework that allowed for a customized response to different transmission levels in different areas of the country, thereby avoiding the need for nationwide lockdowns and their associated economic consequences.
“Cambodia sincerely appreciates WHO’s evidence-based policy advice, and technical and operational support. WHO has been working actively hand in hand with Cambodia’s health officials and health workers to respond to COVID-19, while contributing to the safe and sustainable re-opening of Cambodia.”
- H.E. Professor Mam Bunheng, Minister of Health
When COVID-19 vaccines first became available in late 2020, WHO provided technical support to the Cambodian government to expand access to them through the National Immunization Programme (NIP). The government procured vaccines and, with WHO’s technical input, rapidly developed the National Deployment and Vaccination Plan (NDVP) which was endorsed in January 2021. Cambodia proactively sought to secure vaccines and, in March 2022, became the first country in the region to receive them through the COVAX initiative. WHO provided technical and operational support to all levels of RGC and NIP on the various components of COVID-19 vaccination necessary for successful deployment, including training, cold chain and vaccine management, immunization and safety data management, community engagement and outreach vaccination.
To promote public health and social measures and build trust in vaccines, WHO, with the support of health partners and donors, including the European Union, provided technical support and guidance to the MoH and other stakeholders to develop and implement a Risk Communication and Community Engagement (RCCE) strategy. The RCCE strategy was launched in March 2022 in nine priority provinces and promoted public health measures such as wearing masks, frequent hand washing, avoiding crowded places and getting vaccinated. WHO conducted perception and behavioural insight surveys to modify messaging and developed 80 new or adapted RCCE tools and materials that were disseminated through local TV and radio stations and social media platforms. Over 8.5 million people were reached through more than ten COVID-19 and four non-COVID-19 Facebook campaigns. WHO also provided supportive supervision and training to the MoH to enable personnel to support communities with monitoring activities.
“An impressive part of the Royal Government of Cambodia’s strategy is that risk-based decision-making is being applied together with insights into the Cambodian context, including social and cultural dimensions. For example, recent social listening research shows that in Cambodia people worry more about the health of their loved ones than their own. This is a powerful motivator to make individual right choices to take COVID-19 measures for protecting their family and community.”
- Dr Li Ailan, WHO Representative to Cambodia
To strengthen health care delivery, WHO provided technical support to the MoH to create and adapt key documents and guidance covering clinical management and treatment, patient pathways, infection prevention and control (IPC), and monitoring. These were brought by WHO to over 120 hospitals and health care facilities by various means – workshops, webinars, clinical study sessions, onsite coaching and mentorship – resulting in an increased quality of care and surge capacity at the national and subnational levels. To avoid exceeding health care capacity, WHO and MoH collaborated to strengthen national and subnational patient pathways, including home-based recovery. This included conducting a survey on home-based care and recovery in five provinces and revising communication materials and guidance accordingly. Living guidelines on therapeutics were also developed, including conditional recommendations on the use of molnupiravir for non-severe patients at the highest risk of hospitalization.
WHO also provided technical advice, reagents and training to strengthen the capacity of the National Institute of Public Health (NIPH) to conduct whole-genome sequencing, better enabling the identification and characterization of new and emerging pathogens in the Western Pacific Region. The NIPH uploaded 173 sequences to the Global Initiative on Sharing Avian Influenza Data (GISAID) between January and June 2022.
Cambodia’s successful control of COVID-19 is attributable to a rapid and comprehensive response, effective implementation of restrictive measures and a highly successful vaccination programme. The partnership between the Cambodian government and WHO was instrumental in this achievement. To sustain these gains and strengthen health security in Cambodia and the wider region, continued partnership between the two entities will be crucial.
