Learning from Cambodia’s COVID-19 Response

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What looked like light at the end of the tunnel earlier this year has given way to increasing infections and mortality rates from Europe to the Asia-Pacific region as the highly contagious Delta Tribe prevails. Countries that appear to control the virus are now making efforts to limit the spread as a new wave overwhelms already strained health systems.

But one country seems to be bucking the global trend. The Kingdom of Cambodia is pushing against the fourth wave of COVID-19 and appears to be on the verge of an economic turnaround to pre-pandemic levels. Despite having a GDP per capita of one tenth of EU GDP, Cambodia has achieved a similar vaccination rate and a 20 times lower death rate.

This success does not come without a price. The country’s authoritarian government has imposed vaccinations on its citizens and used the pandemic to crack down on opponents and critical voices.

Southeast Asia’s battle against the Delta variant

Southeast Asia is not immune to the new strain of COVID-19. Thailand has seen an explosion in infections, from a 7-day average of around 130 in March to a high of 21,000 in August. In neighboring Myanmar, the Delta Tribe has trampled on a people already grappling with the economic and health effects of a violent military coup. The country has so far seen 16,700 COVID deaths. Vietnam was originally hailed as a model of success but has also struggled to hold the line, with a 7-day average of over 12,000 cases in September.

Wealthier countries in the Asia-Pacific region are hardly better off. Australia protected itself from the worst of the pandemic by controversially closing its borders, leaving Australians stranded overseas and unable to return home. But the Morrison administration wasted the time it had by failing to vaccinate its population faster and is now losing the battle against swelling Delta infections and a rising death toll.

Amid an alarming surge in both case numbers and deaths, Cambodia is currently standing alone to hold back the tide of the delta-powered third wave.

Get vaccinated and move on

A report by Mekong Strategic Partners, titled “Vaccination Nation: Demasking Cambodia’s Vaccination Success,” suggests that a swift introduction of vaccination is the reason the country is so successful. Cambodia is one of the first countries in the world to offer booster and vaccinations for children.

The data speak for themselves. Currently, 57 percent of Cambodians have received two doses, in neighboring Thailand the figure is 17 percent and in Vietnam only 4 percent. Now in Australia, less than 40 percent of the population has received both doses. And with 36 percent of the Australian public hesitating to do so, it is possible that the country Down Under will not return to normal any time soon.

Cambodia’s vaccination benefits result in far fewer deaths than those of its ASEAN neighbors. The country’s lower death rate translates into an additional survival rate of 340 Cambodians per week compared to other countries in the region. This is partly because the government uses a mix of all sorts of vaccines, including Sinovac, Sinopharm, AstraZeneca, and Johnson & Johnson.

With fewer people infected, transmitted, and contracted by the virus, the country’s health system is less burdened and can focus on managing seasonal illnesses that flare up during the monsoons. Cambodia’s gradual dismantling of lockdowns and opening of customer-centric stores makes it well-positioned to return to a (new) normal.

If further encouragement was needed to convince skeptics of the benefits of vaccination, Cambodia is well on its way to reopening its economy to foreign investment and tourism. The pandemic has hit the tourism, construction and manufacturing sectors particularly hard, and has already hit poor and vulnerable households hard. But revised forecasts for 2022 now see the country growing between 5 and 6 percent as vaccinated workers return to factories, offices and construction sites.

All of this is good news for Cambodians and vaccination advocates. But it comes at a price.

Political price

On the surface, the success of one of the poorest countries in the region is due to a mix of low vaccination reluctance, a sense of community responsibility and an approach to getting vaccines where the best is “the one you can get”. But the government has forced citizens to get vaccines and their quarantine strategies have been dashed.

In March 2020, Prime Minister Hun Sen issued an ominous warning that anyone who spreads fake news about the pandemic is a terrorist. Within days, two people were charged with questioning whether the government was fully disclosing information about the virus. In 2020 there were also a number of unprovoked attacks and raids against political activists and opponents.

At the beginning of this year the government closed the markets and closed the “red zones” in the capital Phnom Penh. Penal quarantine measures people’s drastically reduced ability to work, buy groceries, and procure medicines. Communities protested these measures, claiming they were on the verge of starvation. NGOs rushed to fill the void by providing emergency food aid and essentials. Additional reports of police violence against increasingly desperate families led Human Rights Watch to declare a humanitarian crisis.

Vaccination offers freedom

Cambodia’s success in suppressing the Delta variant gives hope to other countries currently struggling to contain the pandemic. But it came in a distinctly authoritarian style. Is there anything that can be learned from the Kingdom’s Pandemic Response?

First, vaccinations save lives. It seems alarming that this has yet to be said, but vaccination skepticism in wealthy countries is costing lives and delaying victory over the virus. Closing the borders is no substitute for gun strikes, a lesson Australia is learning the hard way.

Second, vaccinations have positive downstream outcomes that allow health workers to focus on other equally challenging medical emergencies.

Third, the basics are important – wearing masks and washing your hands help save livelihoods and lives, and allow business owners to reopen restaurants, bars, and construction sites and get back to work.

Cambodia is not out of the woods yet, with cases rising lately and the challenge of new varieties continuing. But its vaccine success puts it in an enviable position compared to its neighbors. Despite missteps and authoritarian tactics, it is important that we learn from Cambodia’s obvious successes. The fight against COVID is far from over and we will have to use every experience to bring it under control.

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