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MSF has been in Cambodia since 1979. Public health problems are dominated by HIV/AIDS and tuberculosis (TB) but MSF, the first to provide antiretroviral therapy (ART) for HIV patients, has helped to improve the situation by developing national treatment guidelines with the Ministry of Health.

A substantial increase in funding by international donors has helped fortify government efforts to tackle prevalent diseases, allowing MSF in turn to reduce its HIV programmes. Teams now focus on the treatment of TB and drug-resistant TB (DR-TB) in Kampong Cham, and on the detection and treatment of TB and HIV within prisons.

In Takeo and Siem Reap, MSF introduced a new model of care treating HIV/AIDS as a chronic disease in clinics alongside diabetes and hypertension. The approach proved successful and teams were able to hand over these activities in June.

In the provincial hospital of Kampong Cham, MSF handed over HIV patient care to health authorities and local partners in March. At the same time, teams extended the TB programme started in September 2008 by building a new TB ward in the hospital and by providing technical support to the hospital laboratory. The initiative is focused particularly on drug-resistant patients, children, and patients co-infected with HIV, but aims to improve case detection and access to care for all TB patients.

In the Khmer-Soviet Friendship (KSF) hospital in Phnom Penh, MSF has been handing over the treatment and follow-up of patients in the infectious diseases ward, and has already transferred the 3,600 HIV-positive patients to health authorities in preparation for a formal handover in March 2010.

HIV/AIDS and TB are particularly challenging to manage in closed settings such as prisons. Since 2007, MSF has been treating HIV patients in Phnom Penh’s prisons via mobile clinics run by the KSF hospital team.  MSF supported voluntary confidential counselling and testing, but teams have now scaled up activities to include HIV and TB case detection and improve access to care, treatment and follow-up of all prisoners in the three prisons. In the prison near Kampong Cham, MSF helped to provide adequate primary healthcare to all inmates as well as conducting a five-month nutritional programme for those who had become severely malnourished.

MSF has worked in Cambodia since 1979.