31 January 2024
CO24018 | Small States and COVID-19: Cambodia’s Approach
SYNOPSIS
Cambodia’s humanitarian, citizen-centric policies were applied flexibly to manage the COVID-19 pandemic. They may not have always been on target, but Cambodia’s successful management and containment of the virus with its very limited resources belies accusations of government politicking.
COMMENTARY
On 21 December 2023, Singapore’s gov.sg WhatsApp channel broadcast a message about exercising caution to manage a spike in COVID-19. The significance of the message lay in the fact that it was the first about the virus in ten months and that the earlier message was about standing down to DORSCON Green (Disease Outbreak Response System Condition, Green indicating mild presence of COVID-19 and not spreading easily).
Though COVID-19 never left us, its resurgence is new and not limited to Singapore. Malaysia reported almost a doubling of cases. Cambodia has also seen an increase but it is well below the peak recorded in July 2021. Despite this, Cambodia has seen unusually low numbers of cases and deaths.
It is this that makes Cambodia’s political and practical experience a useful study in the management of COVID-19 in the “new normal”. That it remains the operating environment is reiterated by the Cambodian Health Ministry’s recent advisory which also encourages people to take care during the winter.
Political Allegations but Factual Successes
Nonetheless, the assertion lingers that the Cambodian People’s Party, either intentionally or otherwise, used the pandemic for political purposes. The allegations ranged from the party’s use of the pandemic for a power-grab, to that of stifling free speech, and even as a weapon against striking workers.
The facts, however, speak for themselves. Cambodia had just two doctors and some nine hospital beds per 10,000 citizens at the onset of COVID-19 in 2020. Yet, the country was able to prevent infections and deaths from overwhelming societal assets till at least December 2021.
Moreover, Cambodia reported less than 500 cases at the beginning of those two long years of the pandemic. Inevitably though, the numbers spiked in late February 2021 – as they did elsewhere and earlier. There were two subsequent, and less intense spikes, till late 2022, before the numbers settled in 2023.
In short, a country ranked 89th out of 195 countries in the 2019 Global Health Security Index boasts a far lower death rate when compared to several highly-developed nations. In other words, the minimal loss of life in itself belies the allegations of a miscreant government.
Assertions that the pandemic was harnessed to narrow party-political purposes were further eroded by the government noting and making public socio-political setbacks. For instance, Cambodia’s Ministry of Education, Youth and Sport, alerted the world during the height of the pandemic to the losses that the disease was inflicting on students.
Such announcements indicate a commitment to humanity as well as a responsibility to the citizenry. It is ironic that countries popularly regarded as the most democratic did not live up to such commitments during the worst of the pandemic. Furthermore, unlike some other states, Cambodia did not pursue “herd immunity” which would have sacrificed the elderly and the children. Instead, it sought to preserve all. Nor was this just a principled stance or a rhetorical device. Words became concrete but flexible policy, which accounted for Cambodia’s successes.
Humane Citizen-centric Policies
Cambodia began by ensuring that temperature screening was in place by February 2020, to detect, isolate and quarantine the infected. People were strongly advised to mask up and to maintain social distancing. These humane social policies, like those widely adopted elsewhere, were intended to save lives.
Hence, there were just some two dozen cases reported by March but it was enough for the government to take the next step and close schools so as to safeguard some of its most vulnerable citizens. Later that month, travel restrictions both into and within Cambodia were also tightened. As numbers stayed low, it was decided to ease travel restrictions, and by September, to reopen schools.
This reversal of policy to return life to normal, was somewhat premature. Within weeks Cambodia reported its first community outbreak. However, the incidence rate remained low.
By March, medical supplies including test kits were being supplied by several countries and agencies and accepted regardless of political affinities. Although data is scarce for the period, the Pasteur Institute reported that by June over 400 tests were conducted daily and infection rates were very low.
Alongside these social and medical interventions, economic aid was prioritised early on when over US$4 billion was earmarked for stimulus packages. Funds were allocated to the sectors most affected by the virus, and also for a cash transfer programme.
Implemented in June 2020, the programme was the country’s first. By the end of September 2021, there had been six transfer rounds, with payments between US$20 to US$30 per family. The World Bank noted that this sped up the economy’s digitalisation and opened the door to the advantages it had delivered elsewhere.
The adequacy of Cambodia’s groundwork became evident during the sustained human-to-human transmission of COVID-19 in 2021. The pandemic’s rapid spread was largely inevitable since people across the globe were not immune to what was a very new virus. However, Cambodia managed to secure vaccines from various sources, and the first began to arrive as early as February 2021. Soon supply lines were secured and so the vaccination policy was changed to inoculate not just those aged 18 and above, but those 12 and above as well.
In addition to the state’s pro-life policies and flexibility, there was an uncompromising approach to safeguards and openness. A programme monitored doses dispensed but also deaths and adverse reactions. All the data were made public, on Facebook for instance.
As a result, in 2023, Cambodia has seen a lower incidence of cases than several developed nations; thanks to Phnom Penh’s efforts, including the rigour of its testing and reporting regime. Indeed, the Nikkei COVID-19 Recovery Index, which evaluated over 120 countries for post-pandemic recovery efforts, ranked Cambodia fourth because of the steps it took from 2020 to 2022.
The Uniqueness of Small States
The pandemic was a unique test for Cambodia. However, like other small states with centralised governments, it had shown remarkable agility in responding to the crisis. The challenges they face are similar. Being small, they are more vulnerable to external shocks than bigger states. They are often densely populated, which facilitates community transmission. Medicine costs per capita are higher while the health infrastructure may not be able to treat large numbers of people.
Despite these vulnerabilities, small states have distinct advantages. They are quick to respond to changes in the security landscape, and the sense of insecurity they suffer from sometimes motivates them to adapt more quickly, unhindered by the bureaucracy that often plagues bigger countries.
Post-pandemic, Pandemic?
The newest variant of COVID-19, the BA.2.86, has already been detected in Cambodia. The Centers for Disease Control and Prevention (CDC) in the United States reportedly stated that the variant does not cause more serious diseases but also noted that it accounts for over 60 per cent of US cases and that hospitalisation has increased to some 20 per cent. The variant will likely have the same effect in Cambodia, and the attendant strains on healthcare and the economy there will therefore be heightened.
To manage the strain, the Cambodian Health Minister is encouraging continued vigilance, renewing earlier policies, as well as advocating booster shots. The government also announced a framework to live with the “new normal”. It is strengthening international cooperation, local capacity, and resilience. For that purpose, Cambodia has, with the WHO’s assistance, built 19 laboratories since 2020 and can test over 20,000 samples daily, besides having trained over 3,000 healthcare workers in the provinces. The country also negotiated a World Bank credit of US$274 million to make its SMEs resilient.
Like other states, Cambodia will have to continue to manage COVID-19 and its many manifestations. The politics of that management is a lesson on how to craft policies to manage scarce resources humanely to realise an equitable future. In this, there is no doubt that Cambodia was assisted by a society sensibly responsive to the pandemic’s challenges – there was, for instance, practically no vaccine hesitancy. That societal sensibility would have been damaged if the political allegations of a self-serving government were true. Cambodia’s renewed efforts to improve its already impressive COVID-19 response, suggest otherwise.
About the Author
Deep Datta-Ray is a Visiting Senior Fellow at the S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University (NTU), Singapore. He is the author of The Making of Indian Diplomacy: a Critique of Eurocentrism (New York, OUP: 2015). This commentary is part of an RSIS series.
SYNOPSIS
Cambodia’s humanitarian, citizen-centric policies were applied flexibly to manage the COVID-19 pandemic. They may not have always been on target, but Cambodia’s successful management and containment of the virus with its very limited resources belies accusations of government politicking.
COMMENTARY
On 21 December 2023, Singapore’s gov.sg WhatsApp channel broadcast a message about exercising caution to manage a spike in COVID-19. The significance of the message lay in the fact that it was the first about the virus in ten months and that the earlier message was about standing down to DORSCON Green (Disease Outbreak Response System Condition, Green indicating mild presence of COVID-19 and not spreading easily).
Though COVID-19 never left us, its resurgence is new and not limited to Singapore. Malaysia reported almost a doubling of cases. Cambodia has also seen an increase but it is well below the peak recorded in July 2021. Despite this, Cambodia has seen unusually low numbers of cases and deaths.
It is this that makes Cambodia’s political and practical experience a useful study in the management of COVID-19 in the “new normal”. That it remains the operating environment is reiterated by the Cambodian Health Ministry’s recent advisory which also encourages people to take care during the winter.
Political Allegations but Factual Successes
Nonetheless, the assertion lingers that the Cambodian People’s Party, either intentionally or otherwise, used the pandemic for political purposes. The allegations ranged from the party’s use of the pandemic for a power-grab, to that of stifling free speech, and even as a weapon against striking workers.
The facts, however, speak for themselves. Cambodia had just two doctors and some nine hospital beds per 10,000 citizens at the onset of COVID-19 in 2020. Yet, the country was able to prevent infections and deaths from overwhelming societal assets till at least December 2021.
Moreover, Cambodia reported less than 500 cases at the beginning of those two long years of the pandemic. Inevitably though, the numbers spiked in late February 2021 – as they did elsewhere and earlier. There were two subsequent, and less intense spikes, till late 2022, before the numbers settled in 2023.
In short, a country ranked 89th out of 195 countries in the 2019 Global Health Security Index boasts a far lower death rate when compared to several highly-developed nations. In other words, the minimal loss of life in itself belies the allegations of a miscreant government.
Assertions that the pandemic was harnessed to narrow party-political purposes were further eroded by the government noting and making public socio-political setbacks. For instance, Cambodia’s Ministry of Education, Youth and Sport, alerted the world during the height of the pandemic to the losses that the disease was inflicting on students.
Such announcements indicate a commitment to humanity as well as a responsibility to the citizenry. It is ironic that countries popularly regarded as the most democratic did not live up to such commitments during the worst of the pandemic. Furthermore, unlike some other states, Cambodia did not pursue “herd immunity” which would have sacrificed the elderly and the children. Instead, it sought to preserve all. Nor was this just a principled stance or a rhetorical device. Words became concrete but flexible policy, which accounted for Cambodia’s successes.
Humane Citizen-centric Policies
Cambodia began by ensuring that temperature screening was in place by February 2020, to detect, isolate and quarantine the infected. People were strongly advised to mask up and to maintain social distancing. These humane social policies, like those widely adopted elsewhere, were intended to save lives.
Hence, there were just some two dozen cases reported by March but it was enough for the government to take the next step and close schools so as to safeguard some of its most vulnerable citizens. Later that month, travel restrictions both into and within Cambodia were also tightened. As numbers stayed low, it was decided to ease travel restrictions, and by September, to reopen schools.
This reversal of policy to return life to normal, was somewhat premature. Within weeks Cambodia reported its first community outbreak. However, the incidence rate remained low.
By March, medical supplies including test kits were being supplied by several countries and agencies and accepted regardless of political affinities. Although data is scarce for the period, the Pasteur Institute reported that by June over 400 tests were conducted daily and infection rates were very low.
Alongside these social and medical interventions, economic aid was prioritised early on when over US$4 billion was earmarked for stimulus packages. Funds were allocated to the sectors most affected by the virus, and also for a cash transfer programme.
Implemented in June 2020, the programme was the country’s first. By the end of September 2021, there had been six transfer rounds, with payments between US$20 to US$30 per family. The World Bank noted that this sped up the economy’s digitalisation and opened the door to the advantages it had delivered elsewhere.
The adequacy of Cambodia’s groundwork became evident during the sustained human-to-human transmission of COVID-19 in 2021. The pandemic’s rapid spread was largely inevitable since people across the globe were not immune to what was a very new virus. However, Cambodia managed to secure vaccines from various sources, and the first began to arrive as early as February 2021. Soon supply lines were secured and so the vaccination policy was changed to inoculate not just those aged 18 and above, but those 12 and above as well.
In addition to the state’s pro-life policies and flexibility, there was an uncompromising approach to safeguards and openness. A programme monitored doses dispensed but also deaths and adverse reactions. All the data were made public, on Facebook for instance.
As a result, in 2023, Cambodia has seen a lower incidence of cases than several developed nations; thanks to Phnom Penh’s efforts, including the rigour of its testing and reporting regime. Indeed, the Nikkei COVID-19 Recovery Index, which evaluated over 120 countries for post-pandemic recovery efforts, ranked Cambodia fourth because of the steps it took from 2020 to 2022.
The Uniqueness of Small States
The pandemic was a unique test for Cambodia. However, like other small states with centralised governments, it had shown remarkable agility in responding to the crisis. The challenges they face are similar. Being small, they are more vulnerable to external shocks than bigger states. They are often densely populated, which facilitates community transmission. Medicine costs per capita are higher while the health infrastructure may not be able to treat large numbers of people.
Despite these vulnerabilities, small states have distinct advantages. They are quick to respond to changes in the security landscape, and the sense of insecurity they suffer from sometimes motivates them to adapt more quickly, unhindered by the bureaucracy that often plagues bigger countries.
Post-pandemic, Pandemic?
The newest variant of COVID-19, the BA.2.86, has already been detected in Cambodia. The Centers for Disease Control and Prevention (CDC) in the United States reportedly stated that the variant does not cause more serious diseases but also noted that it accounts for over 60 per cent of US cases and that hospitalisation has increased to some 20 per cent. The variant will likely have the same effect in Cambodia, and the attendant strains on healthcare and the economy there will therefore be heightened.
To manage the strain, the Cambodian Health Minister is encouraging continued vigilance, renewing earlier policies, as well as advocating booster shots. The government also announced a framework to live with the “new normal”. It is strengthening international cooperation, local capacity, and resilience. For that purpose, Cambodia has, with the WHO’s assistance, built 19 laboratories since 2020 and can test over 20,000 samples daily, besides having trained over 3,000 healthcare workers in the provinces. The country also negotiated a World Bank credit of US$274 million to make its SMEs resilient.
Like other states, Cambodia will have to continue to manage COVID-19 and its many manifestations. The politics of that management is a lesson on how to craft policies to manage scarce resources humanely to realise an equitable future. In this, there is no doubt that Cambodia was assisted by a society sensibly responsive to the pandemic’s challenges – there was, for instance, practically no vaccine hesitancy. That societal sensibility would have been damaged if the political allegations of a self-serving government were true. Cambodia’s renewed efforts to improve its already impressive COVID-19 response, suggest otherwise.
About the Author
Deep Datta-Ray is a Visiting Senior Fellow at the S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University (NTU), Singapore. He is the author of The Making of Indian Diplomacy: a Critique of Eurocentrism (New York, OUP: 2015). This commentary is part of an RSIS series.
