Lessons From Cambodia on How to Respond to COVID

From Europe to the Asia-Pacific, what looked like light at the end of the tunnel earlier this year has given way to rising infections and an uptick in mortality rates as the highly infectious Delta strain has taken hold. Countries that appeared to be controlling the virus are now scrambling to limit the spread as a new wave overwhelms already strained health care systems.

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

This success has not come without a price. The country’s authoritarian government has forced vaccines on its citizens and used the pandemic to crackdown on opponents and critical voices.

Southeast Asia’s Fight Against the Delta Variant

Southeast Asia has not been immune to the new strain of COVID-19. Thailand has seen an explosion of infections, from a 7-day case average of around 130 in March to a high of 21,000 in August. In neighboring Myanmar, the Delta strain has run roughshod through a people already struggling with the economic and health impacts of a violent military coup. The country has seen 16,700 COVID deaths to date. Vietnam was initially hailed as a model of success but is also struggling to hold the line, with a 7-day average of over 12,000 cases in September.

Wealthier countries in the Asia-Pacific region are faring little better. Australia shielded itself from the worst of the pandemic by controversially closing its borders, leaving overseas Australians stranded and unable to return home. But the Morrison government squandered the time they had by not vaccinating its population faster and is now losing a fight against surging Delta infections and a mounting death toll.

Among an alarming uptick in both case numbers and deaths, Cambodia currently stands alone as having held back the tide of the Delta-driven third wave.

Get Vaccinated and Move On

A report by Mekong Strategic Partners titled “Vaccination Nation: Unmasking Cambodia’s Vaccination Success,” suggests a swift vaccination rollout is the reason for the country’s success. Cambodia is one of the first countries in the world to be offering booster shots and vaccinating children.

The data speaks for itself. At present 57 percent of Cambodians have received two doses, while in neighboring Thailand the rate is 17 percent, and in Vietnam only 4 percent. Meanwhile, in Australia, less than 40 percent of the population has had both doses. And with 36 percent of the Australian public hesitant to do so, it’s possible that the land down under may not return to normal anytime soon.

Cambodia’s vaccination achievements have resulted in far fewer deaths than its ASEAN neighbors. The country’s lower mortality rate is equivalent to an additional 340 Cambodian’s surviving each week, compared to other countries in the region. This is partially thanks to the government using a mix of whatever vaccines it could get, including Sinovac, Sinopharm, AstraZeneca, and Johnson & Johnson.

With fewer people contracting, transmitting, and falling ill from the virus, the country’s health care system is under less strain and can concentrate on managing seasonal illnesses that flare up during the monsoon. Cambodia’s gradual phasing out of lockdowns and opening of customer-facing businesses makes it well-positioned to return to (a new) normal.

If further encouragement were needed to convince skeptics of the benefits of vaccination, Cambodia is on track to reopen its economy to foreign investment and tourism. The pandemic hit the tourism, construction, and manufacturing sectors particularly hard, severely impacting already poor and vulnerable households. But revised forecasts for 2022 now peg the country at between 5 and 6 percent growth, as vaccinated workers return to factories, offices, and building sites.

All this is good news for Cambodians and vaccine advocates. But it’s come at a cost.

Political Price

On the surface, the success of one of the region’s poorest countries is due to a blend of low vaccine hesitancy, a sense of communal responsibility, and an approach to securing vaccines where the best one is “the one you can get.” But the government has forced citizens into receiving vaccines and its quarantining strategies have been ham-fisted.

In March 2020, Prime Minister Hun Sen issued an ominous warning that anyone spreading fake news about the pandemic was a terrorist. Within days two people were charged for questioning whether the government was fully disclosing information on the virus. 2020 also saw a string of unprovoked attacks and crackdowns on political activists and opponents.

Earlier this year, the government closed markets and locked down “Red Zones” in the capital, Phnom Penh. Punitive quarantine measures drastically limited peoples’ ability to work, purchase food, and source medicine. Communities protested these measures, claiming they were on the brink of starvation. NGOs rushed to fill the gap, providing emergency food assistance and necessities. Further 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 has come 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 still needs to be said, but vaccine skepticism in wealthy countries is costing lives and delaying victory over the virus. Closing borders is no substitute for getting jabs in arms, a lesson Australia is learning the hard way.

Second, vaccinations have positive downstream outcomes, freeing up healthcare workers to focus on other, equally challenging, medical emergencies.

Third, the basics matter — mask-wearing and hand-washing contributes to saving livelihoods and lives, allowing business owners to reopen restaurants, bars, and construction sites, and get back to work.

Cambodia is not yet out of the woods, with a recent increase in cases and the continuing challenge of new variants. But its vaccine success places it in an enviable position compared to its neighbors. Despite missteps and authoritarian tactics, it remains vital that we learn from Cambodia’s obvious successes. The battle against COVID is far from over, and we will need to use every experience we have to bring it under control.

This article first appeared on FPIF.

Sam Macdonald is the International Solidarity Coordinator for the Korean Federation for Environmental Movements, South Korea’s largest environmental NGO. The views expressed are those of the author alone.