U.S. HIV Investment in Cambodia

Cambodia is heralded worldwide as an HIV success story. The southeast Asian nation may be the first country to achieve virtual elimination of HIV by 2025, after achieving control of its HIV epidemic more than a decade ago. Beyond a vaccine or a cure, virtual elimination of HIV is the next frontier for the global fight against the pandemic. Few countries are at a position in their HIV epidemics to set virtual elimination as a near-term goal.

However, Cambodia faces crucial challenges in its drive for virtual HIV elimination, including finding the remaining people living with HIV who are yet to be diagnosed, retaining current patients on antiretroviral treatment (ART), achieving viral suppression of those on treatment, and preventing new infections. Further, its weak health sector, lack of skilled health workers, and reliance on external funding, which has decreased in recent years, raise concerns about the long-term sustainability of Cambodia’s success. Its efforts to overcome these challenges will serve as important lessons for other countries.

The U.S. government invests a very small amount annually in the Cambodia HIV response through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), but the potential benefits of the small investments far exceed the costs. In January 2017, the authors traveled to Cambodia to understand the U.S. government’s HIV investment, how that investment is driving further gains against the HIV epidemic, the return on investment, and what challenges and opportunities lie ahead.

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