WHO Moves Regional Malaria Office to Cambodia

The World Health Organi­za­tion (WHO) is moving its re­gional malaria office from Bang­kok to Phnom Penh to be closer to the epicenter of the problem and fight against drug-resistance in western Cambodia.

A coordinator for the project is scheduled to arrive here on Wednes­day to start setting up the new office and scaling up the fight, said Steven Bjorge, the WHO’s malaria team leader in Cambodia.

When the coordinator in Bang­kok retired last year, he said, “The office…took upon itself to see if a Bangkok office made sense or not. They said let’s ei­ther consider Cambodia or My­anmar because these are two countries still facing resistance on a daily basis.”

With malaria already relegated to a “minor” problem in Thailand, the WHO settled on Cambodia, both because it was more easily accessible by air than Burma and because it had the most acute problem with growing drug resistance.

“In Cambodia, it’s more front and center,” Mr. Bjorge said. “The drug resistance problem is more severe here than in any of the other countries.”

Though Artemisinin-based Combination Therapies (ACTs) remain effective in Africa and most of Southeast Asia, resistance has been growing along the Thai-Cambodian border since health workers first detected it there in 2007. Resistance has also started to show up in Vietnam and—most recently—in Burma.

But it is in Cambodia’s Pailin province that ACTs are failing the fastest. The region has already gone through two variations of ACTs since 2007 and tests are expected to start soon on the efficacy of a third before it is finally rolled out.

Health workers still do not know whether the signs of resistance showing up in Vietnam and Burma developed on their own or spread from Cambodia. What they fear most is that it will spread to Africa, where most of the more than 600,000 annual ma­laria deaths occur.

To keep that from happening, the WHO in 2009 started a re­gion-wide project to contain the malaria strain showing ACT resistance with a two-year, $22.5 million grant from the Bill and Me­linda Gates Foundation.

With a new combined $15 million grant to cover the next three years from the Gates Foundation and AusAid, the Australian government’s foreign aid arm, Mr. Bjorge said the WHO will work with Cambodia and its neigh­bors to scale up the work they have al­ready started.

“We’ll have more people working out of the hub and staff in the various countries,” he said.

The WHO has already started advertising for a permanent coordinator and hopes to have one in place within three months.

The regional office will take shape amid allegations of “serious financial wrongdoing” by the Cambodian government’s Na­tional Malaria Center (CNM) in its handling of separate malaria grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The Global Fund has yet to re­lease a report of its investigation or any other details, however, and will not say how much money was allegedly misspent, only that it amounted to less than half-a-million dollars.

A CNM deputy director, Chea Nguon, declined to comment and referred questions to director Char Meng Chuor, who could not be reached.

Despite the alleged misspend­ing and growing drug resistance, Cambodia has registered major gains against malaria.

The number of infections and deaths have dropped steadily since the containment project was launched. Registered infections dropped by more than 14,000 cases to 51,752 between 2011 and 2012. Deaths over the same period dropped from 77 to 40.

And, in its annual World Ma­laria Report released last month, the WHO identified Cambodia as one of eight countries in the West­ern Pacific region to have cut its infection rate by 75 percent or more since 2000.