His Excellency Dr Mam Bun Heng, Minister of Health,
Ms Claire Van der Vaeren, UN Resident Coordinator,
Dr Kol Hero, Director of Preventive Medicine Department, Ministry of Health,
Excellences, Government officials, Development partners, UN colleagues, Ladies and gentlemen,
It is my great pleasure to welcome you all to this meeting on the joint mission of UN Inter-agency Task Force of the Prevention and Control of Non-communicable diseases to Cambodia.
I would like to express my sincere appreciation to the Ministry of Health and the UN team for organizing this meeting and a week-long joint mission on NCDs.
As you know, over the past two decades, Cambodia has achieved a significant improvement in the health status of the population due to stable economic growth and the initiatives of the Government in accelerating health sector reform and health system strengthening since the 1990s.
The life expectancy in Cambodia rose to 66.7 years for men and 70.8 years for women in 2015, although they are still lower than the global average.
Cambodia achieved most of the MDG targets, especially in reducing maternal and child mortalities and bringing many communicable diseases under control.
Along with these notable achievements, Cambodia is facing new health challenges in the 21st century with a demographic transition and the change of disease pattern.
Like many other developing countries, population ageing, urbanization and an increase in unhealthy lifestyles have driven a sharp rise in the prevalence of non-communicable diseases (NCDs), principally cardiovascular disease, diabetes, cancer and chronic respiratory disease. These NCDs have overtaken communicable diseases as the leading health burden.
For example, in 1990 the top leading causes of death in Cambodia were lower respiratory infection and diarrhea diseases, while ischaemic heart disease and cerebrovascular disease were ranked as the 9th and 11th cause of death respectively. By 2013 they moved up as the top and 4th leading causes of deaths.
Collectively, these four NCDs caused 52% of all deaths in Cambodia in 2014, up from 46% in 2011. What is particularly concerning is that many of these deaths occur among people younger than 70.
It is now recognized that failing to control NCDs will pose a threat not just to the attainment of national health targets, but also to national social and economic development goals, given the enormous financial burden and medical service needs induced by NCDs on families, health system and the whole society.
Most premature NCD deaths are preventable by taking cost-effective action to tackle four main risk factors – tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol.
Since the the UN General Assembly in September 2011 adopted the political declaration of a high-level meeting on the prevention and control of NCDs, Cambodia initiated efforts to implement the WHO global and regional NCD action plans and achieved impressive progress. These actions include:
- The adoption of the National Strategic plan for the prevention and control of NCDs in November 2013;
- The adoption the National Law on on tobacco control in 2015, and related Sub Decrees in 2016 to:
- raise the Excise Tax rate on cigarette products from 15% to 20% effective on the 1st April 2016;
- on pictorial health warnings on all tobacco product packaging, and
- to ban smoking and the blowing of tobacco smoke in all workplaces and public places
- Also in 2016, under the leadership of the Ministry of Health the Oversight Board and Executive Working Group on the Enforcement of Sub Decree 133 on Marketing of Infant and Young Child Feeding Products was established to better coordinate efforts of four key ministries tasked with enforcement.
- In addition to these achievements, the Ministry of Health has led the effort to develop a National Multi-sectoral Action Plan or the Prevention and control of NCD which is going through the final stages of inter-ministerial consultative meetings prior to submission for adoption.
But even these significant achievements cannot ensure a reversal of the ever increasing NCD epidemic. More work has to be done for accelerating the prevention and control of NCDs to maintain the health gains in last decades, achieve the national health targets set in the 3rd National Health Strategy for 2016-2020 and attain the long-term social economic development objectives and SDGs.
The current health system is not adequately equipped and orientated to tackle NCDs, mainly due to limited human resources and expertise, underfunded programs and insufficient community mobilization and participation in the prevention and control of NCDs.
We also know that many of the driving forces behind the NCD epidemic are powerful multi-national industries that aggressively undermine the adoption of effective public health policies and their enforcement. This is most clearly seen in the actions of the Tobacco Industry, and the inclusion of specific measures to counter Industry interference within the WHO Framework Convention on Tobacco Control.
In the face of these challenges, the epidemic of NCDs facing Cambodia cannot be solved by health sectors alone. Many of the underlying causes of NCDs lie beyond health sector, closely linked to other social determents such as food security, effective enforcement of policies and laws, working and living environment, lifestyle, social norms, and people’s knowledge about the underlying causes of NCDs.
In the 2011 Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of NCDs, Heads of State and Government set out action for a whole-of-government and whole-of-society approach for the prevention and control of NCDs, and decided to integrate NCDs into national development agendas, including the United Nations Development Assistance Framework design processes and implementation.
It is for this purpose that the UN Inter-agency Task Force mission comes to Cambodia, to review NCDs status and policies, coordinate UN programs to support the national multi-sectoral action plan on NCDs, share international experience, strengthen international cooperation and help mobilize global and regional support and resources for NCD prevention and control.
I encourage everyone who will participate in the meetings and discussions that will take place this week to take full advantage of this opportunity to seek solutions and identify actions that we can take collectively to ensure a healthy future for Cambodia.
I wish you all a fruitful meeting and a successful joint mission.
Thank you.