Avian influenza: the political economy of disease control in Cambodia.
Abstract   In the wake of avian flu outbreaks in 2004, Cambodia received $45 million in commitments from international donors to help combat the spread of animal and human influenza, particularly avian influenza (H5N1). How countries leverage foreign aid to address the specific needs of donors and the endemic needs of the nation is a complex and nuanced issue throughout the developing world. Cambodia is a particularly compelling study in pandemic preparedness and the management of avian influenza because of its multilayered network of competing local, national, and global needs, and because the level of aid in Cambodia represents approximately $2.65 million per human case-a disproportionately high number when compared with neighbors Vietnam and Indonesia. This paper examines how the Cambodian government has made use of animal and human influenza funds to protect (or fail to protect) its citizens and the global community. It asks how effective donor and government responses were to combating avian influenza in Cambodia, and what improvements could be made at the local and international level to help prepare for and respond to future outbreaks. Based on original interviews, a field survey of policy stakeholders, and detailed examination of Cambodia's health infrastructure and policies, the findings illustrate that while pandemic preparedness has shown improvements since 2004, new outbreaks and human fatalities accelerated in 2011, and more work needs to be done to align the specific goals of funders with the endemic needs of developing nations.
Department of National Security Affairs, U.S. Naval Postgraduate School, 1411 Cunningham Road, Monterey, CA 93943, USA. sear@nps.edu
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D000818:Animals; D001717:Birds; D002160:Cambodia / Q000453:epidemiology; D005378:Financial Support; D006291:Health Policy; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D053124:Influenza A Virus, H5N1 Subtype; D005585:Influenza in Birds / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D007391:International Cooperation; D058873:Pandemics / Q000191:economics / Q000517:prevention & control* / Q000662:veterinary; D011050:Policy Making; D011159:Population Surveillance; D015397:Program Evaluation; D013785:Thailand / Q000453:epidemiology; D014744:Vietnam / Q000453:epidemiology