In the 1990s, when Cambodia was still recovering from the brutal legacy of the Khmer Rouge, the country faced a new threat: the rapid spread of HIV and AIDS.
Dr Tia Phalla, the Vice-Chairman of the National AIDS Authority in Cambodia, recalls that they were seeing 100 new cases reported daily. “The Khmer Rouge had already taken one generation, we couldn’t afford to lose another to HIV,” he said.
Determined to turn the HIV/AIDS tide in Cambodia, Dr Tia Phalla applied for and was offered an Australia Awards scholarship to study a Masters of Public Health. It was this qualification which radically changed his view about how to approach the HIV/AIDS epidemic back home.
When Dr Phalla returned to Cambodia with new skills and ideas in 1998, he quickly realised there was a problem with the way authorities were trying to spread awareness about HIV/AIDS. “They had been providing technical information, without understanding what people wanted or needed to know about the disease,” he said.
In the absence of accessible information, dangerous misinformation was spreading and infected people were routinely stigmatised. Using what he learned in Australia, Dr Phalla led the national authority in developing public health messages and materials that resonated with people from all walks of life. These were delivered through television dramas, fun public events and in many other ways. Dr Phalla was also instrumental in promoting widespread condom use.
Slowly but surely the country began to see a dramatic change as fewer new cases of HIV/AIDS were reported. Today, while HIV and AIDS are still public health issues, the country has successfully controlled the situation.
The focus now is on reaching out to at-risk-groups such as sex workers. Dr Phalla is using the same approach of ensuring that information and encouragement to change behaviour is delivered in a way that works. For example, the National AIDS Authority supports former sex workers to visit women in bars and clubs and encourage them to get tested and use condoms.
At the same time, Dr Phalla has put a heavy emphasis on helping infected people. In 2003, he started a program to dramatically scale-up care and treatment options. “We need to see infected people as assets, rather than burdens,” he said. “They can still be very productive members of society.” Cambodia is also now one of the first developing countries to have over 90 per cent of adults with advanced HIV infection already on antiretroviral therapy.
Dr Phalla says that his opportunity to study in Australia was a key turning point for him, giving him the critical thinking, analytical and technical skills he needed to devise a public health response that helped turn the tide of HIV/AIDS in Cambodia.