(as prepared for delivery)

• Your Excellency, Dr. Mam Bunheng, Minister of Health
• Your Excellency, Dr. Mao Tan Eang, Director of the National Center for Tuberculosis and Leprosy Control and Advisor to the Ministry of Health
• Distinguished Guests, Ladies and Gentlemen, students

I am honored to be among you – the front line in the fight against one of the world’s toughest diseases. 

On March 24, the global health and scientific community gathered in Washington, DC, and around the world, to celebrate World TB Day, and we’re gathered here to mark the occasion as well.

We have made important progress in fighting TB, both globally and here in Cambodia, for which you should be proud. Please raise your hand if you have tested for TB. I have. I get tested for TB every year. TB remains a major global problem. Every year over ten million people are infected, and nearly 2 million lose their lives to TB. Over 4 million of those who fall ill each year do not receive a proper diagnosis or notification of their illness. This can lead to drug-resistant forms of TB, infections that can’t be treated with first line drugs, and require longer, harsher, and more expensive treatments.

Despite all of Cambodia’s successes, Cambodia still has the highest burden of TB within the region, and TB remains a priority for USAID here. In order to turn the tide on TB, we need to address drug sensitive and Multi- or Extensively-Drug Resistant TB – as challenges to ending the TB epidemic, but also as threats to global health security. We also need to do a better job to find the unreported and undiagnosed TB cases – more than a third of all cases– and prevent them from spreading to other people.

We need to work harder to make access to TB services a reality, in particular for high risk and vulnerable populations, who find it difficult to access TB services. We also need to work smarter by linking up with other health services to address missed opportunities to identify TB patients who may show up to other departments for care.

The theme for this year’s World TB Day, "Unite to End TB," is a call on governments, affected communities, civil society, health care providers, and international partners to join the drive to reach everyone who has TB, and ensure that everyone suffering from TB has access to adequate care, including diagnosis, treatment and cure. treated. We need to maximize the resources available to tackle TB.

Let’s take a concrete example, and a really meaningful segment of the at-risk population: the elderly. Older people are four times more likely to contract TB than those under 55 years of age. And if we can manage to address TB among the elderly, we’ll also address a prominent source of TB infection for children.

In Cambodia, as you all know, we see working-age mothers and fathers migrating to take advantage of work opportunities, and the grandmothers and grandfathers become the primary caretakers of their grandchildren. If they contract TB, they can pass the disease on to their beloved grandchildren as well.

Here’s one innovative way that USAID and its partners are helping the Cambodian National TB Program to address this: carrying out TB screenings among the elderly. Screening the elderly population for TB and putting those infected on timely and appropriate treatment not only helps the patients themselves, but reduces the chance of passing on the infection to their loved ones and others in the community. 

To illustrate very directly the difficulties in accessing care, let me tell you about one of your sisters.

Yeay Bou raised 6 children in Kampong Speu, and she is now 73 years old. For months Yeay Bou had night sweats, chronic fever – she lost a lot of weight. 

She lives six kilometers from the nearest health center, she is poor, and has no way to travel to the health center to have a checkup. 

But a TB screening at the pagoda near her home gave her a chance to see health center staff. She was screened and, based on her symptoms and what they saw, the staff requested a sputum sample. The sample was sent for a modern TB test called “GeneX-pert.” Just three days later, the health center staff informed Yeay Bou that she had TB.

She was worried, but was reassured by the Village Health Support Group that she could be treated and cured, and can recover from her illness. The Village Health Support Group delivers her medication every day, and she takes her drugs regularly in front of a health worker at the pagoda.

Yeay Bou now is committed to finishing her treatment, even though it takes quite a long time and the drugs have side effects.

The point here is that targeted community-based approaches – screening for TB at the pagoda, using what’s called a contact investigation to have a look at all close contacts of confirmed TB patients – can be very effective in helping us address that large segment of “missing” cases. It helps get services to the elderly, who are most in need, and who face great difficulties accessing care.

Today let’s renew our commitment to support more responsive, innovative, and effective approaches to TB control.

USAID continues to to help Cambodia capitalize on the gains made so far and take them to the end goal. Together with our partners, we are working to help Cambodia achieve the Stop TB Partnership goal of eliminating TB globally by 2035!

Thank you.