Cambodia

Alliance linking organisation: Khmer HIV/AIDS NGO Alliance (KHANA)

Cambodia is one of the countries worst affected by HIV in south-east Asia. Despite a decline in prevalence from 3.3% in 1998 to 1.6% in 2006, over 250,000 people have been infected with HIV since the beginning of the epidemic in 1991, and over 16,000 people have died of AIDS.

The decline in prevalence is attributed to a combination of high mortality rates among those infected with HIV and successful HIV prevention programs among some populations. These programmes were the result of committed efforts on the part of government, non-governmental organisations and civil society. The new challenge is not to become complacent while the highest levels of HIV infection are still to be found among sex workers, men who have sex with men, men in uniform, and drug users, national statistics show that the epidemic is also shifting from these traditionally high-risk populations into the general population. The highest number of new infections now occur among housewives as men switch to having casual sex with ‘sweethearts'.

Partly as a consequence of high levels of HIV prevalence, it is estimated that 7.8% of children below 15 in Cambodia have lost one or both parents – approximately 335,000 children. Care of orphans is a major concern in a country still recovering from decades of civil unrest and facing extreme poverty.

What we do

With United States Agency for International Development (USAID) support, the Alliance’s programme in Cambodia started in 1996, and in 1999 the Khmer HIV/AIDS NGO Alliance (KHANA) formally registered as a local non-governmental organisation, supporting community action on HIV. KHANA has expanded rapidly and is now recognised as one of the key national players in the HIV response, supporting 68 local non-governmental and community-based organisations across 14 provinces, including the municipalities of Phnom Penh and Siem Reap.

KHANA establishes partnerships with local non-governmental and community-based organisations to build their skills and resources to work on HIV issues and to strengthen their organisational and financial management. Partner organisations implement focused HIV prevention activities, provide care and support to people living with HIV and their families, and carry out advocacy activities to challenge stigma and discrimination and improve the lives of people living with HIV.

The populations reached include people living with HIV and their families, orphans and vulnerable children, sex workers, men who have sex with men, drug users, those in uniformed services, garment factory workers and young people in and out of school.

What we have achieved

KHANA has played a pioneering role in supporting the establishment of self-help groups for people living with HIV and the national network of Cambodian People Living with HIV/AIDS (CPN+). It is also a key player in supporting the government to implement the Continuum of Care framework, through its extensive home-based care programme and support to networks of people living with HIV. KHANA has also been instrumental in HIV prevention with key populations, particularly through its work with men who have sex with men, whose existence has long been denied in Cambodia. As a result of KHANA’s work with this key group, the first network for men who have sex with men has been established in the country. The government now recognises the importance of involving representatives from the men who have sex with men (MSM) network in planning National HIV Strategies and finally it has also agreed to include MSM as a sentinel group when it collects data on HIV prevalence.

As part of the Frontiers Prevention Programme funded by Bill and Melinda Gates Foundation, KHANA has developed pioneering materials for working with drug users including ‘Let’s Talk About Drug Related HIV/AIDS’. Another aspect of this programme has been the development of a book called Unheard Voices, Hidden Lives. This book provides a poignant insight into tghe lives of people who are affected by HIV and AIDS in Cambodia, Ecuador and India, in their own words and photos.

In 2006 KHANA reached over 190,000 people through its HIV prevention activities, its home care teams provided care and support to 13,000 orphans and vulnerable children and 9,400 people living with HIV/AIDS.

KHANA has reached a new phase in its funding, becoming a direct recipient of USAID funds for the three year period to September 2009. A new EC proposal has also been approved to carry out work with key populations. Meanwhile it continues to receive direct funds from the Global Fund to Fight AIDS, Tuberculosis and Malaria and the World Food Programme.

Future plans

The Alliance is in the process of developing a training pack on sex work and gender based violence. This is a key entry point into tackling one of the common hazards faced by sex workers which significantly increases their risk of getting HIV and responds to a need expressed by them. KHANA also plans to explore further the needs of orphans and vulnerable children. Finally KHANA has a new policy unit and it will be developing a strategic plan for 2008-2010 in 2007. Watch this space…