Quarterly Review 3 – 2025
In November 2024, the Ministry of Health had asked MoPoTsyo to renegotiate our standard agreements, that we have since 2012, with our local government counterparts (operational districts, referral hospitals and health centers) in such a way that the public health facilities buy the medicines from us directly (paying to finance MoPoTsyo’s RDF) and distribute these medicines to their patients, instead of letting the patients (registered as our members) pay for them, as has been the custom since 2012. In April 2025 we reported to MoH that MoPoTsyo is ready to sign the new standard agreements.
Now, at end of 2025-Q3, our counterparts still hesitate to sign the new deal. They wait for instruction to sign. As a local NGO we are not in a position to exert force, but we would prefer to be compliant in order to qualify for a new Memorandum of Agreement 2027-2029 when our current one expires. MoPoTsyo’s 13-year-old “Revolving Drug Fund” in the public services now continues as before. The verbal feedback that we receive from patients, doctors, directors is that they hope we can continue beyond 2026 as before because many patients -after trying the new primary care system (lower user fee…) return back to MoPoTsyo’s (less costly overall in using??) system as more convenient for them.
Chhlong Referral Hospital in Kratie province felt forced to stop abruptly in mid-April 2025. Since then, we saw the great majority (70% of them according to the patient utilization data in our database) of its patients with diabetes and hypertension travel to neighboring provinces to hospitals where our NGO still facilitates the services. We are finding out precise reasons why patients do this and will report our findings when they are ready. It is not one isolated factor but rather a range of factors that make patients choose this option.
Primary Care for diabetes patients in transition: As it appears, more reforms are needed to make the current Primary Care system attractive for stabilised chronic patients with diabetes. It was never going to be easy. The electronic medical record is still being introduced. 7 important medicines such as Insulin and its syringes are not available for patients in rural areas where we supply. Recent data confirm that about 7 or 8 items are not available for patients (Simvastatin, Enalapril, Losartan, Thiamin, Insulin 10ml vials, Insulin syringes, Multivitamin…). 2-weeks incomplete treatment turns out more costly for patients than travelling far for 2 months supply.
National Hospitals in Phnom Penh provide the required medicines to these patients, for 2 week periods, but most of our rural members cannot travel up and down to Phnom Penh every 2 weeks. National Hospitals can do this because they get much higher reimbursement fees per case from the National Social Security system compared with rural hospitals. This is part of an answer as to why National Hospitals are attractive enough for some patients, even if they provide only 2-weeks medication, while many rural hospitals continue to struggle with their newly added responsibilities.
Reimbursement rates: There is no plan to raise reimbursement rates any time soon by the Ministry of Economy and Finance (for social security beneficiaries). The MoH would have to provide a costing study that can justify a raise and this study does not exist until now. The consequence is that Health Centers must provide diabetes care and hypertension care for 4,000 riels (1USD$) and rural hospitals (CPA1, CPA2) for amounts like 4 or 5 USD$ user-fee if they do not use the extra government budget that these public health facilities also receive to buy all the needed medicines on the free market that MoPoTsyo patients typically receive when they pay Out of Pocket for these medicines from MoPoTsyo’s RDF.
National University Singapore: Each year, students of Global Health come to visit projects in Cambodia including MoPoTsyo: on 8 July a group of about 30 got a lecture about diabetes and how our peer educator program fits in the Cambodian context. After the lecture, the students went into the Boeungkak area to see Ms Meach Lina at her home as peer educator helping other diabetes patients with self-management of their diabetes patients.
Royal Academy: On 10 July 2025, Dr Em Savoeun, who is still doing medical consultations for diabetes patients at Khmer-Soviet Hospital, and I gave short lectures to students and teachers at Royal Academy. I focused on Diabetes prevention and Dr Savoeun on treatment, followed by Q & A.
General Secretariat Social health protection: on 1 July 2025 was the dissemination of the results of the survey into the availability of NCD medicines. It showed lack of availability of the surveyed items, including lack of insulin.
Digital Policy: Our staff jointed the CCC event on topic “Building CSO readiness for the Cambodia Digital Government Policy 2022 to 2035 at Cambodiana Hotel on July 3rd
Gender and NCD: On 9 July 2025: Our staff joined seminar “ Gender and NCDs: Outcome Study on a Pilot Study”. This is the JICA’s pilot study on Gender mainstreaming in NCD continuum of care in Cambodia at Cambodiana Hotel. The researchers had visited MoPoTsyo as part of their study and were interested on the imbalance between the proportions of female patients (high) and female peer educators (low).
National Institute Public Health NIPH Conference C-HOPE: On 4 September 2025 NIPH had organised the first of so-called C-HOPE conferences to present and explain Cambodia’s public policy on NCD. It was opened by H.E. Chheang Ra. MoPoTsyo was participant as development partner. Main conclusions from Meeting 4 September 2025 about Public Policy for Managing NCD in Cambodia can be summarized as:
1) Digital Health is key opportunity and also risk. Need to protect the patients.
- EMR is first step
- AI great opportunity but need to protect Equity of society
2) Primary Health Care
- Cambodia’s policy follows the main international recommendations
- Need to strengthen Basic Services
- Need to focus on Diet/Nutrition and HEALTH LITERACY
- Referral needs to improve
3) So called “SINTAXES” (taxes on unhealthy behavior will be levied on sugar and alcohol and smoking) to discourage this and to raise revenue for better policies.
4) Research: not for major big ambitious research but practical small that serve local policy objectives and useful for improving health priorities