Cambodia at risk of being last in line for vaccines

By DAVID HUTT

Lack of coherent inoculation plan means a majority of Cambodians may not be vaccinated until mid-2023

Whether or not Cambodian Prime Minister Hun Sen meant to snub China when he said his nation would only accept internationally-recognized Covid-19 vaccines seems like an increasingly moot point without a coherent inoculation rollout plan.

With an exceptionally weak healthcare system, feeble bureaucracy and faltering finances, Cambodian hopes for entering a post-pandemic era in 2021 are fast diminishing as richer states buy up limited vaccines for their own citizens.

“No one knows anything at all” about when the vaccine rollout will begin, a source with knowledge of the Cambodian government’s planning who spoke to Asia Times on condition of anonymity said.

“Cambodia is really still in ‘will we get it’ mode rather than ‘vaccine preparation’ mode,” the source said, adding that sentiment in Phnom Penh is that it’s a “long way off” before vaccines start to arrive in the country.

The government has been mainly mum on the matter since stating in December that it would only accept vaccines approved by the World Health Organization (WHO), which currently includes only those produced by Pfizer-BioNTech, a German-US partnership.

The most pessimistic of projections among sources tracking the government’s response is that inoculation of the majority of Cambodia’s 16.7 million population won’t take place until late 2022, if not mid-2023.

The Economist Intelligence Unit recently forecast that vaccines won’t be widely available in Cambodia until at least April 2022, a prediction that noted the emerging stark contrast in vaccine access between rich and poor nations.

Because Cambodia is “largely dependent” on the WHO-backed global health initiative COVAX to access vaccines, which currently only guarantees inoculations for a fifth of a country’s population, “it may take time for COVAX to increase this, and Cambodia only has limited fiscal resources to purchase vaccines independently,” Imogen Page-Jarrett, an EIU research analyst, said.

“We therefore do not expect Cambodia to immunize 60% of its population until sometime between June 2022 and June 2023,” she added.

Phnom Penh’s attention is for now diverted by the more pressing issue of preventing further viral outbreaks, a major concern since the more-virulent variant of Covid-19, first detected in the UK, was found last week in neighboring Vietnam and Thailand.

New restrictions on border crossings have been imposed by Cambodia on both countries.

Cambodia has officially not recorded any Covid-19 fatalities, although fears were raised after community outbreaks emerged in November. At the time of writing, credibly or not, there have only been 383 documented coronavirus cases nationwide.

There are now also concerns about whether returning migrant workers from Thailand, several of whom have tested positive for Covid-19 in recent days, will spark another viral wave and community spread when they return to their home villages, sources say.

Earlier images of mass vaccinations in Europe in December appeared to signal the beginning of the pandemic’s end, with many Cambodians sensing that it might be over within a matter of months. Although there have been few social distancing restrictions imposed in Cambodia, its economy is reeling from the pandemic.

Unemployment rates reached near record-highs in 2020 whilst the true number of Cambodians pushed back into poverty will only be clear in the coming months. The Asian Development Bank in August reported that 8% of the population could be thrust back into poverty because of the pandemic.

Cambodia’s economy most likely contracted by around 2% in 2020, the World Bank contends, although the full-scale of the crisis may only be apparent when additional economic data is published later this year.

In early January, the National Bank of Cambodia, the central bank, forecast economic growth of around 4% in 2021, according to its recently-released Macroeconomic and Banking Sector Update 2020 report. This is consistent with the World Bank’s forecasts.

But this growth level, modest compared to the average 7% mark the country enjoyed throughout the 2010s, “depends solely on the efficacy of the vaccines” delivered in Cambodia as well as how quickly mass inoculation happens abroad, the central bank noted.

Cambodian exports actually grew by 14% last year, according to Prime Minister Hun Sen, thanks in part to a major push by the government to kickstart the agricultural sector.

But the health of Cambodia’s domestic economy – including its ultra-important tourism sector, in which visitor numbers plunged by 76% in the first ten months of 2020 – will depend on how quickly Cambodians are vaccinated.

Although not articulated by officials, if Cambodia’s neighbors in Southeast Asia are able to more quickly inoculate their populations, it could redirect investment away from Cambodia in 2021 and 2022 and compound already brewing structural economic problems.

In mid-December, Hun Sen said the government has set aside $200 million for vaccine purchases, though analysts reckon that figure will need to be increased to vaccinate a majority of the population.

Fresh News, a government mouthpiece, reported later in the month that at least $54 million has been raised from private donations, including from wealthy tycoons who regularly donate to the long-ruling Cambodian People’s Party (CPP), a practice that dates back decades.

Last month, Australia promised to do more to support Cambodia’s vaccine rollout on top of the US$380 million grant it pledged to Southeast Asia and the Pacific region for vaccine financing in October. The US and the European Union have also pledged financial aid to Cambodia for its vaccination program.

In mid-December, a minor controversy was sparked after Hun Sen announced his country would only accept WHO-approved vaccines, which some in the international media saw as a snub to China, Cambodia’s closest political and economic partner.

Many pundits had expected Beijing to rush to engage in so-called “vaccine diplomacy” with Phnom Penh and for Hun Sen to publicly laud the efficiency of China-produced vaccines. The fact that neither has happened has sparked rumors of a breakdown in trust.

Health Ministry spokeswoman Or Vandine quickly rebuked outlets for misquoting the prime minister, who she asserted last month had never expressly rejected China-made vaccines.

Indeed, Hun Sen later stated that he would use Chinese-produced vaccines if they were approved by the WHO.

To be sure, Hun Sen would have faced criticism if he was seen as toadying up to Beijing by volunteering Cambodia’s population for vaccines not yet approved by the WHO.

However, it still doesn’t explain why Beijing hasn’t rushed to pre-offer a significant number of vaccines, in the event of WHO approval to its claimed “ironclad friend.”

Other Southeast Asian states haven’t waited for WHO recommendations. In Laos, another China ally, vaccination began in late December after it received more than 2,000 doses of the China-produced Sinopharm vaccine, which Beijing had pledged in mid-December.

On January 3, the WHO reported that Thailand had ordered two million doses from Chinese firm Sinovac Biotech, with the first batch of 200,000 to arrive by the end of February and the remainder by early May.

The following day, Indonesia began nationwide distribution of the vaccines it has so far procured from Sinovac Biotech, with mass incolulation expected to begin at the end of this month.

Phnom Penh’s insistence on following the WHO means it will be late to the game, raising questions about what authorities will do between now and then.

The government has reportedly drafted a National Deployment and Vaccination Plan and Operational Guidelines, but this has not yet been made public and sources say they haven’t seen the text.

“WHO is pleased that Cambodia has already developed its draft National Deployment and Vaccination Plan and Operational Guidelines. It’s encouraging to see preparation ongoing in Cambodia,” said a WHO spokesperson without elaborating.

Hun Sen reportedly said this week that the government has set aside $20.2 million for subsidies to the garment and tourism sectors for the first three months of 2021, which may need to be greatly expanded in value and time if mass vaccination is unlikely before next year or 2023.

The World Bank stressed in a recent report that if Cambodia’s economic growth is to hit around 4% this year it will require “pro-poor and growth-enhancing public investment including cash-for-work projects,” namely state funds for those unemployed or laid-off from their jobs.

Analysts reckon Phnom Penh has sufficient funds to pay for large relief handouts, but it will come down to whether Cambodia’s leaders have the political will to do so.

“With a relatively low ratio of debt to GDP – we estimate total debt was equivalent to 55.1% of GDP in 2020 – Cambodia has room to take on additional borrowing. Meanwhile, the government does also have some remaining savings due to strong revenue collection in the years before the pandemic,” says Page-Jarrett of the EIU.

It may have to be the case that, like in 2020, major cuts are made to the budget to pay for the relief efforts. The 2021 state budget was set at $7.6 billion, slightly down from the initial package for 2020.

“However, the cash handout program only covers around 4% of the population and is likely only enough to sustain the livelihoods of low-income families,” Page-Jarrett noted.

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