This is an overview of the USAID/Cambodia FY 2021 Tuberculosis (TB) Roadmap, implemented with FY 2020 budget. It was developed in consultation with the National TB Program (NTP) and with the participation of national and international partners involved in TB prevention and care in the country.
Despite improvements in TB control efforts, among the top 30 high TB burden countries, Cambodia ranked twenty-second.1 From 2000 to 2018, the estimated TB incidence in Cambodia declined from 575 to 302 per hundred thousand.2 Cambodia conducted two National TB Prevalence Surveys in 2002 and 2011, which revealed that the prevalence of bacteriologically confirmed TB decreased by 45 percent between the two surveys.3 Additionally, while there have been successes in the treatment of drug-susceptible TB (DS-TB) and multidrug-resistant TB (MDR-TB) in Cambodia, case detection of all types of TB remains a challenge, with more than 40 percent of estimated cases remaining undetected.4 In 2019, the NTP reported that 30,017 TB patients were notified,5 an increase of 1,397 cases as compared to 2018;6 however, the country’s estimated TB burden is approximately 52,000,7 illustrating that there is still a large gap in case notifications.
TABLES
The following tables illustrate the distribution by technical area of the Global Fund* and USAID TB budget for Cambodia that will be used for the implementation of Cambodia’s FY21 TB Roadmap (Table 1) and the core indicators that will be used to monitor implementation of Cambodia’s TB Roadmap and the country's progress towards the United Nations General Assembly High-Level Meeting on TB targets (UNGA targets) (Table 2).
Table 1: USAID Budget for Cambodia per Technical Area*
| Technical Area | USAID TB budget for FY21 | USAID Percentage of TB budget for FY21 |
| REACH | $2,820,000 | 43% |
| CURE | $935,000 | 14% |
| PREVENT | $1,285,000 | 20% |
| SELF-RELIANCE | $1,465,000 | 23% |
| TOTAL BUDGET: | $6,505,000 | 100% |
*USAID is working with the Global Fund to provide similar budget data for next year. It is anticipated this information will be added once the discussions have been finalized.
Table 2: TB Core Indicators in Cambodia from 2015-2019 and Targets from 2020-2022
| # | Name | 2015 | 2016 | 2017 | 2018 | 2019 | 2020* | 2021* | 2022* |
| REACH: Increased DS- and DR-TB case notification | |||||||||
| 1 | TB Detection | 61.7% | 60.8% | 65.8% | 58.4% | 64% | UNGA target: 33,900 | UNGA target: 33,900 | UNGA target: 31,300 |
| 2 | Bacteriological Diagnosis Coverage (Pulmonary TB) | 48.4% | 50.2% | 53.5% | 53.0% | 54% | — | — | — |
| 3 | Childhood TB Notifications | 6,885 | 5,195 | 6,757 | 5,341 | 1,849 | UNGA target: 6,300 | UNGA target: 6,300 | UNGA target: 5,800 |
| 4 | Drug-Resistant TB Notifications | 77 | 102 | 137 | 128 | 135 | UNGA target: 553 | UNGA target: 821 | UNGA target: 882 |
| 5 | Private Sector TB Notifications | — | — | — | — | 0 | — | — | — |
| 6 | Contact Investigation Coverage*** | — | — | — | — | 13,521 | — | — | — |
| CURE: High treatment success rate in DS- and DR-TB | |||||||||
| 7 | TB Treatment Success Rate | 93.9% | 93.6% | 94.5% | 94% | — | — | — | — |
| 8 | Drug-Resistant TB treatment Success Rate | 70.7% | 64.4% | 71% | — | — | — | — | — |
| PREVENT: Prevent TB transmission and development | |||||||||
| 9 | TPT Coverage | 868 | 631 | 3,164 | 4,869 | 2,088 | UNGA target: 14,630 | UNGA target: 21,300 | UNGA target: 24,390 |
| SELF-RELIANCE: Commitment and sustainability | |||||||||
| 10 | Proportion of Domestic Financing for TB | — | — | — | 34.3% | 37% | — | — | — |
*Projected UNGA targets.
**Based on limited available data.