MoPoTsyo is a medium-size Cambodian not-for-profit NGO working in the health sector since 2005 with a focus on chronic diseases, in particular Diabetes. Over the years, the NGO has become mostly self-financing through small contributions by thousands of its members. They are patients living with chronic disease in poor or rural areas who have registered with MoPoTsyo through a Diabetic Peer Educator who lives in their community. This Peer Educator was trained by MoPoTsyo in diabetes self-management and in how to help facilitate medical services in cooperation with the public hospitals and health centers with support from our NGO. MoPoTsyo is active not just inside the communities but also inside public health facilities in close cooperation with government staff using “an innovative model of revolving financing” of imported bulk low-cost generic medicines, and materials for services for laboratory, consultations and follow-up facilitated by hundreds of trained community-based patient-volunteers that benefit another more than 23,000 members with diabetes and high blood pressure. Thanks to its unique approach, the NGO grows steadily while implementing Cambodia’s (Ministry of Health) National Strategic Plan for Prevention and Control of Diabetes and Hypertension. MoPoTsyo implements these activities through a Memorandum of Agreement with Ministry of Health each time in periods of 3 years (2021 – 2023).
The results (“health outcomes”) in terms of diabetes patient benefits are excellent if compared to other models. MoPoTsyo’s approach was selected by The Lancet, World Bank, WHO for publication in its collection of best practices the DCP3 (Volume 5 chapter 17) while scientific articles have analysed and described its strengths and weaknesses.
Like in many other developing countries, Cambodia’s health care system for chronic disease suffers from “market failure” leaving enormous health service needs unmet: lacking adequate provision at prices that are affordable. But in addition, when Cambodia’s public health care system was created almost 30 years ago, the experts did not design chronic care into the basic health care system. This diabolic combination of 2 failures has become a recipe for disaster with COVID19 because we know from other countries that people with diabetes who do not control their blood sugar are 9 times more likely to die from COVID19 than non-diabetic patients.
MoPoTsyo’s demonstrates through its approach that an important part of those unmet needs can be met. For example, low-cost generic medicines from established global suppliers with decades of experience and extensive quality control systems, familiar to agencies from UN, Red Cross and large humanitarian NGO’s but unknown to the wider public, can be imported for Cambodia’s public health care system. Then, they could be paid for at cost level and that revenue can be used to replenish the stocks.
It is not MoPoTsyo’s wish to remain the only supplier of low-cost revolving funding medicines, let alone to become national monopolist. Perhaps, members of the business community with professional expertise and logistics could find inspiration in the surprisingly successful mechanisms that we are using to maintain our private – public collaborations for 15 years?
We hope that the decentralization will generate many similar positive experiences and we will glad to share our ideas.
9E, Street 3C, Phum Trea 1, Stung Meanchey, Meanchey, Phnom Penh, Cambodia
Tel: +855 (0)12 800 322
Website: www.mopotsyo.org
