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Fighting tuberculosis in Cambodia: Global partnerships in action
29 May 2025
Strengthening health systems to improve TB outcomes in Cambodia
The SHIFT-TB and SAPPHIRE projects in Cambodia aim to fight tuberculosis (TB) through population-wide community-based screening and integrated care, scaling proven TB screening models in Vietnam.
A new €2.9 million (A$5 million) program is underway in Cambodia to tackle tuberculosis (TB), one of the world’s deadliest infectious diseases.
Led by KHANA, a Cambodian health NGO, in collaboration with local and international partners including the University of Sydney and the National University of Singapore, SHIFT-TB (Strengthening Health Systems through Integrated Risk Factor Intervention and Tuberculosis (TB) Case-Finding) is funded by L’Initiative/Expertise France, a French government agency that facilitates international projects and collaborations.
Dr Alvin Teo and Dr Emily MacLean played a central role in securing the funding and designing the program, which builds on the SAPPHIRE (Sydney Asia-Pacific Partnership for Health Innovations and Resilient Ecosystems) project in Vietnam and Cambodia funded by Australia’s Department of Foreign Affairs and Trade Partnerships for a Healthy Region initiative and led by Professor Greg Fox.
“TB is still a major problem in Southeast Asia,” said Dr Teo, one of SHIFT-TB’s lead investigators. “We have the tools and drugs to treat it, but what we lack is political support and funding. SHIFT-TB is about translating proven models into real-world impact.”
HE Dr Youk Sambath, Secretary of State, Ministry of Health, Cambodia (centre), with HE Mr Jacques Pellet, French Ambassador to Cambodia (left) and HE Mr Derek Yip, Australian Ambassador to Cambodia (right), at the official launch of SHIFT-TB and SAPPHIRE projects
The projects were launched in Phnom Penh in April by HE Dr Youk Sambath, Secretary of State of the Ministry of Health, Cambodia, at a ceremony attended by Cambodian, Australian and French partners, the Australian and French Ambassadors to Cambodia, and representatives from the University of Sydney, National University of Singapore, UN agencies and government institutions.
The Cambodian government’s strong presence at the launch, including a speech by the Secretary of State and participation from TB survivors, underscored the country’s commitment to joining the global effort to end TB by 2030.
“This vital work led by Alvin, Emily and the team at KHANA Cambodia is making a major contribution towards tuberculosis elimination in Cambodia, and will be of huge interest across Southeast Asia,” said Professor Fox, who represented the University of Sydney at the launch. “This partnership could not be more important during a tumultuous period for vital health funding in Southeast Asia.”
The launch of SHIFT-TB comes at a critical time when global funding for TB programs have seen significant cuts. The four-year project helps fill the gap left by the withdrawal of major donors like USAID and keep the momentum going.
“SHIFT-TB will scale up SAPPHIRE Cambodia by expanding population-wide TB case finding to more sites in the country,” Dr Teo said. “We will use it as a platform to strengthen the health system by integrating interventions for other TB risk factors such as diabetes, HIV, smoking, alcohol use and undernutrition.”
The project includes partnerships at all levels, including civil society organisations, NGOs, national disease programs, the Ministry of Health and a network of TB survivors whose lived experience is seen as essential to shaping effective interventions. It also includes a research component focused on children and adolescents, two groups historically neglected in TB research due to the difficulty of addressing the problem.
“We carved out a section of the project specifically for children and adolescents,” said Dr Teo. “It’s a shared interest with our French partners, and we’re collaborating with the Pasteur Institute Cambodia and other French organisations on this front.”
One of the defining features of the project is its community-based approach. “KHANA is deeply embedded in communities,” said Dr MacLean. “Their experience as a trusted organisation working directly with communities is crucial for the success of large-scale projects like population-wide TB screening.”
Participants from Cambodia and Vietnam at the TB case-finding workshop held in Phnom Penh ahead of the SHIFT-TB and SAPPHIRE Cambodia launch
SHIFT-TB draws on over a decade of research and implementation in Vietnam, where similar models have proven effective. A pre-launch workshop in Phnom Penh brought together Vietnamese and Cambodian teams to share knowledge and co-develop action plans for population-wide TB screening.
The workshop, co-hosted by Woolcock Vietnam and the Sydney Vietnam Institute, emphasised inclusive approaches to active case-finding, focusing on reaching the most vulnerable populations. Participants shared insights on community engagement, data collection, diagnosis and treatment referrals through participatory methods such as presentations, voting, group discussions and consensus building.
This cross-country collaboration laid the groundwork for evidence-based implementation in Cambodia. The implementation plans will be piloted under the SAPPHIRE project, screening around 3,000 people, before being scaled up under SHIFT-TB to reach up to 90,000 people annually.
University of Sydney SHIFT-TB and SAPHHIRE Cambodia researchers with partners from Woolcock Vietnam/Sydney Vietnam Institute. From left: Mr Luong Tien Phong, Dr Alvin Teo, Professor Greg Fox, Dr Emily MacLean, Ms Leanne Howie, Ms Khanh Boi Luu and Ms Thu Hien Le at the launch of the SAPPHIRE and SHIFT-TB projects in Cambodia
A model for future partnerships?
While the University of Sydney is not the primary recipient of SHIFT-TB funding, its role as a technical partner together with the National University of Singapore in the project’s design, monitoring and evaluation is central to the program.
The project includes comprehensive capacity-building for healthcare professionals, community health workers and key populations, as well as integrated services addressing TB risk factors and other respiratory diseases. It exemplifies a model of equitable collaboration, where local organisations lead and international partners support.
“It’s not a typical grant structure for research,” Dr Teo noted. “But it’s a powerful model for capacity-building and sustainable impact. This project is about translating evidence into action and doing it in a way that empowers local communities.”
The team hopes SHIFT-TB will serve as a blueprint for similar initiatives across the region, especially as global health funding becomes more uncertain.
The SHIFT-TB and SAPPHIRE Cambodia projects represent a collaborative effort to address TB and its associated risk factors. By leveraging the experience and knowledge gained from similar initiatives in Vietnam, the projects aim to translate proven interventions into practice, ultimately contributing to the fight against TB in Southeast Asia and globally.