Arya News - The communiqué positions parliamentarians as key to implementation, urging them to leverage legislative, budgetary, oversight, and representative powers to ensure access to quality healthcare without financial hardship—especially for the vulnerable and remote communities.
PHNOM PENH – Parliamentarians from 16 Asia-Pacific countries have called for stronger laws, protected health budgets and greater government accountability to accelerate universal health coverage, while warning that artificial intelligence and climate change could deepen existing health inequalities if governments fail to act.
The commitments were contained in the Phnom Penh Communiqué adopted at the conclusion of the Ninth Asia-Pacific Parliamentarian Forum on Global Health (APPF-GH), held in Phnom Penh from August 11-13.
The communiqué places parliamentarians at the centre of implementation, calling on them to use their legislative, budgetary, oversight and representative powers to ensure people can obtain quality healthcare without suffering financial hardship, particularly those in poor, vulnerable, rural and remote communities.
The three-day forum, themed “Universal Health Coverage in an Era of AI and Climate Change”, was hosted by the National Assembly of Cambodia. It brought together parliamentarians, health leaders and development partners from across the region to discuss universal health coverage (UHC), climate-resilient health systems and the opportunities and risks posed by AI.
Opening the forum, Lork Kheng, chairperson of the National Assembly’s Commission 8 and chairwoman of the 9th APPF-GH Organising Committee, framed UHC as a question of political responsibility rather than simply a technical health-sector challenge.
“Every law we pass, every budget we approve and every question we raise through parliamentary oversight can either move our countries closer to health for all, or allow inequality to continue,” she said, according to a National Assembly statement.
Kheng noted that Cambodia had made progress in reducing maternal and child mortality, expanding immunisation and strengthening responses to infectious diseases, including through the country’s Covid-19 vaccination campaign.
Cambodia is now implementing its Roadmap towards Universal Health Coverage 2024-2035, which aims to expand social health protection to 80 per cent of the population, achieve at least 80 per cent coverage of essential health services and reduce out-of-pocket health expenditure to 35 per cent.
Minister of Health Chheang Ra told the forum that universal health coverage extended well beyond questions of health financing, hospitals, doctors, medicines or insurance.
“It is a social contract,” he said, according to the National Assembly.
Ra said access to healthcare should not be determined by where people live, their age, income or ability to pay.
Cambodia, he said, is pursuing a pragmatic approach to UHC led by primary healthcare, while continuing to confront shortages of health workers, infrastructure gaps, geographical disparities and concerns over quality and safety in the private health sector.
He also stressed that achieving UHC could not be left to the health sector alone and required political, legislative, financial and cross-sector support.
‘Health is a political choice’
WHO regional director for the Western Pacific Saia Ma’u Piukala reinforced the political dimension of healthcare, telling delegates that “health is a political choice”.
According to the National Assembly, Piukala said decisions that determine whether people receive vaccines and safe maternal care or are protected from catastrophic medical bills are ultimately shaped by legislation, national budgets, parliamentary oversight and political leadership.
He argued that spending on healthcare should not simply be regarded as a cost to governments, but as an investment in wider national development.
“Healthy children learn better. Healthy adults contribute more productively. Healthy families are less likely to fall into poverty. Healthy societies are more resilient,” he said.
Piukala thanked National Assembly president Khuon Sudary and the Cambodian parliament for hosting the meeting and warmly welcoming the international delegations.
During the forum, he praised the exchanges among delegates as being centred on improving people’s health and said their field visit to Kampot province would provide another opportunity to understand Cambodia and its healthcare services, according to a separate National Assembly account.
Delegates travelled to Kampot to observe community-based primary healthcare, including a visit to Ang Phnom Touch Health Centre. Their programme also included Sonja Kill Memorial Hospital, a non-profit hospital and training centre.
Piukala highlighted Cambodia’s use of AI-assisted chest X-ray technology for community tuberculosis screening as an example of how technological innovation can be applied to improve public health.
But he stressed that AI should support health professionals rather than replace health workers and human care.
The issue has become increasingly important as AI is integrated into diagnosis, disease surveillance, health planning and healthcare delivery.
Man Hee Lee, president of the APPF-GH and chairman of the Health and Welfare Committee of South Korea’s National Assembly, said AI offered significant opportunities to improve diagnosis, disease surveillance, health planning and access to services, particularly for rural, remote and underserved communities.
However, he warned that technology could have the opposite effect without appropriate safeguards.
According to the National Assembly, Lee cautioned that weak governance, inadequate privacy and data protections, insufficient financing and a failure to consider equity could allow emerging technologies to widen existing inequalities.
He stressed that parliamentarians have a responsibility to ensure technological innovation is guided by equity, evidence and ethics.
Ra echoed the concern, arguing that technological advancement must remain subordinate to the needs and rights of patients.
“Innovation cannot replace compassion, technology cannot replace responsibility, and efficiency cannot replace equity,” the health minister said.
The Phnom Penh Communiqué subsequently called for legal, regulatory and governance frameworks for digital health and AI, including rules governing health data, privacy, ethics, human oversight and public trust.
It also calls for health workers to be equipped with AI and digital-health skills, data literacy and ethical judgement as new technologies become increasingly integrated into healthcare.
Climate pressures threaten health gains
Climate change formed the third major component of the meeting, with speakers warning that extreme heat, floods, storms, droughts, food insecurity, air pollution and changing disease patterns are increasingly affecting people’s health.
Such pressures can also damage health facilities, interrupt supply chains and increase the burden on health workers, potentially undermining progress countries have made towards universal health coverage.
Against those risks, delegates emphasised stronger investment in primary healthcare and climate-resilient health systems capable of continuing essential services during emergencies and climate-related disruptions.
The communiqué identifies climate change as one of the greatest threats to human health and calls on parliamentarians to respond through legislation, budget decisions, oversight and leadership in their constituencies.
The interconnected nature of the three issues — healthcare access, climate change and AI — was a recurring theme throughout the meeting.
For parliamentarians, however, the discussion repeatedly returned to what they could do once the meeting ended.
Kheng said the success of the forum should not ultimately be judged by declarations made in Phnom Penh.
Progress, she said, would depend on what parliamentarians did after returning to their respective countries — “the laws we strengthen, the budgets we protect, the implementation we monitor, and the voices we bring into decision-making”.
Senate first vice-president Ouch Borith similarly urged delegates to focus on tangible results, saying progress should ultimately be measured by whether ordinary people, including those in remote communities, could obtain the healthcare they needed without falling into debt.
Sudary: ‘No one is left behind’
National Assembly president Khuon Sudary reinforced that people-centred approach in her toast remarks at a gala dinner welcoming delegates on the evening of August 11.
Sudary said the opening day’s discussions had been “rich in substance and firm in political commitment”, reflecting a shared determination to produce tangible improvements in the health and well-being of people throughout the Asia-Pacific.
She explained that the ultimate goal was to ensure everyone could obtain quality healthcare without financial hardship, particularly the most vulnerable, while ensuring that “no one is left behind”.
Beyond policy discussions, she said the forum provided parliamentarians with an opportunity to build personal relationships and longer-term regional partnerships.
“Tonight, we celebrate the efforts and achievements we have made together in this shared humanitarian mission, and we build something equally important — personal friendship and long-term partnership,” she said.
Sudary concluded her remarks with a toast to the success of the forum and “to the day when quality healthcare reaches every person in our region and on this planet Earth”.
Two days later, following the adoption of the Phnom Penh Communiqué, Sudary said the regional agreement now needed to produce action.
“The Communiqué is a call to action. It sets out ambitious, concrete measures that deliver meaningful impact on the ground,” she declared.
“We are all accountable for advancing universal health coverage and translating our commitments into tangible results,” she added.
The communiqué pays particular attention to people who risk being excluded from healthcare, including those living in poverty, women and children, persons with disabilities, older people, migrants and communities in rural, remote and island areas. It also identifies refugees fleeing war and conflict among populations requiring particular attention.
It calls for sufficient national budget allocations and integrated investment in rural, remote, refugee-camp and island health systems, while ensuring continued access to in-person healthcare.
The agreement also urges stronger national and regional health data systems, international cooperation and technical assistance to help countries strengthen UHC, responsible digital-health governance and climate-resilient health systems.
With the forum concluded, the measure of the Phnom Penh Communiqué will therefore move beyond the commitments made by delegates in Cambodia.
As Kheng told fellow parliamentarians at the opening of the meeting, their decisions over laws, budgets and government oversight can either bring their countries closer to healthcare for all — or allow existing inequalities to continue.