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Cambodia: Vaccine Mandates Raise Rights Concerns

Covid-19 Vaccination Drive Should Focus on Access, Comprehensive Support

A dose of the Sinovac Covid-19 vaccine being shown at the Phnom Penh Thmey Health Center in Phnom Penh, Cambodia, August 1, 2021.    © 2021 AP Photo/Heng Sinith

(Bangkok) – Cambodian authorities have imposed Covid-19 vaccine mandates that threaten people’s basic human rights, Human Rights Watch said today. The government’s approach risks violating the rights to health, education, and social security, and other fundamental rights.

In October 2021, the governor of Phnom Penh issued orders for Covid-19 vaccination mandates covering specified public and private locations without disseminating public information or providing training on the new restrictions, increasing the likelihood that people would be denied access to food, medical care, or education. The original order failed to mention medical certificates allowing for exemptions to vaccines. And no training was required of people who will check certifications, risking arbitrary denial of access.

“The Cambodian government’s orders to require proof of Covid-19 vaccination without providing public information or training are a recipe for disaster,” said Phil Robertson, deputy Asia director at Human Rights Watch. “The government needs to make sure that Covid-19 vaccines are available to everyone and that restrictive measures don’t arbitrarily keep people from meeting their basic needs and getting essential services.”

On October 5, the Phnom Penh governor issued Order No. 027/21, making access to public and private spaces, including educational institutions, markets, restaurants, and other establishments, subject to proof of Covid-19 vaccination for everyone age 6 and over. On October 10, the National Social Security Fund (NSSF) announced that proof of a Covid-19 vaccination was required for people applying for social security cards. On October 17, the governor issued additional Instructions No. 028/21 to revise the original order, exempting children under 18 from having to show vaccination cards to enter schools.

When people refuse to cooperate, establishments are instructed to report incidents to the nearest local authority. Establishments that fail to comply with the notice risk losing their licenses and face legal action under the Law on Measures to Prevent the Spread of Covid-19 and Other Serious, Dangerous and Contagious Diseases.

The nationwide vaccine mandate adopted by the NSSF could leave many Cambodians without access to basic services, Human Rights Watch said. A spokesperson for the National Social Security Fund claimed the policy will not affect the “ability to access social services such as health care” because it allows people who cannot be vaccinated for health reasons to get certification from a health center that will allow them to obtain a social security card. Cambodian authorities should make sure this process is widely accessible to everyone who needs to seek this type of medical exemption, Human Rights Watch said.

The Cambodian government began making Covid-19 vaccines available to the wider adult population in February 2021. The vaccine distribution campaign started predominantly in Phnom Penh and extended to other provinces in June. AstraZeneca, Johnson & Johnson, Sinopharm, and Sinovac vaccines are currently available. As of October 20, 13 million people in Cambodia have been fully vaccinated. Data from the United Nations Development Programme suggests the country does not have sufficient supply to vaccinate all adults, which may hinder access in some parts of the country.

In September, Cambodia became one of few countries offering Covid-19 vaccines to children ages 6 to 12. To date, the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) has concluded that only the Pfizer/BioNTech vaccine is suitable for children ages 12 years and older, “with no vaccine currently approved by WHO for children under 12 years old.” The Pfizer/BioNTech vaccine is not currently available in Cambodia.

Prime Minister Hun Sen presented a plan to vaccinate children as part of the country’s efforts to reopen all schools, most of which had been closed for months. UNICEF Cambodia said that “schools do not drive the spread of COVID-19 in the community” and that “safeschool reopening is possible through risk mitigation measures,” such as wearing masks and maintaining social distance. Since mid-September, secondary schools and high schools have been gradually reopening and all schools fully reopening on November 1.

However, on September 27, the Ministry of Education, Youth and Sport issued guidance regulating the reopening of higher educational institutions that requires students over 18 to show a vaccination card.

The newly adopted vaccine mandates follow a series of troubling compulsory vaccination policies by the Cambodian government, Human Rights Watch said. In April, following a speech by Hun Sen ordering a 30-day Covid-19 vaccination drive, military personnel were deployed to implement a “compulsory” vaccination campaign in parts of Phnom Penh designated as “red zones.” The plan aimed to inoculate half a million people.

That month, Hun Sen threatened that any civil servant who refused vaccination would be fired. At the time, the only vaccines available to civil servants had not yet received emergency use listing from the WHO. His statement was quickly followed, on April 11, by the adoption of the Sub-Decree on “Compulsory Covid-19 Vaccination,” which established mandatory vaccinations for civil servants, armed forces personnel, and elected public officials, as well as public officials at legislative and judicial bodies. These mandates risk committing abuses if the authorities disregard fundamental human rights essential to the regulation of access to vaccines, choice, and consent, as well as oversight and transparency.

On May 4, the UN special rapporteurs on the human rights situation in Cambodia and on the right to health issued a letter to the Cambodian government expressing concerns around the Sub-Decree with respect to infringements on the right to health and the ability to benefit from scientific progress under articles 12 and 15 of International Covenant on Economic, Social and Cultural Rights and the right to freedom of expression under article 19 of International Covenant on Civil and Political Rights. The rights experts urged the government to guarantee everyone’s right to choose or refuse vaccinations, subject to limitations provided by law that are compatible with these rights, and are solely for the purpose of promoting the general welfare.

Vaccine mandates can be an important tool in dampening the pandemic so long as they are rooted in a broader strategy to make vaccines and other preventive measures genuinely accessible, Human Rights Watch said. The Cambodian government should ensure that its vaccine mandate does not infringe on other human rights or create undue burdens for any section of the population. The right to health includes an obligation to prevent and control epidemic disease, for which widespread vaccination is an important tool. The right to health applies to everyone, whether vaccinated or not. Vaccine mandates should be designed with deep attention to context, including the social, political, and economic barriers people might face.

“Hun Sen should ensure that the country’s Covid-19 response protects the rights of everyone in Cambodia instead of imposing mandates that risk cutting people off from essential services,” Robertson said. “The World Health Organization needs to work with the government toward a more rights-based response to the pandemic.”


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