Synergies and dis-synergies between universal health coverage and global health security: A case study of Cambodia.

Background: After the coronavirus disease 2019 (COVID-19) pandemic, the global community's increased focus on pandemic preparedness has driven efforts such as the Pandemic Treaty proposed by the World Health Organization (WHO) and the Pandemic Fund managed by the World Bank. While these initiatives will enhance countries' capabilities in pandemic preparedness, synergies could be achieved by exploring the intersections between universal health coverage (UHC) and global health security (GHS). This is particularly relevant for developing countries like Cambodia. As it transitions to higher income status and reduces its reliance on external funding, the synergistic development of UHC and GHS will help Cambodia maximise health investment and align with its population health goals. We aimed to identify synergies and dis-synergies between UHC and GHS and recommend implementations that the government can consider moving forward. Methods: We conducted a rapid review of policy documents based on the World Health Organization (WHO) Health System Framework and undertook consultations with key stakeholders in Cambodia. Results: Our findings show the synergies between the two agendas in Cambodia resulted from having a central coordinating authority through the Ministry of Health (MoH), an extensive primary care network, and intersecting human resources that drive both UHC and GHS. We also identified potential dis-synergies such as vertical programmes and funding sources, inadequate regulation and engagement of the private sector, and underutilisation of information and data. Recommendations include cross-consultations between departments within the MoH when developing policies in GHC or UHC, and training programmes to increase awareness of the synergies between UHC and GHS. Conclusions: Our findings reinforce those of previous case studies in Bangladesh, Ethiopia, and Ghana, offering recommendations for building resilient health systems by integrating UHC and GHS.