With a goal of ending HIV and TB by 2030, the Government of Vietnam has increased its domestic funding and management responsibility for the HIV and TB responses, including integrating HIV and TB treatment into the services covered by social health insurance. Mobilizing additional domestic resources to meet current and future health demands is an urgent priority - particularly as the country graduates to a middle-income status and international funding declines.
Approach
LHSS is partnering with the Government of Vietnam to strengthen its capacity to both finance and manage health programs, including comprehensive HIV and TB services. Our health financing, public financial management, health governance, and procurement and supply chain management experts are supporting the government's effort to:
- Strengthen public financial management to find greater efficiencies and support the mobilization of domestic resources for the health sector
- Increase domestic financing for the national HIV and TB responses to give more people access to services
- Improve how financial resources are allocated and used for HIV and TB services, with a focus on prevention
- Ensure a continuous supply of best value, quality commodities to improve health outcomes
- Strengthen financial sustainability of the national TB program by integrating TB services into Vietnam's social health insurance scheme
- Work with health policymakers to update the legal framework to enhance local ownership of the national HIV and TB responses through social health insurance and other domestic financial resources
Progress Highlights
- LHSS grantee, CMC Applied Technology Institute initiated work to develop an artificial intelligence module that will automate the currently manual social health insurance claim review process, helping to reduce errors and enhance efficiency.
- The government of Vietnam has developed and enacted 17 key policies and legal documents to facilitate and strengthen domestic financing, procurement and supply chain management, and overall management of the national HIV and TB programs.
- Provincial Centers for Disease Control and HIV treatment facilities are now taking a lead role in managing their programs. This is evidenced by all 63 provincial-level centers and HIV treatment facilities now using national procurement and medicines logistics platforms for managing the supply of antiretrovirals.
- In August 2023, 91% of people living with HIV on anti-retroviral therapy (more than 160,000 people) received medications through the social health insurance scheme. This is a dramatic shift away from what has historically been a donor-funded program in Vietnam.
- As of September 2023, 52 out of 63 provinces approved financial sustainability plans for their respective HIV programs, with 83 percent of all provincial HIV financing requirements resourced through these plans and budgets.
- Vietnam is piloting a social contracting mechanism for community-based delivery of HIV services through community-based organizations and social enterprises in eight provinces. Pilot results will provide evidence to support policy change efforts to allow community-based delivery of HIV services using the state budget in the long term.
- In July 2022, the first TB patients received medications through social health insurance. Since then, over 133,000 patients have received TB medicines from more than 4,000 health facilities across the country.
- LHSS supported the National TB Program and Vietnam Social Security to update the electronic logistics management information system to include management of TB drugs for use by provincial TB programs, TB treatment facilities, and TB drug suppliers. With supportive capacity strengthening and training, the national program will effectively take responsibility for oversight of TB commodity quantification, procurement, supply, utilization, reallocation, and cost reimbursement.
