Delegates at the ceremony expressed the will to end tuberculosis. VNA/VNS Photo

HÀ NỘI - Việt Nam's tuberculosis burden remains high, according to the Global Tuberculosis Report 2023 by the World Health Organization.

The country has risen from 16th to 11th place among nations with the most tuberculosis patients globally and also ranks 11th for multi-drug-resistant tuberculosis among 30 countries.

Particularly in the Southern region, the tuberculosis situation is severe and more complex than in the Northern and Central regions. Provinces such as An Giang and Cần Thơ in the Southwestern region reported a high number of tuberculosis cases in 2023, with incidence rates of 270 and 218 cases per 100,000 people, respectively.

In some areas, the high-risk group exhibits extremely high tuberculosis rates, reaching 400 to 500 cases per 100,000 people.

At the World Tuberculosis Day (March 24) commemoration on Friday  in Hà Nội, Đinh Văn Lượng, Director of the Central Lung Hospital and Head of the National Tuberculosis Control Programme, highlighted Việt Nam's ongoing struggle with tuberculosis.

Lượng noted that Việt Nam ranked 11th globally for both overall tuberculosis burden and multi-drug-resistant tuberculosis burden, indicating a persistent and concerning situation. He emphasised the complexity of tuberculosis trends in Việt Nam, citing a slow decline rate and inadequate investment in tuberculosis control efforts, which raises the risk of a community outbreak.

Lượng also expressed concerns that the number of tuberculosis patients detected annually in Việt Nam only accounts for about 60 per cent of the estimated total meaning more than 40 per cent of tuberculosis patients in the community remain undetected and untreated.

During the COVID-19 pandemic, tuberculosis control efforts in Việt Nam were severely affected. The number of patients detected in 2021 decreased by 22 per cent compared to 2020 and 24.5 per cent compared to 2019, making Việt Nam one of the countries with the highest reduction in tuberculosis detection globally due to the pandemic's impact.

Additionally, changes in the policy mechanism for procuring tuberculosis drugs from state budget sources pose challenges for the drug supply system of the National Tuberculosis Control Programme, according to Lượng.

The existence of locally sourced medicines with short-term shelf life risks expiration without approved policy mechanisms while funding for purchasing drugs for tuberculosis patients without health insurance cards remains uncertain. Tuberculosis patients at facilities lacking conditions for health insurance payment face difficulties. Financial autonomy at the grassroots level also impacts control activities to some extent.

Many provinces and cities face challenges due to insufficient manpower and funding. Coordination between public and private healthcare sectors is not sufficiently tight, affecting the referral of suspected tuberculosis cases from healthcare facilities outside the National Tuberculosis Control Programme.

A collective effort from society is needed

Following the aftermath of the COVID-19 pandemic, the National Tuberculosis Control Programme has implemented comprehensive interventions to boost tuberculosis control. These efforts aimed to increase patient detection, improve diagnosis, and facilitate treatment admission to halt community transmission, effectively restoring tuberculosis detection activities post-COVID-19 impact.

The programme focused on enhancing and broadening active case-finding in communities, detecting positive cases at healthcare facilities, and employing advanced diagnostic strategies such as X-ray and Xpert testing methods. Integration with grassroots healthcare systems significantly improved diagnosis, treatment quality, and sustainable tuberculosis prevention.

To address financial constraints, the programme successfully transitioned tuberculosis drug payments from state budgets to the Health Insurance Fund. Additionally, it leveraged Ministry of Health support to facilitate payment for other tuberculosis-related services via the Health Insurance Fund, ensuring easy access to treatment options and transmission prevention for tuberculosis patients.

The Central Lung Hospital, under Ministry of Health guidance, developed "Guidelines for Active Case-Finding Activities, Tuberculosis Detection, and Respiratory Disease Management," aiming to standardise and synchronise nationwide active case-finding and tuberculosis detection activities. This initiative maximises the role of healthcare systems, particularly grassroots healthcare, in tuberculosis prevention and control.

Across the nation, 51 out of 63 provinces and cities have established specialised hospitals such as Lung, Tuberculosis and Lung Disease hospitals. This expansion reinforces tuberculosis control efforts and enhances case detection capabilities.

Dr Lượng outlined that the Ministry of Health - National Tuberculosis Control Programme would persist in executing suitable strategies and policies to bolster the role and capability of grassroots healthcare systems, encompassing personnel involved in tuberculosis control endeavours. This would entail proactive case-finding activities and the active detection of tuberculosis within communities and healthcare establishments.

Moreover, the National Tuberculosis Control Programme, along with provinces and cities, would provide counsel and proficiently implement documents and directives to reinforce the role of grassroots healthcare systems, healthcare services and drug procurement utilising the Health Insurance Fund. This would encompass the adoption of information technology in deploying electronic medical records. Simultaneously, efforts to sustainably mobilise resources domestically and internationally would be intensified, alongside the effective execution of the National Tuberculosis Prevention and Control Strategic Plan, with the ultimate objective of eradicating tuberculosis in Việt Nam by 2035.

Minister of Health Đào Hồng Lan underscored the aspiration for Vietnamese citizens to live in a tuberculosis-free environment, entrusting responsibility to the Ministry of Health, pertinent ministries, and localities through robust engagement. The Ministry of Health would oversee the assessment and synthesis of the objectives, tasks, and solutions outlined in Decision 374, which endorsed the National Tuberculosis Prevention and Control Strategy from 2020 to 2030. This would entail consultations, reviews, adjustments, and supplementation to align with global objectives.

In tandem with the implementation of the tuberculosis control programme, Việt Nam must bolster the capacity of grassroots healthcare and preventive healthcare, according to the minister. Integration of tuberculosis control initiatives with grassroots healthcare is imperative, alongside proactive efforts to locate and identify tuberculosis patients directly within communities. Additionally, establishing a robust legal framework is essential to execute tuberculosis prevention and control at the grassroots level. Furthermore, devising sustainable financial plans for long-term tuberculosis control funding sources poses a significant challenge, necessitating suitable transformation strategies to address this circumstance. VNS