Eamonn Murphy (middle) meets with patients receiving methadone treatment at a health clinic in Tân Yên District, Bắc Giang Province. — VNS Photo Khoa Thư

Việt Nam News reporter Khoa Thư talks to Eamonn Murphy, Regional Director of UNAIDS, Asia and the Pacific, about the opportunities and challenges facing the elimination of HIV as a public health threat by 2030

Over the past decade, Việt Nam has witnessed a decline in the number of new HIV cases and AIDS-related deaths. 2020 is the deadline set for the ambitious goal of 90-90-90 by the UN. How do you assess the country’s performance in the fight against HIV/AIDS and its chances to achieve the goal?

90-90-90 is a set of treatment-focused targets to move the agenda faster, saying 90 per cent of those living with HIV know their status, 90 per cent are receiving treatment and 90 per cent on treatment have viral suppression which stops forward transmission.

Yes, these are ambitious targets. But if we don’t set ambitious targets we are not pushing the agenda.

With a communicable disease like HIV, we need ambitious targets to get community control. 

Việt Nam has set these targets and is doing very well in terms of working toward these targets. Viral suppression is very high, you may achieve the target there.

Việt Nam is also innovative in testing; self-testing for example.

If you are afraid to go to health services, to a doctor or healthcare worker, even sometimes to an NGO, having a test at home means you know your status and if you’ve got HIV then you know you can access treatment.

Social health insurance is another innovation to make treatment available locally and with subsidised costs so more people can get it.

The viral suppression and the message about U=U (Undetectable=Untransmittable) are to encourage people why they should access it early.

Việt Nam has set in place the right, sustainable programme to achieve these ambitious targets.

It just needs a little more time than 2020.

Việt Nam wants to put an end to the AIDS epidemic by 2030. Based on your evaluation, what are the challenges facing Việt Nam?

Việt Nam recognises that the epidemic is changing. In response, the country is innovating and changing its programmes including bringing in PrEP(pre-exposure prophylaxis).

Thailand was the first country in the region to use PrEP. Việt Nam is overtaking Thailand because it recognises the importance of the new tool of prevention as we don’t want people to be on HIV treatment for life.

The social dynamic of young people has also been well recognised. A community participation organisation (CPO) in HCM City, for example, found up to 77 per cent of approached young MSM (men having sex with men) have never accessed testing or services.

With the support of the Government, they can improve the programme to reach people.

It is also critical to have political leadership and services to continue to innovate across the board and to maintain that leadership and service innovations.

Việt Nam’s achievements have been built on a sustainable base. There are some countries with better outcomes but it’s all thanks to foreign donors. That’s why I think Việt Nam can achieve the end of HIV as a public health threat by 2030.

A patient gets ARV HIV drugs. — VNA/VNS Photo

Since March 2019, HIV sufferers in Việt Nam have been switching to ARVs covered by social healthcare insurance, making Việt Nam one of a few countries in the world that allocates social insurance funds to pay for HIV/AIDS treatment. What do you think about the change in terms of efficiency and sustainability?

The move has made HIV treatment and hopefully later some of the prevention available through the public system through insurance. 

Because your economy is thriving, foreign funding is now moving to more disadvantaged countries.

The government needs to both encourage and support people to continue treatment.

It is also important to set the goal of having a separate HIV programme in the general health system that fights against stigma and discrimination, as healthcare workers need to understand the issue to make sure clients are comfortable to come and stay in the services.

Otherwise, we’re going to push people underground and the epidemic will rebound.

It has been not even a year since the change and the Government reviews how it is operating every month. We should be aware of the need to continually refine and change the nature of the programme to best serve clients and push back HIV.

The World AIDS report 2019 released on November 26 stressed upon the role of communities in prevention and control of HIV/AIDS. What are your recommendations for Việt Nam’s society to accelerate their involvement in the fight against HIV/AIDS?

Việt Nam needs to further strengthen its partnership with communities via social contract which is not just for HIV but many other health issues.

The Government should start funding CPOs working in this field which support HIV-infected people who need lifetime treatment and accelerate HIV/AIDS prevention. 

Successful countries have shown many experiences in building partnerships with communities, non-profit and private sectors in helping deliver services because it cannot be done solely by the Government’s health system. — VNS