Home to roughly 93 million, Vietnam is a southeast Asian country bordered by Laos, Cambodia and China. The Vietnamese have had a tumultuous past, having been occupied by Imperial China, Imperial Japan, France and the USA, the latter two losing successive independence wars which lead to the establishment of modern-day Vietnam. Since 1975, Vietnam has developed from a nation scarred by war into an economic success story, producing some of the highest growth rates in the world since 2000. Successful economic reforms have helped revitalize Vietnam’s diverse economy which is based on a variety of exports, from hydrocarbons to manufactured and agricultural products. Vietnam’s recent economic success has also proven to be somewhat of a curse, as recent economic success has reduced foreign aid for the National healthcare programs, while Vietnam’s healthcare system struggles to cope with persistent rural malnutrition, inadequate funding and a shortage in staff and supplies.
Tuberculosis in the country
Tuberculosis is a top-10 cause of death in Vietnam, with 16,000 succumbing to the disease in 2015, with an additional 1100 casualties to a combination of HIV/AIDS and TB.
Mortality rates have gradually decreased since the turn of the century, but rates remain unacceptably high.
KNCV Activities in the country
In 2015, KNCV assisted Vietnam in becoming one of the first countries with programmatic access to Bedaquiline, the first life-saving new medication for pre-XDR TB and XDR-TB patients. Vietnam also embarked on a shorter, more effective and patient-friendly treatment regimen for MDR-TB, with the patient triage approach.
Vietnam is the first country where the KNCV Patient Triage concept was applied
Vietnam is a country where the Challenge TB program is active. Challenge TB is USAID’s flagship global mechanism for implementing USAID’s TB Strategy and is led by KNCV Tuberculosis Foundation, who also led USAID’s previous TB Control projects TB CARE I, TB CAP and TBCTA.
The National Childhood TB policy was rolled-out and evaluated in three additional provinces, preparing for countrywide implementation of Childhood TB contact screening.
The introduction and scale-up of GeneXpert machines is making a significant contribution to the diagnosis of MDR-TB in Vietnam. In addition to the 71 existing GeneXpert systems, 20 new systems were implemented in 2016. Since GeneXpert was introduced in Vietnam in 2012, more than 85,000 tests have been performed.
174 physicians, radiographers, and pediatricians were trained on reading radiographic film to detect TB infection.
The scale-up of programs for the Programmatic Management of Drug Resistant TB (PMDT) is progressing well. KNCV plays an important role in advising and supporting the National TB Program in terms of policy, work plan development, implementation and quality assessment. In 2015 Vietnam pioneered the KNCV Patient Triage Approach for rifampicin resistant TB (RR-TB) patients. In 2016, a total of 88 pre-XDR and XDR-TB patients, for whom new drugs hold the only hope of a cure, were enrolled on appropriate treatment. The treatment of eligible MDR-TB patients with the shorter nine-month regimen was implemented in April 2016, with 104 MDR-TB patients enrolled so far. The KNCV Triage Approach enables MDR-TB patients to be treated with the most appropriate and least toxic regimens currently available.