(Source: Viet Nam Social Security)

According to the Ho Chi Minh City Centre for HIV/AIDS Prevention and Control, more than 31,000 HIV-carried patients (about a quarter of the total nationwide) are receiving anti-retroviral (ARV) treatment. However, only 76.8 percent of them have health insurance. By the end of 2018, subsidies for ARV therapy will be cut, and patients will have to rely on health insurance.

Inadequate conditions for establishment of general clinics

Tieu Thi Thu Van, head of the Ho Chi Minh City Centre for HIV/AIDS Prevention and Control, said when the subsidies end, health insurance will pay for ARV treatment. To adapt to the new circumstance, agencies have devised several measures, including setting up general and specialised clinics at health centres and transferring patients from health centres to district-level hospitals.

However, establishing general clinics at district-level centres is hindered by a shortage of facilities, equipment and personnel. The workforce lacks professional licences, while many health establishments do not have a surgery department, radiation safety kits or waste treatment facilities.

As of September 2017, only two general clinics of this kind in Go Vap district and District 9 were licensed to operate, four others’ registration applications were rejected and no clinic secured a health insurance contract for check up and treatment.

The Can Gio health centre is treating more than 100 HIV patients. Its department for public consultancy was previously in charge of ARV treatment. Due to health insurance policy, the department, which lacks a treatment function, cannot sign contracts with the Vietnam Social Security.

Under guidelines of the municipal Health Department, Can Gio health centre submitted documents to set up a general clinic but failed due to a lack of surgeons and radiologists. The centre proposed transferring all HIV patients to a district-level hospital, expecting to complete one third of the workload in December, and finish within the second quarter of 2018. The two sides agreed on the plan two months ago, however, the district-level hospital is yet to treat the HIV patients or send doctors to guide treatment at the centre.

No treatment interruption allowed

A feasible approach that experts urged is setting up HIV-specialised  clinics within district-level hospitals. As part of these hospitals, the clinics will be allowed to treat HIV patients. 

Luu Thi Thanh Huyen, deputy head of the HCM City Social Security, said each locality should establish a general clinic within its district level hospitals. In line with the law, health insurance can now also pay for treatment of a patient without permanent residency in Ho Chi Minh City.

Nguyen Huu Hung, deputy director of the HCM City Health Department, suggested that all models be completed prior to July 31, 2018. The subsidised ARV sources will run out by the end of 2018, thus insurance payment is necessary from 2019. Each district must come up with measures to ensure treatment is uninterrupted.

Hung requested district-level health centres work with local hospitals to select suitable organisation options for HIV/AIDS treatment and process the centres’ documents registering to establish general and HIV/AIDS – specialised clinics.

International Cooperation Department