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Situation of Current ARV Treatment in

Vietnam

HAIVNHarvard Medical School AIDS

Initiative in Vietnam

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By the end of this session, participants will be able to:

Describe the HIV care and treatment situation in Vietnam

Explain the role of international agencies in the treatment program

Outline the challenges and the future plan for the ART program in Vietnam

Learning Objectives

National report on HIV cases:

HIV infection 204.019

AIDS patient 58.569

AIDS-related Deaths 61.856

Discovery of HIV infection:

• 63/63 provinces/cities

• 98% districts

• 78% communes/wards

HIV and AIDS in Vietnam (1)

National report on HIV/AIDS –MOH - 2012

0

50000

100000

150000

200000

250000

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

30/6

/12

AIDS patients

Death

HIV infection

HIV and AIDS in Vietnam (2)

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The epidemic is concentrated in high risk groups

Sexual transmissions are increasing The majority of infected people are men

(68.6%), 20-39 years old Demand for care and treatment is

increasing due to increasing number of infected prople

Drug supply did not meet the demand for ARV treatment

Characteristics of HIV Epidemic in Vietnam

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HIV/AIDS Care & Treatment in Vietnam

7TOWARDS UNIVERSAL ACCESS, Scaling up priority HIV/AIDS interventions in the health sector, Progress Report 2010

People Receiving ART in Low and Middle Income Countries, 2002-2009

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Overall objective:Control the rate of HIV infection in the community under 0.3% in 2020Reduce the impact of HIV / AIDS on developing of economic and social

The Goal of HIV Care and Treatment by 2020 (1)

MOH 2012

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Having adequate knowledge about HIV / AIDS (15-49 years old)

80%of population

No discrimination, discrimination against HIV-infected people

80%of population

New HIV-infected people among IDUs Reduce 80%

New HIV-infected people by sexual transmission

Reduce 80%

The rate of mother to childtransmission

Drop below 2%

HIV-infected people eligible for ARV treatment

80%

The Goal of HIV Care and Treatment by 2020 (2)

MOH 2012

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HIV/AIDS Care & Treatment in Vietnam

Vietnam Administration of HIV/AIDS Control (VAAC) established in 08/2005

Health system provides care and treatment services at multiple levels:

ARV treatment support from donors GFATM, PEPFAR, WB, ESTHER…)

Source: MOH-Bases for Building up the Action Plan 3

Level Reach

Central 3 Centers

Provincial Care & treatment of in- & out-patients

District QCT Program (Management, Care, Counseling)

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Vietnam Ministry of Health:• Provides ARVs to 63 provinces

PEPFAR :• Supports 18 provinces development the

care models and comprehensive treatment Global Fund:

• Supports 20 provinces of OI and ARV drugs

Clinton Foundation:• Support for ARV treatment of HIV-infected

children

The ARV program in Vietnam

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PEPFAR Support: 7 Key Provinces and 11 Additional ARV Provinces

Hai Phong

Quang Ninh

Ha Noi

Can Tho

An Giang

TP Ho Chi Minh

Nghe An

Ba Ria-Vung Tau

Soc Trang

Cao Bang

Nam Dinh

Son La

Hoa Binh

Thai Binh

Bac Ninh

Da Nang

Long An

Vinh Long

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The Global Fund Supports 20 Provinces

Quảng Ninh

TP HCMAn Giang

Hà Nội

Lạng Sơn

Cao Bằng

Khánh Hòa

Thanh Hóa

Nam ĐịnhThái Nguyên

Phú Thọ

Đắc Lắc

Tây Ninh

Kiên Giang

Cà Mau Sóc Trăng

Cần Thơ

Nghệ An

Hải Dương

100 quận/ huyện578 xã

Hải Phòng

50 100 5002670

7818

15273

25,597

36008

41527

63490

428 930 1462 1987 2344 3567

0

10000

20000

30000

40000

50000

60000

70000

Adults

Children

Number of Adults and Children on ART

Nguồn: VAAC, MOH 2012

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Program Number of ART sites

National Program 94 sites/63 provinces

Global Fund Program 64 sites/20 provinces

PEPFAR 114 sites/24 provinces

Clinton Foundation and Children's National Program

8 sites/6 provinces

ART Treatment in Vietnam (1)

(Source: VAAC)

(up to 11/2010)

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ART Treatment in Vietnam (2)

Current ART regimens (at PEPFAR sites)

Patients on 1st line regimens 97%

Patients on 2nd line regimens 3%

Treatment target by 2015 (reported by MOH)

Adults who need ARVs 70% ~

105,000 cases

Children who need ARVs 95%

Patients still on ARV after 12 months treatment 85%

Districts establishing HIV care and treatment services 65%

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Successes of ARV Treatment Program in Vietnam (1)

Rapid scale–up of ARV treatment since 2005

ART now available in all provinces 2nd line ART available in many

provinces through PEPFAR Coordination between national

programs and international donors by VAAC

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Successes of ARV Treatment Program in Vietnam (2)

Expansion of:treatment for childrenavailability of pediatric drug formulationsnew OPCscapacity for CD4 testing

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Group Discussion:

What are Some Challenges of ARV Treatment in Vietnam?

What are Some Ways To Overcome These Challenges?

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Key Points

IDUs are the main group of currently HIV infected patients but sexual transmission is increasing

ARVs are now available in all provinces in Vietnam

The ART program in Vietnam still faces various challenges which are being addressed

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Thank you!

Questions?