Encouraging private funding of sustainable health

What are the highlights in the renovation of Vietnam’s healthcare system towards sustainability?

Nguyen Thanh Long, Minister of Health

The Millennium Development Goals (MDGs) comprises eight goals set by the 189 United Nations member states, including Vietnam, and agreed to be achieved by the year 2015. Among the eight, five are directly related to the health sector. The MDGs 4, 5, and 6 focus on improving health and the MDGs 1 and 7 have some indexes related to health.

Therefore, the successful implementation of the MDGs in the health sector plays a decisive role to Vietnam’s successful performance of MDGs.

As of 2015, Vietnam achieved 16 out of the 17 subtargets, and the remaining is nearly completed. Compared to 1990, Vietnam reduced child malnutrition and death under five by two thirds, and the death rate among mothers had been reduced by three fourths. Moreover, people’s access to clean water has been improved by 50 per cent, the HIV infection rate is now below 0.3 per cent of the population, and malaria has been under control since 2011.

Meanwhile, the capacity of forecasts, supervision, and prevention of diseases has been increased. Vietnam stopped pandemics such as Mers-CoV, Ebola, and Zica, and kept epidemics like influenza A (H5N1, H1N1), tuberculosis, malaria, and measles. Vietnam was also the first country controlling SARS.

Vaccinations have been strengthened and reinforced, and sustainably implemented in all communes and wards with the rate for children reaching over 90 per cent for 12 kinds of vaccines. In-service vaccinations have now 23 kinds of vaccines (out of the world’s 35 kinds of vaccines). The implementation of the national target programme on prevention and fight against some dangerous and infectious diseases has contributed to decreasing these dramatically.

The death rate among mothers postpartum decreased by over three times from 233 in 1990 to 54 in 2015. The rate of mothers and newborn babies receiving first-week care postpartum in 2010-2015 hit 76-79 per cent. With these achievements, Vietnam was highlighted by the World Health Organization (WHO) as a bright spot in the implementation of MDGs in the healthcare sector.

What are the main focal points in the healthcare sector in the future to promote sustainable development?

The sector will focus on a number of issues in sustainable development, such as reducing infection, death, and disability rates; controlling infectious diseases; and ensuring the efficiency in prevention and control of diseases, especially emerging ones to prevent massive transmissions.

Moreover, investments in the development of the primary healthcare system are being planned. The grassroot healthcare system shall be renovated, and the development of human resources pushed to ensure lifelong healthcare for each individual and community, aiming towards achieving universal healthcare coverage.

The quality and efficiency of the service network should also be improved from the central to the grassroot level to adapt to changes like an ageing population, global integration, and digital transformation. Further, developments are planned for the non-public health sector and public-private partnerships in healthcare.

Additionally, we want to keep an eye on the replacement fertility rate, ensure sex balance at birth, and adapt to our ageing population.

An important goal is to develop human resources for the healthcare sector while intensifying scientific research and the application of high-tech prevention, diagnosis, and treatment.

In the pharmaceutical industry, domestically produced medicinal herbs and devices shall be used to ensure sufficient medicines, vaccines, and equipment at reasonable prices, meeting people’s demands for health prevention and treatment. We also need to control food safety based on risk assessment, production, and business.

Public spending on healthcare also needs to increase, similar to the efficiency of allocation and use of state budget and other resources for the sector. Priority needs to be given to state funding to develop preventive and grassroot healthcare in underprivileged areas.

Finally, we need to enhancing the capacity of management and performance of healthcare policies and boost administrative reform while developing a health information system to meet the sector’s renovation and development demands.

How can private players contribute to the healthcare sector’s sustainable development?

In the past, private health facilities mainly provided diagnosis and treatment services for paying customers, but now many of them offer health insurance-based activities.

The number of private-run hospitals rose from 170 with 9,800 sickbeds in 2015 to 272 hospitals in 2020 with a total of 17,500 sickbeds; and more than 37,600 private-run clinics which significantly contribute to meeting people’s healthcare demands. In addition to fully foreign-invested hospitals, private ones are equipped with modern facilities. Some investors developed hospital chains like Hoan My and Vinmec.

In regard to private-run pharmacies, more than 550 domestic pharmaceutical companies distribute medicines to 2,000 drug wholesalers, 43,000 retail drugstores, and those in hospitals.

Together with medical services, private firms also provide other services like sanitation, waste treatment, medicines, equipment, and infrastructure, thus contributing to increase the healthcare quality to meet people’s diversified demands.

The health insurance market also develops strongly with an annual growth rate of over 20 per cent in the past 10 years, which involves about 40 players and over 16.5 million contracts.

Resolution No.20-NQ/TW from 2017 aimed to enhance citizens’ health protection, improvement, and care. The state prioritised budget for investment and adopted mechanisms and policies to mobilise and efficiently use resources to protect and care for and improve people’s health. The resolution set the goals of achieving 30 hospital beds per 10,000 people, and a proportion of 10 per cent of private hospital beds by 2025. And by 2030, these rates are 32 and 15 per cent, respectively.

To date, the proportion of private hospital beds makes up over 20 per cent of the country’s total. However, new private hospital beds account for just 6 per cent, and mainly provide outpatient treatment services. Therefore, the role of businesses is very important in the sector’s sustainable development.