General information
According to a study titled “Social protection for vulnerable groups in Vietnam” by Le Bach Duong, Dang Nguyen Anh and Khuat Thu Hong, published in 2005 by the “The Gioi” (World) Publishing House, patients with HIV/AIDS are one of the most vulnerable groups and in greater need of social support from their families, communities and the State. At the time of the study, many people with HIV/AIDS were poor and could not afford regular treatment as they only relied on their own income and their health was worsening; consequently, their poor health did not allow them to work to earn their living and they became dependent on their families.
Apart from that, social discrimination remained high, causing people with HIV/AIDS to suffer from inferiority and often ran the risk of losing their livelihoods and income, unable to have access to basic treatment. Besides, people with HIV/AIDS had very limited knowledge of the social protection policies to which they were entitled. They did not know what they could enjoy free of charge in treatment. The number of people with HIV/AIDS holding health insurance cards was also very low for various reasons, including the fact that people with HIV/AIDS do not want to disclose their personal information. This was a great barrier to improving the quality of treatment and care for people living with HIV/AIDS.
In the face of those challenges, Vietnam has devised a number of proactive policies and mechanisms giving priority to people with HIV/AIDS in medical treatment and getting jobs. It can be confirmed that over the past nearly 30 years of implementing the policies and mechanisms, Vietnam has made important achievements, in reducing the number of newly-infected cases, increasing the life span for people with HIV/AIDS, and strengthening the dissemination of knowledge of HIV/AIDS to communities. Initial results have shown that the efforts of the whole political system and society have contributed to pushing back negative impacts of HIV/AIDS in communities and decreasing the vulnerability of those with HIV/AIDS.
Favorable policies and mechanisms
Vietnam has long devised the general strategy for taking care of its citizens’ health and support workers in vulnerable groups, which also forms policies and mechanisms giving priority to taking care of people with HIV/AIDS both in terms of medical health and job creation, helping them integrate into communities and reducing the number of newly-infected cases.
These favorable policies and mechanisms have been solidified by a system of legal documents including the Law on HIV/AIDS Prevention and Control; Law on Gender Equality; Decision No.61/2000/QD-TTg of the Prime Minister on the Establishment of the National Committee for AIDS, Drug and Prostitution Prevention and Control, etc. Vietnam also approved the National Strategy on HIV/AIDS Prevention and Control towards 2020 with vision towards 2030 to continue devising goals, plans and solutions to prevent the transmission of HIV/AIDS in the long-term and ensure that this work can be done effectively and sustainably.
Those documents and mechanisms provide the legal foundation to ensure that people with HIV/AIDS can enjoy all rights and practice all obligations defined in the laws, have the right to integrate in their communities and society, the right to have jobs and the responsibility to prevent transmission of the virus from person to person. All of those regulations have no other purposes than to ensure that people with HIV/AIDS can lead a normal and equal life like all other people and prevent the spread of HIV virus in communities.
Encouraging results
Under that legal foundation, organizations and authorities of localities have carried out legal, medical consultation and support activities for people with HIV/AIDS. The number of people living with HIV/AIDS holding insurance cards has increased significantly and ARV drug has been included in the list of medicines covered by Vietnam Health Insurance. According to current regulation, children under six, poor people, and people of ethnic minority groups living with HIV/AIDS are covered with 100% of the expense for medical examination and treatment. Near poor people and pensioners are paid with 95% and others are paid with 80% of the costs. Therefore, people with HIV/AIDS will only have to cover a maximum amount of 20% of the expense for their treatment and medical services, including medical examinations, tests, ARV drug, treatment for opportunistic infections, etc. At present, there are 312 outpatient clinics and 526 ARV collection points in communes and wards nationwide. Particularly, ARV drug is also provided free for prisoners with HIV/AIDS. In 2015, 95,752 people including 4,596 children with HIV/AIDS were treated with ARV drug, the rate of mother-to-child transmission decreased from 10.8% in 2010 to 3.2% in 2014. Currently, Vietnam has about 227,000 people living with HIV/AIDS and the number of newly-infected cases each year stands at about 12,000 to 14,000. Overall, the number of people with HIV/AIDS alive keeps increasing, but the number of new cases is on the downturn. By the end of 2015, the number of newly-infected cases dropped by more than 60% and deaths from AIDS decreased by 50% compared to 2007.
In addition to health care, the Government of Vietnam has also been implementing a number of solutions to support people living with HIV/AIDS with their livelihoods. For example, the Prime Minister issued Decision 29/2014/QD-TTg in 2014 regulating the credit support for people with HIV/AIDS and their families. Accordingly, from June 15, 2015 onwards, people with HIV/AIDS are entitled to borrow up to VND 20 million (for individual) and VND 30 million (for households) for economic production. This decision was piloted in 15 provinces/cities in 2015 and 2016 and has been implemented nationwide since 2017. These solutions not only help people with HIV/AIDS have income to improve their living standards, but also help remove their feelings of inferiority, helping them get equal status in their communities. By working, people with HIV/AIDS can also reaffirm their values, gain respect, and contribute to the national economy and social progress.
In terms of awareness, it can be said that Vietnam has made great strides in altering the perception of individuals and organizations about HIV/AIDS. The press, media and special dissemination agencies (such as the Department of Communications and Community Mobilization – Vietnam Administration of HIV/AIDS Control) have actively implemented dissemination of information about the HIV virus and AIDS epidemic. This has helped reduce discrimination against people with HIV/AIDS, especially during treatment and at work, contribute to positive changes in public awareness, and remove inferiority among people with HIV/AIDS. In reality, many organizations and enterprises no longer discriminate against people with HIV/AIDS, pay more attention to taking care of their health, and allocate suitable jobs for them. People living with HIV/AIDS in the community can also participate in any activities and enjoy the same benefits as other people... According to statistics, in the first quarter of 2015, dissemination on HIV/AIDS prevention and control was targeted to 2.9 million people, giving detailed information about the mechanism of HIV virus transmission, ways to prevent transmission in daily life, and how to effectively handle cases of HIV exposure.
Despite difficulties during implementation, the solutions set out under the system of favorable policies and mechanisms have brought about encouraging results, showing the special care of the Party and State of Vietnam for vulnerable groups in general and people with HIV/AIDS in particular.
Translated by Huu Duong