Toward ending tuberculosis epidemic by 2030

Expert urges to maintain sustainable outcomes in TB prevention and control

Saturday, 2018-10-27 07:37:13
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Associate Professor, Dr. Nguyen Viet Nhung, Director of the National Lung Hospital cum Head of National TB Programme.
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NDO – Vietnam has converged almost enough conditions to announce an end to tuberculosis (TB), however, more efforts are needed to maintain sustainable results in TB prevention and control across the nation.

The suggestion was made by Associate Professor, Dr. Nguyen Viet Nhung, Director of the National Lung Hospital cum Head of National TB Programme.

At the end of last September, Vietnam attended the United Nations General Assembly's first-ever high-level meeting on ending TB in New York, the United States, with the participation of the Heads of State, senior officials and representatives from UN agencies. At the event, Vietnam made a commitment to end the TB epidemic by 2030.

Thien Lam, a Nhan Dan Online correspondent, interviewed Associate Prof., Dr. Nguyen Viet Nhung on the goals and measures that are required to put an end to TB across the country.

Q: How were Vietnam’s efforts assessed at the first UN General Assembly high-level meeting on global TB ending? What does this event mean for Vietnam?

A: Vietnam is considered as a typical model on the way to end TB, so after the opening session, Minister of Health, Nguyen Thi Kim Tien, was invited to deliver her speech in welcoming the Declaration of the first-ever UN High Level Meeting on TB.

The event is very meaningful for all countries and is particularly significant for Vietnam's anti-TB work, as most of the interventions mentioned in the Declaration have been applied in Vietnam in different levels. The document will provide sufficient resources and mechanisms for implementation across the country. On the other hand, the event is expected to promote activities that ensure sustainable resources for the National TB Programme until its final victory to end TB by 2030.

The event is also very meaningful for Vietnam to call for international organisations, such as the Global Fund to Fight AIDS, TB and Malaria, the WHO, the US Centres for Disease Control and Prevention (CDC), the Royal Netherlands Chemical Society (KNCV) and many other partners, in providing both financial and technical support, as well as cooperating in deploying new breakthrough research that is appropriate to Vietnam’s conditions.

Q: At the event, what commitments did Vietnam make to achieve the goal of ending TB by 2030?

A: Vietnam fully supported the political statement at the high-level meeting and pledged to focus its resources and mobilise the relevant authorities, organisations, communities and citizens for the successful implementation the global TB ending programme, along with the Sustainable Development Goals.

Q: What are some bright spots in Vietnam’s TB prevention and control to be considered as one of the leading countries in the field?

A: Vietnam is one among the nine countries that reached the Millennium Development Goals regarding all three indicators of TB incidence, morbidity and mortality. So far, after three years, the TB mortality rate has dropped from 16,000 in 2015 to 13,000 in 2016 and 12,000 in 2017.

Vietnam has converged nearly enough fundamental conditions to put an end to TB by 2030. Firstly, in terms of political commitments, the Resolution adopted at the 6th plenary session of the 12th Party Central Committee has set the basic target of ending TB by 2030, while the Government launched a national TB strategy by 2020 with a vision to 2030, in addition to a range of documents from the Government, the Ministry of Health and the Prime Minister, to facilitate TB prevention and control in Vietnam.

Vietnam has standardised technical guidelines and unified treatment regimens throughout the country, with a long-standing, strong and dedicated network of experts from the central to local levels that are capable of effectively implementing multiple interventions.

We have received strong international support both in finance and technique, in addition to great determination from the senior leaders in the health sectors for the humanistic purpose of avoiding the deaths of tens of thousands and the fears of hundreds of thousands of families each year.

Vietnam has established a national lung and TB research network featuring the coordinating and connecting role of the Vietnam Integrated Centre for TB and Respirology Research and the participation of many other domestic and international partners.

Currently, we have applied most of the world's advances, new tests and new drugs that have helped facilitate early TB detection and treatment with high success rates, including multi and super drug-resistant TB. Furthermore, we have a very good research capacity to be ready to apply new innovations and techniques in the world, while also being able to contribute experience to help other countries in the region, thus increasing Vietnam's prestige and gaining strong potential for international assistance in the future.

Minister of Health, Nguyen Thi Kim Tien (L), and Director of the National Lung Hospital, Nguyen Viet Nhung, at the first-ever UN General Assembly high-level meeting on ending TB, in the US in late September 2018.

Q: Vietnam pledges to end TB by 2030. So, what are the challenges in this work?

A: The biggest challenge for the current National TB Programme is to maintain all of the current favourable conditions and positive achievements gained by 2030. Vietnam needs an active community-based approach to TB services for early detection and treatment of all TB. Cutting off the source of infection will help stop TB.

Regarding the solutions for sustainable development, we need to establish a national inter-branch commission, a national action plan, a TB Law and a multi-sectoral accountability framework that is evaluated annually.

We also need active participation from the community and the solution for active community-based access is facilitating communication campaigns to reduce stigma and discrimination against TB, as well as providing support, especially economic support for all, in order to eliminate barriers that allow them to hide the disease or give up treatment. The Patients Support Foundation to End Tuberculosis (PASTB) is actively promoting its role in how to make people aware of and no longer have to worry about TB, no matter how disadvantaged they are.

Q: In the near future, what strong policies does Vietnam need to achieve the goal of ending TB by 2030?

A: After the UN General Assembly high-level meeting, the Ministry of Health will propose that the Government integrates the TB component into the National Committee for Prevention and Control of AIDS, Drugs and Prostitution, making it the National Committee for Prevention and Control of TB, AIDS, Drugs and Prostitution. Alongside that is the development of a national action plan to end TB by 2030 based on the current conditions and the forecast breakthroughs in science and technology. The ministry will also propose that the Government holds a conference on the implementation of the National Action Programme on TB to mobilise all central and local agencies to take part in and then organise an inter-agency review on the programme’s annual progress.

We will also propose to the National Assembly to put the issue of ending TB into law, which may be the Law on the Care and Protection of People's Health or the revised Law on Communicable Disease Prevention and Control.

As for the organisation of the TB prevention and control system, we will advise the Ministry of Health on the TB programme model that has been applied in 15 provinces where there is no specialised hospital for the disease, while strengthening the training for local medical facilities in integrating chronic disease control into the public healthcare coverage plan.

We need to increase capacity and expand research from the central to local levels, as well as building a regional TB research network among the Asia-Pacific Economic Cooperation (APEC) members, in collaborating with Australia, Singapore, China, Cambodia, Thailand and other countries, as proposed at the recent APEC meeting on TB prevention in Papua New Guinea.

Vietnam remains among the 30 countries with the highest TB burden in the world, ranking 16th in TB infected cases and 16th in the burden for multi drug-resistant TB. Of these, 64% of normal TB infections and 98% of drug-resistant TB patients suffer from a catastrophic cost burden, i.e. spending over 20% of the total household income for one year due to TB. 70% of TB patients are in working-age. Therefore, TB is really a problem affecting the economy of each family in particular and the country in general. Investing in ending TB is an investment in sustainable development.