Illustrative image (Source: VNA) With international support, ARV treatment has been made available free ofcharge in Vietnam.
But from next year, the two men will no longer enjoy free medicines andtreatment, and health insurance cards will be the lifebuoy for HIV patientslike them.
They live together in a rented house in Binh Tan district, but have been comingto the centre for HIV treatment for the past three years for fear of being seenin their neighbourhood waiting in a queue to pick up medication for HIV.
But since social stigma and discrimination remain widespread in the country,most insured people living with HIV are unwilling to use their health insurancecards for fear of revealing their infection status.
“My company buys a health insurance card for me,” N.C.T said.
“The company might discover my HIV infection if I register for treatment usingthe health insurance card.”
According to Bui Thi Tu Anh, deputy head of the centre’s public healthconsulting and support department, the concern about disclosure of their HIVinfection status is very common among patients.
Around 2,000 people are being treated at the department, with 74 percent havinginsurance.
“Many patients are teachers, students, State officials, managers and seniorworkers in large companies, and all of them have health insurance. But theyrefuse to use the insurance for HIV treatment due to the fear of leaking theirinfection status.”
Many patients want to buy additional health insurance to exclusively use fortheir HIV treatment, but one person is allowed to get only one health insurancecard.
As international donors are phasing out assistance for HIV/AIDS control in Vietnam,patients have to pay for health checks, regular tests and ARV treatment nextyear if they do not have national health insurance.
With donors phasing out assistance, social health insurance for people livingwith HIV will become vital to sustain the delivery of HIV treatment services.
Between 2008 and 2013, HCM City received international support for HIV/AIDSprevention and treatment from long-term sponsors such as the U.S. President’sEmergency Plan for AIDS Relief (PEPFAR), the Asian Development Bank, the WorldBank, and the Clinton Foundation.
PEPFAR’s aid accounted for 80-85 percent of the city’s financial resources tocombat HIV/AIDS, Tieu Thi Thu Van, Director of the HCM City HIV/AIDS PreventionCentre, said.
"International financial support has been decreasing since 2011 and isexpected to dry up in the next two years," she said.
Funding from the central budget falls short of the need, plunging from nearly 7.9billion VND (349,550 USD) in 2012 to just 1.7 billion VND (75,220 USD) in 2014.
In 2016-20 there is not a single national programme for HIV/AIDS prevention andcontrol.
HIV/AIDS work in the city is estimated to require more than 2.8 trillion VND (123.89million USD) in 2014-20.
But only 2.22 trillion VND (98.23 million USD) is likely to be mobilised,resulting in a shortage of nearly 579 billion VND, according to Van.
HCM City has nearly 30,000 people living with HIV, 70 percent of whomwere covered by health insurance, according to statistics from the HCM CityHIV/AIDS Prevention Centre.
"The city government targets bringing everyone living with HIV into thehealth insurance net next year," Duong Minh Hai, head of the centre’s careand treatment department, said.
To achieve the target, the People’s Committee has approved use of the surplusin the health insurance fund last year to buy health insurance cards fordisadvantaged HIV patients who cannot afford them.
However, there are nearly 1,000 HIV patients without identity documents such asidentity cards, household registration books and residence cards or in jail.
“Insured HIV patients without identity documents are ineligible for healthinsurance as patients are required to furnish identity documents,” Haisaid
“This is the greatest challenge yet to be addressed.”
Kim Chi Na, head of the District 11 Preventive Medicine Centre’s public healthconsulting and support department, said for people living with HIV, ARV hadbeen a life-saver.
Those who do not stick to the ARV regimen prescribed by their doctors mightbecome resistant to the drugs.
Resistance increases the risk that the virus will mutate and producedrug-resistant HIV.
Patients without identity documents would not be able to adhere to theirtreatment regime due to a lack of financial support, increasing risk of HIVdrug resistance, she said.
To address this problem, the HCM City HIV/AIDS Prevention Centre plans to workwith the municipal Public Security Agency to set up a team dedicated to studyspecific cases and help such patients get identity documents.
Since November 2015, the Ministry of Health has ordered local healthdepartments to make payments for the treatment of insured HIV patients as wellas expand insurance coverage for people living with HIV.
The city has 46 outpatient clinics that provide ARV treatment, according to theHCM City HIV/AIDS Prevention Centre.
Outpatient clinics at the HCM City Hospital for Tropical Diseases, Pham Ngoc ThachHospital, and Paediatrics Hospital No.1 and No.2 have provided health checksand treatment for HIV patients with insurance.
Bui Duc Duong, Deputy Director of the Vietnam Administration of HIV/AIDSControl, said with the current limited resources it was essential for everyonewith HIV to sign up for the health insurance scheme.
The administration would mobilise all resources and create favorable conditionsfor people with HIV to be covered by health insurance and help them comply withthe ARV regime at any cost, he said.
The Vietnamese Government targets bringing 100 percent of people with HIV intothe health insurance net by 2020.
It targets the 90-90-90 goal by 2020, which refers to 90 percent of all peopleliving with HIV knowing their HIV status, 90 percent of all people diagnosedwith HIV getting sustained antiretroviral therapy, and 90 percent of all peoplereceiving the therapy having viral suppression.
By the end of last January, the country had 116,000 people with HIV getting ARVtreatment.-VNA
VNA
