1. 1 Situation of Current ARV Treatment in Vietnam HAIVN Harvard Medical School AIDS Initiative in Vietnam

2. 2 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

3. National report on HIV cases: HIV infection204.019 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

4. HIV and AIDS in Vietnam (2)

5. 5 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

6. 6 HIV/AIDS Care & Treatment in Vietnam

7. 7 TOWARDS 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

8. 8 Overall objective: Control the rate of HIV infection in the community under 0.3% in 2020 Reduce the impact of HIV / AIDS on developing of economic and social The Goal of HIV Care and Treatment by 2020 (1) MOH 2012

9. 9 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 child transmission Drop below 2% HIV-infected people eligible for ARV treatment 80% The Goal of HIV Care and Treatment by 2020 (2) MOH 2012

10. 10 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 LevelReach Central3 Centers ProvincialCare & treatment of in- & out-patients DistrictQCT Program (Management, Care, Counseling)

11. 11 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

12. 12 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

13. 13 The Global Fund Supports 20 Provinces Quảng Ninh TP HCM An Giang Hà Nội Lạng Sơn Cao Bằng Khánh Hòa Thanh Hóa Nam Định Thái Nguyên Phú Thọ Đắc Lắc Tây Ninh Kiên Giang Cà Mau Sóc Trăng Cần Thơ Nghệ An Hải Dương 100 quận/ huyện 578 xã Hải Phòng

14. Number of Adults and Children on ART Nguồn: VAAC, MOH 2012

15. 15 ProgramNumber of ART sites National Program94 sites/63 provinces Global Fund Program64 sites/20 provinces PEPFAR114 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)

16. 16 ART Treatment in Vietnam (2) Current ART regimens (at PEPFAR sites) Patients on 1st line regimens97% Patients on 2nd line regimens3% Treatment target by 2015 (reported by MOH) Adults who need ARVs 70% ~ 105,000 cases Children who need ARVs95% Patients still on ARV after 12 months treatment85% Districts establishing HIV care and treatment services65%

17. 17 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

18. 18 Successes of ARV Treatment Program in Vietnam (2) Expansion of: treatment for children availability of pediatric drug formulations new OPCs capacity for CD4 testing

19. 19 Group Discussion: What are Some Challenges of ARV Treatment in Vietnam? What are Some Ways To Overcome These Challenges?

20. 20 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

21. 21 Thank you! Questions?