Free treatment & insecticide-treated
nets reduce malaria deaths in Viet Nam
Viet Nam reduces malaria death toll by 97% within five years
Government commitment to malaria control in
Viet Nam, largely through the supply of free insecticide-treated bednets
and the use of locally produced, high quality antimalarial drugs, has
reduced the malaria death toll by 97% within five years. The concerted
drive against malaria has involved major investment in training and
disease reporting systems, the use of mobile teams to supervise health
workers in malaria-endemic areas, and the mobilization of volunteer
A concerted drive against malaria in Viet Nam --largely through the
country-wide provision of insecticide-treated bednets, indoor spraying
with insecticides, and the use of locally produced high quality drugs--
has had a dramatic impact on malaria deaths and cases. Over a five-year
period from 1992-97, the death toll from malaria was reduced by 97%
and the number of cases fell by almost 60%. Meanwhile, epidemics of
malaria declined by over 90%, with only 11 small outbreaks recorded
A decade earlier, the prospects for malaria control were far from promising.
Primary health care and malaria control networks were weak and malaria
control was ineffective in many areas. The country was in the grip of
an economic recession, donated supplies of insecticide had dried up,
and migrant workers were carrying malaria into areas where it had once
been eliminated. In 1991 alone, there were 144 epidemics of malaria.
Over one million people were affected. To make matters worse, the drugs
used to treat malaria were rapidly losing their effectiveness. Resistance
to first-line malaria drugs was reported in all southern provinces and
in some northern provinces as well. Malaria threatened to spiral out
Then in the early 1990s, the Vietnamese Government took advantage of
an upturn in the economy-- increasing its investment in malaria control
and identifying the drive against malaria as a national priority. Coordination
of malaria control efforts was stepped up and village health care networks
improved. There was a major investment in training and supervision and
mobile teams were set up to supervise health workers in malaria-endemic
areas. Volunteer health workers were mobilized at community level. Disease
reporting and epidemic forecasting systems were strengthened and supported
by 400 mobile teams.
The first major breakthrough was the development and manufacture of
a "new" drug --artemisinin-- to treat severe and multidrug-resistant cases
of malaria. The antimalarial drug, extracted from the indigenous Thanh
Hao tree, had been used in traditional Chinese and Vietnamese medicine
for centuries. It was rediscovered by Chinese scientists in the 1970s.
In Viet Nam, collaboration between industry and researchers led to local
production of high quality artemisinin and other derivatives at low
cost. The new drugs had a major impact on severe and complicated cases
of malaria and helped reduce the number of deaths.
At the same time, there was a major expansion in efforts to prevent
malaria. The number of people protected from mosquito bites by indoor
house spraying with insecticides increased from 4.3 million in 1991
to 13 million by 1997. Meanwhile, the number of people sleeping under
insecticide-treated bednets soared from 300 000 to over 10 million by
1997. Insecticide treatment of bednets is provided free of charge for
people living in malaria-endemic areas.
Despite the recent successes, continued vigilance will be needed to
prevent a resurgence of malaria in Viet Nam. More than one-third of
the population -- over 26 million people -- live in malaria-endemic areas.
The country is prone to natural disasters, including drought, typhoons,
and most recently storms and floods -- all of which can spark off epidemics
of malaria. Today the malaria control programme is working in close
collaboration with malaria researchers in efforts to improve control
measures and develop new drugs and treatment regimens for malaria. And
Viet Nam has also joined a regional initiative -- under the umbrella
of Roll Back Malaria -- aimed at reducing malaria deaths throughout the
Mekong region by at least 50% between 1998 and 2010.