A new blueprint for reducing the impact of noncommunicable diseases (NCDs) in Viet Nam has been presented by the United Nations Inter-Agency Task Force on the Prevention and Control of NCDs.
The plan was presented during a joint mission conducted by the Task Force over 12-16 September 2016 to Viet Nam, a country where NCDs - principally cardiovascular disease, diabetes, cancers and chronic respiratory diseases - cause 73% of all deaths (more than 379,000) each year, of which 163,000 are premature (people dying between 30 and 70 years of age). Over one third of deaths are caused by cardiovascular diseases.
The Joint Mission also heard from government leaders and parliamentarians about the socioeconomic impact of NCDs in Viet Nam. “We are committed to preventing premature deaths from NCDs in our country. The prevention and control of the NCD epidemic requires all parts of the government and our development partners to work together”, said Dr Nguyen Thanh Long, Vice Minister of Health of Viet Nam.
NCDs epidemic on the rise
Viet Nam has seen outstanding economic development in recent decades, but the country is facing the inevitable scourge of diseases driven by globalisation, urbanisation and population ageing.
Almost half of all Vietnamese men use tobacco (45%) and drink alcohol excessively over a 30 day period (44%). Overweight and obesity have increased from 12% to 16% over the past 5 years. On average, the population of Viet Nam consumes twice the WHO recommended level of salt. Hypertension is also increasing and now one in five adults has raised blood pressure.
Blueprint to reduce NCDs impact
The Task Force Joint Mission set out a blueprint for responding to the NCDs epidemic by promoting a small set of cost-effective, proven interventions. These include increasing the levels of excise tax on tobacco to at least 70% of the retail price and fully enforcing the tobacco law. The Joint Mission also urged the Government to develop an alcohol law.
“These interventions are evidence-based, cost-effective and feasible”, said Dr Nick Banatvala, Senior Adviser from WHO Geneva. “They will save thousands of lives and significantly reduce health care costs over the next few years if fully implemented.”
The Sustainable Development Goals (SDGs) have set a target of a one-third reduction in premature deaths from NCDs by 2030. “NCDs are a central part of the SDGs,” says Ms Pratibha Mehta, United Nations Resident Coordinator in Viet Nam. “Achieving NCD targets will advance the entire 2030 Agenda, given the strong links between NCDs and poverty, social inequities and lack of access to affordable basic services. The United Nations is committed to supporting the Government of Viet Nam to scale up its response in the prevention and control of NCDs.”
Country progress
The Joint Mission also witnessed the country’s strong commitment to universal health coverage. However, nearly one quarter of the population does not have health insurance. The Joint Mission saw evidence of the country’s commitment to tackling NCDs through the National NCD strategy 2015-2025, along with other relevant strategies. Several examples of multisectoral action were also observed, including in the area of tobacco control as a result of multi-stakeholder cooperation aimed at reducing smoking among urban men.
During a visit to Ha Nam province, the Joint Mission toured a new WHO-Government of Viet Nam pilot project on the management of NCDs in community clinics. “We need to learn from this experience and now ensure that primary care centres throughout Viet Nam are able to manage patients with hypertension and diabetes,” says Dr Warrick Junsuk Kim from WHO’s Western Pacific Office. “It is important that all those at high risk of heart attack and stroke receive essential medicine and counselling to reduce their likelihood of premature death.”
Revenue from tobacco taxation has resulted in significant resources for financing aspects of the NCD response, including in the Philippines. The Joint Mission recommended that a NCD Health Promotion Fund be established, building on the successful experience of the Viet Nam Tobacco Control Fund.
Outcome and next steps
The Joint Mission discussed a series of next steps with the Government to strengthen multisectoral coordination and expand NCD prevention and control across Viet Nam. In particular the Joint Mission highlighted the need to develop detailed plans for all 5 projects in the NCD strategy to ensure that involved ministries are on track to deliver the objectives set out in the strategy. The Joint Mission emphasised the importance that the plans should be costed and include time bound targets with indictors to chart progress.
WHO’s 2015 NCD Progress Monitor scored countries against 18 specific targets on national NCD planning, surveillance, as well as policies in place for the prevention and management of NCD. The Joint Mission reviewed Viet Nam’s progress and found that the country has fully met 5 of the 18 targets. The Joint Mission believes that by 2018, when countries next report on their progress at the UN General Assembly, more of these targets can be fully achieved.
To ensure progress against these targets, the Joint Mission recommended the government accelerate completion of the law on alcohol, fully implement the tobacco law, including a sustained increase in tobacco taxation, and fully develop and implement a national salt reduction strategy. The Joint Mission also recommended the establishment of a ministerial committee for NCDs to be chaired by the Deputy Prime Minister. A NCD Health Promotion Fund should also be formed by expanding the existing Tobacco Control Fund, the mission urged.
To demonstrate the return on investment of a set of core interventions to prevent and manage NCDs, the Joint Mission will undertake an economic and epidemiological study in collaboration with the Government.
The Joint Mission included representatives from the following agencies: Food and Agriculture Organization (FAO), International Labour Organization (ILO), United Nations Development Programme (UNDP), United Nations Population Fund (UNFPA), United Nations Children's Fund (UNICEF), the World Bank and the World Health Organization (WHO), which led the mission.