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Please let me start by saying thank you to the National TB Programme at the National Lung Hospital for organizing this important meeting to mark World TB Day, which falls on Sunday the 24th of March.
This year’s global theme, “Yes, we can end TB” is echoed by Viet Nam’s national theme: “Yes, Viet Nam can end TB!” And it’s great to be using the occasion of this World TB Day to discuss how we can do that.
These themes might seem simple, but they are designed to convey a message of hope – that it is possible to make major progress towards ending TB as a public health problem.
This theme is very much in line with the Government of Viet Nam's national strategic plan on TB, which aims to end TB as a public health problem in this country by 2035.
And we have seen very strong commitment to this goal from the highest levels of the Government.
I am a big believer in celebrating – and then building on – success. So I want to first of all acknowledge the incredible progress Viet Nam has made to date in responding to and controlling TB to date, and highlight two particular recent achievements.
First, we saw during the emergency phase of the COVID-19 pandemic, very significant disruptions to TB testing services – and as a result, to diagnosing people and getting them onto treatment. But in the last 12 months or so, we've seen those testing levels restored to pre-COVID levels.
This has been largely the result of rolling out new technology in TB labs across the country which has enabled faster diagnosis, as well as strong outreach efforts in communities, the private sector and health facilities to encourage people to get tested.
The second achievement that I want to highlight is that the cost of TB medication for patients with drug-susceptible TB is now mostly covered by Viet Nam's social health insurance system. This is incredibly important, because if people are diagnosed with TB, it is curable – but only if they have access to the full course of medication that they need, which means making treatment available without financial hardship.
Thank you and congratulations to each and every one of you who has contributed to these achievements.
But despite the progress that has been made, Viet Nam still has a very high burden of TB. Across the country, 11,000 families every year face the grief and suffering of losing a loved one to this disease, even though it is a disease which is both preventable and treatable.
So, there are some very significant challenges that we need to address if the country is to achieve the target of ending TB as a public health problem by 2035.
Here, there are three issues that I would particularly like to highlight.
The first issue is in the area of investment. Viet Nam is a rapidly developing economy. As a result of that, and changing global economic circumstances, external donor support for the TB programme and other public health programmes are likely to decline in the future.
So, we need to start having a conversation about long term sustainability of the TB response, including how to leverage more financing from domestic sources.
This week, WHO released an investment case for TB screening and preventive treatment. It showed that modest investments could lead to significant health and economic benefits, with a return on investment of up to 39 US dollars for every dollar invested. SO while mobilizing domestic resources is always challenging, we have the evidence to show the return on investment is substantial.
The second issue is, we need to be proactive in finding every single person who has the disease, and getting them onto treatment – in other words, active case finding. People with TB are often in hard-to-reach or disadvantaged groups. They don’t always come to the health centre for a check-up. Indeed, they don’t always have symptoms.
Building on the great progress that has already been made in restoring testing levels to pre-COVID 19 levels, we need to step up efforts to identify everyone with TB. Without this, it will be very difficult to interrupt transmission in the community, and as a result, very hard to achieve the elimination target.
The third issue is about making sure the system works for everyone. Despite progress in having TB treatment costs included under Social Health Insurance, we know that there are people who fall through the cracks and are unable to access financial support for medication costs – around 10,000 every year, or 10% of newly diagnosed patients. We need to close these kinds of gaps in the system.
In all of these efforts, the health sector of course has a leading role to play. But we also need to mobilize sectors beyond health: for example, working with civil society to help reach people currently unreached by health services, and to raise awareness and reduce barriers to people coming forward for testing, including stigma.
In all of this work, WHO of course remains steadfastly committed to working together with the Government at the central and provincial levels, with communities and other international partners.
We know these are not easy tasks, but they can be done. And if they are, we can look forward to one day being able to say: “Yes, Viet Nam has ended TB!”
Xin cảm ơn!