Will Impending Cuts in PEPFAR Funding Threaten Vietnam’s HIV/AIDS Response?
Dr. Do Duy Cuong of Hanoi’s Bach Mai Hospital reflects on an uncertain future
Dr. Do Duy Cuong, Dr. Awachana Jiamsakul (Kirby Institute), Ms. Nicole de la Mata (Kirby Institute), Dr. Do Van Thanh (Bach Mai Hospital), and Ms. Boondarika Petersen (TREAT Asia) on a site visit to the hospital in October 2016Dr. Do Duy Cuong, the Director of the HIV clinic at Bach Mai Hospital in Hanoi, has been caring for HIV/AIDS patients since the first cases of the disease were identified in Vietnam in the 1990s. The hospital joined TREAT Asia in 2009, and Dr. Cuong recently became Bach Mai’s TREAT Asia site principal investigator.
Of great concern to Dr. Cuong, care providers, and those infected or affected by HIV in Vietnam is that the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the primary donor for HIV/AIDS programs in the country, will end its support in 2018. Care providers and community groups are trying to cope with major changes in care delivery that have endangered existing testing and treatment coverage.
“Our programs have been a great success—the number of new HIV cases in Vietnam has decreased dramatically over the past 10 years,” says Dr. Cuong. “But we need adequate budgets to maintain and continue our successes. There are plans for health insurance to cover the cost of treatment, but so far most people don’t have health insurance coverage. There’s a lot that still needs to be worked out.”
At the HIV clinic at Bach Mai Hospital
The impending end of PEPFAR funding also brings existing issues of stigma to the forefront. Currently many HIV patients from outlying areas travel to Hanoi for treatment because they are worried about their HIV status being disclosed in their communities. But under proposed government plans, patients will have to pay more if they go somewhere other than their local district to obtain treatment. Dr. Cuong and his colleagues are concerned that this may dissuade many from seeking care.
“Even we as physicians don’t know what will happen in a couple of years when PEPFAR funding stops,” he said. “We need to put a lot of effort into planning now; otherwise the number of cases of treatment failure will increase and much of our progress against the HIV epidemic of the past years might be lost.”