vietnam

Report
Accessing to ARV in
HIV/AIDS care and treatment
programme in Vietnam
Dr.Nguyen Van Kinh
Head, Department of care and treatment
HIV/AIDS situation in vietnam
First case of HIV infection reported:Dec.1990

First case of AIDS reported: 1993
As of Sept.30th, 2003, cumulative reported
cases of HIV/AIDS through out the country
including:

–101,291 cases of HIV infection
–16,528 AIDS patients; 9554 deaths by
AIDS
Estimated HIV/AIDS number in 2005:
263,000

Estimated number of PLWHA need to accessing ARV
treatment during 2005-2010

2005
: 14.775

2006
: 18.975

2007
: 23.040

2008
: 27.690

2009
: 33.075

2010
: 37.275
Accessing to ARV
•
•
•
•
Started since 1995
1995-2003 : 50 patients/year (2 combination)
2004: 500 patients ( three combination)
Current number of patients on treatment (2005)
– Central level:
900 patients
– Provincial level :
2,100 patients
– District level:
140 patients
Total : 3,140 patients
At the end of this year: Estimated 5,600 patients
ARV accessing
• Treatment regime :
- First line : d4T +3TC + NPV; d4T +
3TC + EFV
ZDV + 3TC + NVP: ZDV + 3TC + EFV
- Second line:TDF/ ABC + ddI + LPV/r or SQV/r or NFV
• Funding sources: Government
Global fund
ESTHER project
PEPFAR
Current HIV/AIDS care and treatment
system in Vietnam
VAAC
Subdivision for
Treatment
Subdivision for
M&E
Subdivision for
PMCT
SubDivision
for STIs
NIOTD/TB
Hue General Hos.
TDC -HCMC
NIHE
Regional Pasteur Ins.
CHOGO
CHOC
NIDV
Provincial Health service
-PMC; MCH Hospital/Center
General Hospital/STD center/TB Hospital/Center
Rehab.
Centers
District Health Center
PLWAs and their families
NGOs/CBOs
Commune Health Station
Task force
calculating needs for ARV drugs and
regimens
Main assumptions for planning:
• Following protocol of MOH
• 70% of adults weighed under
60kg
• Estimated 5% children
patients
• Mean weigh of children
patient :15kg
• About 10% of patient needs
second line regimen
• Newborn weigh about 3.0 kg
REGIM ENS
ADUL TS
d4T/3TC/NVP
35%
d4T/3TC/EFV
35%
ZDV/3TC/NVP
ZDV/3TC/EFV
ddI/ABC/NFV
7.50%
12.50%
10%
PEDIATRICS
d4T/3TC/NVP
40%
d4T/3TC/EFV
40%
ZDV/3TC/NVP
ZDV/3TC/EFV
7.50%
12.50%
PM CT
ZDV/3TC/NVP
100%
AZT
100%
Current situation
MOH
GF
PEPFAR
ESTHER
Forecasting
Based M&E
Based on funds
available
Method in place
Based on funds
available
Procurement.
Open bidding
Decision 88,
buffer stocks?
UNICEF,
buffers?
Direct
proc. brand,
FDA approved,
buffer incl.
HCMC-Tender
Hanoi-local
market
Storage/
Distribution
Medinsco
Medinsco
CPS1, Quart.
Deliveries.
Pharmacy in
Hospital
Patient M&E
system
Some sites
(HCMC) have,
As MOH
System in place
Working with
PEPFAR
Inventory
control
Exists in some
facilities
Not prepared
System being
developed
Not prepared
Buffer/minimal
stock level at
facility level
6 months
?
Yes/2months
?
Number of patients started
in the Month with Weight
and Age status
Number of patients
started in the Month
with regimen and drugs
Current Active number
of patients by regimen
Graph Patient Intake
trend over months
in a given year
Standard
Reports
Weight status Adults
that visited Pharmacy
in the month
Cumulative number
of patients up to the date
Number of visits
in the Month by regimen
more indicator
• Number of health workers trained to
deliver ARV/palliative care
• Number of service outlets providing ARV
and OIs
• Number of service outlets providing
palliative care
• Number of patients change into second
regimen
• Number of patients died during treatment
Next strategy
• Completed M&E system
• Completed ARV accessing action plan
• Set up indicators system for ARV using,
procurement...
• ARV source Co-ordinating

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