Strategic progress and policy recommendations to enhance control and management of hypertension and cardiovascular disease in Vietnam

October 12, 2018

Hanoi, Vietnam, October 12 2018—Today the General Department of Preventive Medicine (GDPM), under Vietnam’s Ministry of Health (MOH), and international global health organization PATH and the Novartis Foundation, held a multi-sectoral policy dialogue to review Vietnam’s progress in addressing cardiovascular diseases (CVDs), and to make recommendations for strengthening policies that will enable effective CVD interventions in the country. Other participants included the World Health Organization (WHO), major hospitals, national medical institutes, Hanoi University of Public Health, regional health authorities, private-sector stakeholders, nonprofit organizations, and other relevant departments of the MOH.

CVDs are a major public health threat in Vietnam; hypertension alone currently leads to 21 percent of all deaths per year, with around 25 percent of adults affected by the condition.a Unhealthy diets, physical inactivity, tobacco use and harmful use of alcohol, all increase the risk of developing a CVD. The government of Vietnam has adopted the National Noncommunicable Disease (NCD) Prevention and Management Strategy, which includes a target to reduce the premature death rate due to NCDs by 20 percent in 2025 compared to that in 2015, and to reduce behaviors and conditions that contribute to CVDs, such as containing the proportion of adults with hypertension to less than 30 percent by 2025.b In June, the MOH launched guidance for enhancing NCD management at the primary care level.

Vietnam’s approach to addressing CVDs is guided by the WHO HEARTS technical package, which provides a strategic approach to improve cardiovascular health and prevention, treatment and management of other NCDs in low- and middle-income countries. The package includes six practical modules—Healthy lifestyle counselling, Evidence-based treatment protocols, Access to essential medicines and technology, Risk-based charts, Team-based care, and Systems for monitoring—to guide ministries of health in strengthening CVD management in primary health care settings.

During the dialogue, the MOH provided updates on key policies and strategies designed to address CVDs that align with the WHO HEARTS package.

Dr. Truong Dinh Bac, deputy director of GDPM, updated participants: “On June 21, 2018, the Ministry of Health issued Decision No. 3756 / QD-BYT on guiding the implementation of prevention, early detection, diagnosis and management of some non-communicable diseases. This is an important guideline for the management of non-communicable diseases including cardiovascular and hypertension at primary healthcare levels.”

Vietnamese health authorities leading on CVD prevention and management presented on the progress of key CVD interventions. Presenters included the Ho Chi Minh City Provincial Health Department together with PATH, who presented on the Communities for Healthy Hearts initiative, supported by the Novartis Foundation; Khanh Hoa Provincial Health Department; and the Vietnam National Heart Institute.

“Incubator initiatives such as Communities for Healthy Hearts are testing and demonstrating novel ways to approach the rise of CVDs in Vietnam—such as community-based blood pressure screening run by local social enterprises, partnerships with chain pharmacies to enhance hypertension screening and detection, and public-private health care referral networks—while also drawing on the international best practice laid out in the WHO HEARTS package,” said Dr. Kimberly Green, PATH’s program director for NCDs, HIV and tuberculosis in the Mekong. “Today we’ve shared updates on this model with the government and other stakeholders so that we can work together to find ways to further improve CVD detection, treatment, and care, across the whole of Vietnam.”

“Communities for Healthy Hearts and the other interventions presented today show opportunities for replication,” added Dr. Nguyen Huu Hung from the Ho Chi Minh City Provincial Health Department. “Now we need to see how we can take these ideas, which are having positive impacts in their respective areas, and develop policy that enables us to reach more people and meet the targets set out in the National NCD Prevention and Management Strategy.”

The dialogue featured representation and participation from multisector stakeholders, including the private sector. “Multistakeholder partnerships are essential to make global advancements towards defeating NCDs,” said Christina Wadhwani of the Novartis Foundation. “Innovative public-private partnerships can help Vietnam address NCDs and achieve the Sustainable Development Goals.”

PATH and the Novartis Foundation, in collaboration with GDPM, also presented findings from a review and analysis of policy-related factors that enable and hinder the implementation of the HEARTS package in Vietnam, and insights into how strengthening policy can pave the way for effective CVD interventions. All participants then engaged in a participatory process to consider current challenges and develop recommendations and next steps for an improved policy environment for CVD prevention, treatment, and management in Vietnam.

“CVDs place a huge burden on individuals, families, communities, and society as a whole. The risk factors for CVDs are broad and multi-faceted. Those affected by CVDs or conditions like hypertension often require long-term support. It therefore requires an ongoing and coordinated effort to address this modern-day health threat, including mobilizing primary health care services to make access to services easier,” said Dr. Truong Dinh Bac. “I am therefore encouraged to see this diverse group working together today to discuss the current status of cardiovascular disease and hypertension prevention, current policies, and propose policies needed to effectively implement prevention, treatment and management at the primary care level in the near future.”

In September 2018, Vietnam also attended the Third High-Level Meeting on NCDs at the UN General Assembly at the end of September, reaffirming its commitment to global NCD control goals.

“Following the third high level meeting for NCDs, it is imperative that the global health community now accelerates action to reduce the impact of these diseases,” said Helen McGuire, global program leader for NCDs at PATH. Ensuring an enabling policy environment is critical to preventing new cases and providing care that is accessible and affordable. Vietnam is the place to watch for innovation in this space.”

The policy dialogue was held by GDPM at the MOH, with support from PATH and the Novartis Foundation. Since 2016, PATH and the Novartis Foundation have collaborated with the Ho Chi Minh City Provincial Health Department and Preventive Medicine Center to introduce Communities for Healthy Hearts: a three-year health care delivery program that engages health leaders, the community, the public health system, and the private sector in improving hypertension awareness, management, and control in Vietnam.

Communities for Healthy Hearts is part of PATH’s broader strategy to improve access to prevention and care for noncommunicable diseases using innovative tools and approaches to increase availability of essential medicines and technologies, and integrate NCDs into existing systems and services. Read more at https://www.path.org/resources/communities-for-healthy-hearts-improving-...

About PATH

PATH is a global organization that works to accelerate health equity by bringing together public institutions, businesses, social enterprises, and investors to solve the world’s most pressing health challenges. With expertise in science, health, economics, technology, advocacy, and dozens of other specialties, PATH develops and scales solutions—including vaccines, drugs, devices, diagnostics, and innovative approaches to strengthening health systems worldwide. Learn more at www.path.org

About the Novartis Foundation

The Novartis Foundation (NF) is a philanthropic organization that aims to have a transformational and sustainable impact on the health of low-income communities. NF tackles global health challenges through a mix of programmatic work, health outcomes research, and their translation into policy. NF convenes local and global partners and work with them hand-in-hand to catalyze sustainable healthcare models to improve access and health outcomes. Digital technology has the power to innovate the way healthcare is delivered, while ensuring people remain at the center of care, and is a key enabler in all NF programs. Grounded in evidence and evaluation, NF continually evaluates and adapts programs to achieve the greatest impact.

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a Son PT, Quang N, Viet NL, et al. “Prevalence, awareness, treatment and control of hypertension in Vietnam – results from a national survey.” Journal of Human Hypertension. 2012;26(4):268–280
b Vietnam MOH. National Strategy on Prevention and Control of Cancer, Cardiovascular Disease, Diabetes, Chronic Obstructive Pulmonary Disease, Asthma, and Other Non-communicable Diseases Period 2015-2025. Hanoi, Vietnam: MOH; 2015