Universal health insurance program for people living with HIV in Vietnam: an ambitious approach.

International funding for HIV treatment and prevention drastically decreased when Vietnam transitioned from a low-income to a lower-middle-income country in 2010. Vietnam has attempted to fill the funding gap from both public and private sources to cover antiretroviral therapy (ART) treatment. However, policies that enable social health insurance to pay for ART treatment-related costs often exclude people living with HIV (PLHIV) without appropriate government documents from accessing the health insurance-funded ART program. The Vietnamese Ministry of Health might consider alternative approaches, such as implementing a universal health insurance program among PLHIV regardless of residency or documentation status, to expand coverage of ART treatment to achieve the UNAIDS 95-95-95 targets by 2030. This expanded universal care will increase the uptake of ART treatment among uninsured PLHIV as well as increase coverage of health insurance-funded ART among insured PLHIV. Most importantly, the proposed insurance scheme could significantly improve population health by reducing HIV new infections and providing economic benefits of ART treatment through increased productivity and decreased healthcare costs.