Department of Community Health and Social Sciences, City University of New York's Graduate School of Public Health & Health Policy, New York, USA.
Center for Innovation in Mental Health, City University of New York's Graduate School of Public Health & Health Policy, New York, USA.
J Public Health Policy. 2023 Jun;44(2):300-309. doi: 10.1057/s41271-023-00411-y. Epub 2023 Apr 11.
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.
当越南在 2010 年从低收入国家过渡到中下等收入国家时，国际上用于艾滋病治疗和预防的资金大幅减少。越南试图从公共和私人来源填补资金缺口，以覆盖抗逆转录病毒疗法 (ART) 治疗。然而，使社会医疗保险能够支付 ART 治疗相关费用的政策，往往将没有适当政府文件的艾滋病毒感染者排除在医疗保险资助的 ART 计划之外。越南卫生部可以考虑采取替代方法，例如在所有艾滋病毒感染者中实施全民健康保险计划，无论其居住或身份状况如何，以扩大 ART 治疗的覆盖范围，到 2030 年实现艾滋病规划署 95-95-95 目标。这种扩大的全民关怀将增加未参保艾滋病毒感染者接受 ART 治疗的机会，同时增加参保艾滋病毒感染者医疗保险资助的 ART 治疗的覆盖范围。最重要的是，拟议的保险计划可以通过减少艾滋病毒新感染和通过提高生产力和降低医疗费用来获得 ART 治疗的经济效益，从而显著改善人口健康。
