COUNTERMEASURES OF

THE MINISTRY OF HEALTH OF VIET NAM ON

DISASTER MANAGEMENT AND
DISEASE PREVENTION IN VIET NAM

Presented by Dr. Nguyen Manh Cuong, Ministry of Health,

S.R. Viet Nam
Bangkok, September 4, 2012
CONTENTS:

• Part 1: Overview of disaster

management
• Part 2: Infectious Disease in Vietnam
• Part 3: Preparing preventive vaccines
• Part 4: Working with other agencies
• Part 5: Future steps
 Part 1:
Overview of Disaster management
 Organization structure and activities

• National level:
– National Committee for Flooding and Storm response
– National Committee for Search and Rescue
• Multi-sectoral joint members, Health sector is one of the
member, in–charge of all Health and Medical activities
relating to 3 phases: preparedness, response and recovery
of disaster.
• Ministry of Health:
– Committee for disaster management, search and rescue,
chaired by Vice-Minister.
– Members: Hospital, Food Hygiene and Safety, Preventive
Medicine in the whole country.
– Standing office: Disaster Management Unit (DMU).
 Organization structure and activities

• Health and Medical activities:

– Hospital preparation: bed, medicine, ambulance, personnel…
– Preventive Medicine: outbreak control, dis-infection, increase
personal hygiene…
– Food Safety and Hygiene: Safe food and drink
• Basic Principal: Four-onsite
– Command
– Equipment and Vehicle
– Material
– Personnel
Pictures
 Part 2:
Infectious Diseases in Vietnam
 General Information of Viet Nam

• Area: 332,600 km2

• 7 ecological regions
• Provinces: 63
• Districts: 692
• Communes/wards: 10,999
• Population: 86 millions
(2009)

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• In Vietnam, disease pattern is shifting from
communicable diseases (CDs) to non communicable
diseases (NCDs). However, CDs are still the burden for
the country (Double burden).

• Increasing number of toxic/injury case.

• There is high risk of transmission of those CDs cross

borders.

• Most common CDs are: respiratory, influenza, acute

watery diarrhea syndrome (AWDS), dengue fever, viral
encephalitis,
10 LEADING CAUSES OF MORBIDITY IN 2010
Diseases Cases/100.000 inh.
Influenza 1,693.64
Diarrhea 971.85
Rabies 344.89
Dysentery 191.73
Dengue/DF 146.69
Mumps 39.39
APC 33.37
Varicella 32.65
Salmonellosis 27.79
Adenovirus 10.45
Sources: Communicable Diseases Statistic Year Book 2010 (MOH)
 CURRENT COMMUNICABLE DISEASES OF VIETNAM’ MOST
CONCERNED

Influenza A (H1N1):

 The first case was reported in May 31st, 2009: A student

learning in the United States returned Vietnam
 Until October 2010: there were 11,227 cases reported to
be positive with the Influenza A(H1N1), of whom 61 died.
 The pandemic reached a peak in September 2009 and
then gradually fell down. As of July 2010, the pandemic
has been basically controlled.
.

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 CURRENT COMMUNICABLE DISEASES OF VIETNAM’ MOST
CONCERNED (conti.)

Influenza A (H5N1):

 The first infected case was reported in December of 2003

 Up to now, Việt Nam has recorded 123 infected cases, of
whom 61 died.
 The virus has been transmitted from poultry to human.
None of human to human transmission has been realized.

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Figures of morbidity and motarlity of the Influenza (H5N1) by year

Source: Report of GDPM, 2012

13
 CURRENT COMMUNICABLE DISEASES OF VIETNAM’ MOST
CONCERNED (continue)

Dengue: It is reported by the GDPM that in the first six months

of the year 2012, there were 24,726 acquired cases, of whom
14 were fatal. The disease has mainly occured in the southern
region of Vietnam. No pandemic occurred.

AWDS:
- By the end of July 2010: 281 acquired cases are reported (no
death found) in 17 provinces/cities. In which, 265 Vietnamese
infected patients and 16 others from neibouring countries.
- In the first six months of the year 2012, there was none of
cases confirmed in Vietnam.

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Figures of morbidity and motarlity of the dengue by year
CURRENT COMMUNICABLE DISEASES OF VIETNAM’ MOST CONCERNED
(conti.)

HFMD: is caused by a group of viruses known as enterovirus

(EV), including EV71, which causes fever and sores in the throat
and blisters on the hands and feet, severe complications leading
to death.
- Most vulnerable people to HFMD are infants and children under
the age of 10 years.
- The disease is usually mild and patients generally recover in 7-
10 days.
- HFMD sporadically occurs across Viet Nam but remains most
concentrated in the Southern and Central provinces.
- There is not yet vaccine for specific treatment for EV infections,
so good hygienic practices should be applied to prevent the
spread of the disease
CURRENT COMMUNICABLE DISEASES OF VIETNAM’ MOST CONCERNED
(conti.)

It is accommulatedly that in the first six months of the year 2012,

Vietnam has confirmed 60.120 infected cases in 63 provinces/cities of
the countries, of whom 31 died in 14 provinces/cities.
Figures of morbidity and motarlity of the HFMD by month in 2012
CURRENT COMMUNICABLE DISEASES OF VIETNAM’ MOST CONCERNED
(conti.)

Rabies: It is accommulatedly that in the first six months of

the year 2012, Vietnam has confirmed 27 deaths of rabies,
of whom 89 percent come from moutaineous areas in the
north of Vietnam.
 PREVENTIVE MEDICINE NETWORK IN VIETNAM
Ministry of Health

General Department of Preventive Medicine

• National and Regional Institutes of • Institute of Occupational • Center for

Hygiene & Epidemiology Health and Environment verification of
• Regional Pasteur Institutes biological and
Hygiene
• National and Regional Institute of medical products
• Institute of Hygiene and • Center of Polio
Malaria, Parasitology and
Public Health, HCM city vaccine
Entomology (in the North, Central
• National Institute of Nutrition • Vaccine Institute,
& South)
• Institute of Ocean Medicine Nha Trang

Provincial Provincial Provincial 4 centers for Centers for

Centers for centers for centers for prevention of border health
control of malarial preventive occupational quarantine
social diseases control medicine diseases

District health centers Communal health stations

Surveillance system of communicable diseases in Vietnam
Ministry of health
General dept. of preventive medicine

National institute of Hygiene and Epidemiology

Central hospitals Regional Pasteur Institutes

Provincial Preventive
Provincial hospitals Medicine Centers

District hospitals Commune medical station

Private clinics
 Difficulties and Challenges

- Re-emerging of CDs: influenza A(H1N1), A(H5N1),

DF/DHF, Ebola, SARS, cholera, malaria. The
increased and quick exchanges within and among
countries facilitate the transmission of CDs.
- Understanding and awareness of people, especially of
those in remote areas, ethnic minorities on CDs is
limited. They still have some customs facilitating the
transmission of epidemics.
- Most of health staff in PM are not public health
specialists
Difficulties and Challenges
- Budget spent for the preventive system is limited
(about 25 - 30% overall health budget while PM’s
activities take around 60% of all health activities)
- PM facilities are not equipped enough to deal with
emerging and dangerous CDs (especially at lower
levels).
- Although the diseases surveillance system
established from central to local levels, the
mechanism for providing and sharing information is
not running smoothly.
Lessons learnt:
- Receive strong supports by the whole politics system
of the country and effective involvement of ministries,
sectors and organizations.
- Keep a close cooperation and collaboration between
health sector and other sectors in surveillance and
investigation of the epidemics.
- Good cooperation and support from International
NGOs: WHO, CDC, USAIDS, WB, ADB, UNICEF,
CAREID…. (in terms of technical and financial
supports).
- Good preparation and experience obtained from
previous control measures.
- Regular exercise has been applied.

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 Part 3:
Preparing preventive vaccines
Preventive vaccines used under the National Expanded
Program on Immunization

- The National Expanded Program on Immunization

(Vietnam EPI) started in Vietnam since 1981 as pilot, till
1985, the program has widely implemented in the whole
country and enlarged in term of both area and subjects.
Since 1995, most children have chances to access to the
program.

- 6 vaccines have been used under the program since

1985 including tuberculosis, diphtheria, whooping
cough, tetanus, measles and polio.
- In 1997, 04 other vaccines have been newly supplied
free of charge in Vietnam under the program: vaccines
against hepatitis B, Japanese encephalitis,typhoid and
cholera.

- In June 2010, Hib vaccine against severe pneumonia

and meningitis has been applied in the whole country
as the 11th vaccine used under the Vietnam EPI.

- All vaccines in EPI are free of charge

- 10 out of 11 vaccines are locally produced except for Hib

vaccine which is imported with a quantity of around 5
million doses per year.
Figures of vaccine doses used yearly in average under EPI:

Kinds of vaccines Number of doses

(million)
BCG 3,5
DPT 4,8
OPV 8
Hepatitis B 3.5
Measles 5.3
Japanese encephalitis 2.2
Cholera 0.6
Typhoid 0.4

Source: Report of GDPM, 2012

 Preventive vaccines used in service sector

- From 2006 to 2010, 14,8 million doses of vaccine were

used in service sector, of which 4,3 million doses were
produced locally, the remaining of 10,5 million doses
were imported;

- In 2011, it is estimated that around 4 million doses of

vaccines were used;

- More than 20 kinds of vaccines have been using in

service sector
 Part 4:
Working with other agencies
• Maintain close cooperation with countries of common border:
China, Lao PDR, Cambodia in cross border prevention and
control of communicable diseases at points of entries.

• Working with NGOs and International organizations: WHO,

WB, ADB, USCDC, WHO/FAO/UNDP, Health Bridge, etc. in
implementation of preventive medicine related
projects/programs, including:

- The Annual Cooperation Project with WHO;

- The Project on prevention and control of communicable

diseases in Mekong sub region countries, Phase II (2011-2015)
financially and technically supported by ADB;

- The project on strengthen in surveillance and response to the

pandemic influenza in human, 2007-2012. The project has
been funded by the US- AID and implementing in 9
provinces/cities, 5 National Hospital and Institutes;
- The project to support implementation of the Field
Epidemiology Training in Vietnam (2011-2012);

- The ADB funded project on development of the

Preventive Medicine system (2006-2014) has been
implementing in 45 provinces/cities in the whole country;

- The project on strengthening capacity of early detect

and response to the in human pandemic influenza caused
virus funded by KfW has been implemented in all
provinces/cities of the country;

- The WB funded project in prevention and control of the

avian influenza and preparedness to pandemic influenza
(2011-2014) has been implementing in 11
provinces/cities.
 Part 5:
Future steps
• To maintain all of the set effective measures.

• To mobilize internal resources investing for Preventive

medicine system: personnel, equipment, infra-structure,
mechanism and policy.

• To call for the support of all development partners.

• To strengthen the health collaboration between bordering

countries under IHR, Regional agreement (ASEAN, APEC,
GMS…) and bilateral agreement.
Thank you for your
attention!