Sustaining Vietnam's HIV and AIDS Programs

Financial and in-kind contributions from these organizations have enabled the Government of Vietnam to cover 95% of the costs of ARVs, totaling $21.2 million in 2014. This access to care has improved the lives of individuals affected by HIV and AIDS in Vietnam. However, due to projected declines in donor funds over the next three to five years, the Government of Vietnam faces a pressing need to transition to more sustainable forms of financing to ensure continued coverage of ARVs. To address this challenge, the Government of Vietnam has set a goal of covering up to 70% of ARV costs by 2018. The Health Finance and Governance (HFG) project is assisting Vietnam in managing this financial transition through various management, policy, and financing measures related to sustainable ARV procurement. Several barriers to sustainable ARV procurement have been identified, including national laws that limit competitive pricing, a fragmented and decentralized drug procurement process, and a lack of a comprehensive framework for bidding on government tenders. Additionally, ARVs are not currently registered for circulation in Vietnam, which increases the costs of procuring these essential medications. These barriers limit the Government's ability to provide ARVs to all people living with HIV and AIDS in Vietnam. To address these challenges, HFG has assisted the Ministry of Health and the Vietnam AIDS Administration Control in the procurement process. HFG has helped draft procurement documentation, review bidding packages, secure approvals, review vendor bids, and assist with price negotiations. As a result, seven companies purchased tender documents, and three were deemed eligible to compete for the tender. A bid was awarded based on competitive pricing and other criteria, and a contract has been signed. The new contract stipulates that approximately 6.4 million oral, fixed-dose tablets of a combination first-line ARV will be supplied to treat nearly 17,600 patients for one year, with an estimated value of $2 million. The success of this country-led arrangement has proven that a more comprehensive and sustainable procurement framework can be established. HFG is now working with the Ministry of Health and the Vietnam AIDS Administration Control to form a strategic working group to harmonize and coordinate procurement-related activities. This working group will have three intermediate functions: coordinating activities to strengthen the capacity of domestic partners to assess drug quality and pricing transparency, planning for the formation of a domestic body to purchase ARVs at-scale, and supporting the establishment of a comprehensive Logistics Management Information System. Through its advocacy for the strategic working group, HFG is a leading force in convening stakeholders and harmonizing activities for sustainable procurement of ARVs in Vietnam.