Sustainable Immunization Financing in Asia Pacific: Vietnam Country Brief

Key messages

Context

• Vietnams’ strong economic growth continues to propel the country forward, mirroring its aggressive commitment towards investing in social programs.
• The demographic transition is slow, but epidemiological transition is advanced. Much of the population is projected to remain working age for the next few decades. Conversely, NCDs now account for 73% of total deaths in Vietnam and re-prioritization efforts are underway to better fund chronic disease care.
• Vietnam’s commitment to immunization over the previous decades has produced very strong immunization coverage rates, but a conservative NIP package.

Immunization Financing

• Within Vietnam’s decentralized system, the central government provides immunizations, but limited financing for operations relies on a campaign structure with delivery occurring on dedicated immunization days.
• Financing for immunization is mainly generated through central government revenues (taxes, loans, grants), though efforts to increase cost-share within the system could increase provincial inputs over time.

Key Findings

• The support from Gavi has allowed Vietnam to move forward in expanding their package of vaccines and reaching remote areas and their exit will leave a gap in financing.
• The government has relied on macroeconomic growth for budget increases, and has not explored innovative financing mechanisms like earmarked taxes.
• Decentralization has not been fully embraced by the central government, creating some fragmentation and a lack of clarity regarding authority and accountability in the health system.
• The Ministry of Health is pressing for the national health insurance to include immunization in a new preventative services package prior to the exit of Gavi funding.
• The central government has complete autonomy over decisions regarding the immunization program.
• Prioritization of NUVIs is competing with several other health issues, and historically Vietnam has been conservative in prioritizing new vaccines, so additions are likely to remain few in the coming years.
• The NITAG is quite nascent, heavy in government representatives, and reliant on external agendas and WHO recommendations.
• Domestic manufacturing of products is a critical issue for the Ministry of Health and the Ministry of Finance. There is only one vaccine in the current schedule not produced locally and it is co-financed by Gavi.