Decision No. 37/CP On strategic orientation for the care and protection of people's health during the period 1996-2000 and national policy on medicine in Vietnam

RESOLUTION

Decree No. 37-CP dated June 20, 1996 of the Government on the strategic orientation for health care and protection work for the people during the period of 1996-2000 and the national policy on medicine in Vietnam.

At the meeting on April 23, 1996, the Government heard reports on the health status of the people, the medical work in the past period, then discussed and adopted: The strategic orientation for health care and protection work for the people from 1996 to 2000. The Government also discussed and decided on policies regarding medicines in Vietnam.

Health care and protection are the responsibility of each citizen, each family, all levels of government, people's organizations, and social organizations.

The Government requests that the Ministries, agencies under the Government, People's Committees at all levels organize the implementation of the guidelines and measures for health care and protection of the people as reflected in the two documents attached to this Resolution.:

1- Strategic orientation for health care and protection work for the people from now until 2000 and 2020.

2- National policy on medicine in Vietnam.

The Ministry of Health shall be responsible for developing specific plans to guide and urge all levels and sectors to implement the Resolution.

It is proposed that the Vietnam Fatherland Front and people's organizations within the Front coordinate with the health sector and relevant state agencies to mobilize the people throughout the country to respond positively and actively participate in hygiene and disease prevention activities, health care and protection, effectively implementing the goals set out in the strategic orientation, contributing to improving the quality of life of the people and promoting the economic and social development process of the country.

STRATEGIC ORIENTATION FOR HEALTH CARE AND PROTECTION WORK FOR THE PEOPLE FROM NOW UNTIL 2000 AND 2020

Part One:

EVALUATION OF HEALTH CARE AND PROTECTION WORK FOR THE PEOPLE DURING THE PERIOD OF REFORM, ESPECIALLY FROM AFTER THE SEVENTH PARTY CONGRESS TO DATE

I- BASIC ACHIEVEMENTS:

In recent years, the Party and State's concern and guidance on health care and protection work for the people have been reflected through the resolutions of the Sixth and Seventh Party Congresses, particularly the Fourth Plenum of the Central Committee of the Seventh Party Congress issued a resolution on "urgent issues in health care and protection work for the people." The National Assembly enacted the Law on Health Protection for the People. The Government issued many Directives and Decisions to institutionalize the Party's guidelines and directives. The health sector has made many efforts in organizing and implementing the Party and State's policies, thus health care and protection work for the people have achieved significant results.

1- Consolidating the primary health care system:

After the cooperative agricultural economy implemented the household responsibility system, many commune health stations were affected, leading to cessation of operations or working barely due to lack of resources. In response to this situation, some localities proactively sought measures to consolidate the primary health care system. Particularly after the adoption of the Fourth Plenum Resolution and Decision 58/TTg of the Prime Minister, the primary health care network was consolidated in terms of organization, personnel, facilities, and equipment, with new content in activities, and many specialized staff were strengthened at the grassroots level. Currently, there are 1,800 doctors working at commune health stations. Over the two years 1994-1995, more than 700 new commune health stations were built. The primary health care workforce and district health workers have been reinforced, their qualifications improved both in professional skills and management. The consolidation of primary health care has opened up the possibility of accelerating the Party and State's policy on health care and protection work for the people, doing well the initial health care work at each household, village, and hamlet.

2- The health sector has actively coordinated with administrative agencies and people's organizations to mobilize, educate, and promote the construction of hygiene and disease prevention movements, actively implementing disease control programs, epidemic surveillance, and national health programs, which have been successfully carried out. As a result, the number of cases and deaths caused by infectious diseases has gradually been controlled and reduced. Accelerating disease prevention work: many epidemics have been controlled, and vaccine-preventable diseases in the expanded immunization program have significantly decreased.

The expanded immunization program from 1986 to date has received the attention and guidance of Party committees, governments, mass organizations, and the health sector, maintaining a vaccination rate above 85% for many consecutive years. The prevention and control of malaria have yielded good results, with a noticeable reduction in mortality rates, no large-scale outbreaks occurring, and a significant decrease in infection rates. Other programs such as goiter prevention, tuberculosis control, leprosy control... have also achieved their set targets.

Additionally, the prevention and control of non-infectious diseases commonly found in developed countries, such as cardiovascular diseases and hypertension, cancer, mental illness, drug addiction, musculoskeletal diseases, traffic accidents, and health care for the elderly, addressing health consequences left by war, and preventing common diseases according to age groups, population segments, and types of work and professions have also been given attention and achieved many results.

3- Initial changes in medical examination and treatment work have occurred:

The health sector has rectified hospital management, launched a competition movement across the sector to strengthen hospital operation routines, improve the quality of medical examinations and treatments, especially service attitudes. The collection of part of the hospital fee and health insurance has contributed to supplementing funds for medical examinations and treatments. In recent years, the State and localities have invested in upgrading medical examination and treatment facilities, the appearance of these facilities has initially changed, equipment has been supplemented, personnel have been trained and further educated more, capable of early diagnosis and curing some diseases that we previously did not have conditions for. Initial reorganization of the medical examination and treatment network, diversification of health care service models, mobilizing various components of the people to participate in health services according to the Private Practice Act.

4- The pharmaceutical industry has made considerable progress: It has ensured the majority of drug needs for medical treatment and essential healthcare equipment, addressing the long-standing shortage of medicines and medical tools. In 1994, the average per capita expenditure on drugs was 3.2 USD, six times higher than during the period from 1986 to 1990. Thanks to the expansion of drug supply services (state-owned, collective, and private), medical drugs have reached even remote villages and mountainous areas. The drug market is being regulated to prevent and eliminate the sale of counterfeit, substandard, and addictive drugs.

5- Continue to promote and develop traditional medicine:

The organizational system of traditional medicine (TMT) has been consolidated and restructured in accordance with the new management mechanism, focusing on primary health care within the community, linked to economic and social development programs and poverty reduction efforts in treating common diseases. Each year, about one-third of patients seeking treatment are treated with traditional medicine at healthcare facilities, particularly in the community. Training for traditional medicine practitioners has been strengthened. International relations in traditional medicine have expanded. Some traditional medicine healthcare facilities have been upgraded.

The health status of the people has improved significantly. Life expectancy has increased, while rates of malnutrition among children, infant mortality under one year old and under five years old, maternal mortality, and low birth weight infants (under 2,500 grams) have all decreased. Some health indicators have reached levels comparable to those of countries with twice or three times higher income.

II- CURRENT ISSUES AND CHALLENGES:

1- Healthcare must meet the increasing demand for quality and quantity of health care services from all strata of the population, prioritizing the needs of war veterans, the poor, and difficult regions, revolutionary bases. Ensuring fairness in health care provision for the people and maintaining the humanitarian nature of the Health Sector under the conditions of a market economy is an urgent issue and a long-term policy.

2- Environmental pollution and social evils such as drug addiction, narcotics, prostitution... are negative factors affecting public health, increasing the risk of illness. In rural areas, pollution results from the habit of using untreated manure, chemical pesticides, and fertilizers, and a lack of sanitary latrines; in urban areas, pollution comes from household waste, industrial waste, and noise. The proportion of the population accessing clean water remains very low. Health education campaigns are still sporadic and campaign-based, failing to create a sustained movement of public participation in disease prevention. The proportion of the population accessing clean water remains very low.

3- Material conditions ensuring the implementation of set goals are still far below the required level. Along with national development, the Health Sector is moving towards modernization under limited resources, with most healthcare facilities built long ago equipped with outdated and obsolete equipment, especially district hospitals and those in mountainous regions. In recent years, the state has increased investment in upgrading healthcare facilities but not sufficiently. State funding capacity is limited while medical equipment is very expensive.

4- The pharmaceutical sector has been slow to reform its organization when transitioning to a socialist-oriented market economy mechanism. Government management has not kept pace with the situation, lacking the ability to effectively manage the increasingly diverse and complex drug market, unable to control drug import sources, particularly illegal imports and gifts. Production capacity is limited due to the unorganized pharmaceutical industry, which is fragmented, with most production equipment being outdated and obsolete. Scientific research and management studies have not received adequate attention.

5- The organizational structure and training of healthcare personnel have been slow to adapt to the new mechanism. Although local healthcare organizations have been restructured, many issues remain unresolved, such as the organization and operation of district health centers, grassroots health stations, and departments under the provincial health service, as well as the organization and management of healthcare facilities within territorial boundaries.

While the number of trained personnel has increased, the ratio of doctors per capita remains low. Training has not been linked to employment, leading to an excess of doctors in cities and towns but a shortage of grassroots healthcare workers in rural areas, with very few doctors working in communes.

6- A portion of healthcare personnel lacks a sense of responsibility, fails to uphold the ethics of a doctor, engages in negative behaviors contrary to Party and State policies and laws. Some policies and benefits for healthcare personnel have not effectively motivated them to perform their duties well and fully utilize their capabilities in serving the health protection mission of the people.

Overall, although the health status of our people has improved significantly, it still remains at a low level and is unevenly distributed between regions, between rural and urban areas, and among different strata of the population.

Part Two:

STRATEGIC ORIENTATION FOR HEALTH CARE AND HEALTH PROTECTION WORK UNTIL 2000 AND 2020

I- GUIDING PRINCIPLES FOR HEALTH CARE AND HEALTH PROTECTION WORK

Under the leadership of the Party, our people are striving to make Vietnam a developed socialist industrialized country by 2020, with a thriving ecological agriculture, a diversified and dynamic economy, and a healthy society where human factors and cultural values are emphasized and promoted. As living standards improve, the demand for health care will increase and diversify. At the same time, the development of a market economy will lead to social stratification and unequal income distribution across regions. By 2020, the population of Vietnam will increase by more than 30 million compared to now, presenting significant challenges for health care due to demographic changes. Based on the characteristics of socio-economic development and the health care needs of the people in the new phase, it is necessary to affirm guiding principles for the health care and protection mission:

1- Human beings are the most valuable resource determining the development of the country, among which health is the most precious asset of each individual and the whole society, and also one of the greatest joys of each person and each family. Therefore, investing in health to ensure that everyone receives healthcare is investing in the economic and social development of the country, improving the quality of life for each individual and each family.

2- The humanitarian nature and socialist orientation of medical activities require fairness in healthcare. Implementing fairness ensures that everyone has access to healthcare appropriate to the economic capacity of society, while the State implements free and reduced-cost medical examination and treatment policies for those who have rendered meritorious service to the nation, the poor, people living in areas with many difficulties, and ethnic minority groups.

3- Positive and proactive prevention is a consistent viewpoint throughout the process of building and developing the Vietnamese healthcare system. The viewpoint of positive prevention must be deeply understood and applied in creating healthy and civilized lifestyles, ensuring living, working, and learning environments beneficial for disease prevention and health enhancement, and proactively preventing harmful factors for health during industrialization and urbanization.

4- Combining modern medicine with traditional medicine, traditional medicine is a cultural heritage of the nation that needs to be protected, promoted, and developed. Vigorously implementing research, application, and modernization of traditional medicine combined with modern medicine, but without losing the essence of Vietnamese traditional medicine. Strengthening state management in the field of traditional medicine, preventing and eliminating those who exploit the Party and State's policies on traditional medicine causing harm to public health.

5- Socializing the cause of caring for people's health. Caring for people's health is the responsibility of each individual, each family, each community, each level of the Party Committee, government, sectors, mass organizations, and social organizations. Each level of the Party Committee, government, and mass organizations have the responsibility to lead, direct, mobilize resources, and encourage the entire society to participate in the work of caring for and protecting people's health.

Diversifying forms of organization for healthcare (state, private, and individual) with the state healthcare sector playing a leading role. Developing various types of healthcare services to meet the increasingly high and diverse needs of the people under the condition that the state's investment in healthcare is still limited. Encouraging, guiding, and effectively managing the activities of privately established healthcare facilities and private healthcare facilities to serve the practical needs of medical examination and treatment and health care for the people, combating all negative manifestations in health care services.

II- OBJECTIVES FOR DEVELOPING THE CAUSE OF CARING FOR AND PROTECTING PEOPLE'S HEALTH

The general objective is to reduce the incidence of illness, improve physical fitness, and increase life expectancy.

The target by 2020 is to ensure fairness, improve the quality and effectiveness of healthcare, meet the increasingly high demands of all strata of the population, and bring the health of our people up to the average level of countries in the region.

During the period from 1996 to 2000, it is necessary to seize every opportunity and resource to strengthen investment in upgrading healthcare facilities, especially medical examination and treatment facilities, reform hospital management, enhance medical ethics education, and build a medical examination and treatment system capable of meeting the increasingly high demands of the people. Building the healthcare sector progressively towards modern standardization.

1- The basic health indicators of our people by the year 2000 and 2020 are as follows:

- Average life expectancy increases to 68 years (by 2000) and 75 years (by 2020).

- Neonatal mortality rate decreases to about 35 per thousand live births (by 2000) and 15-18 per thousand by 2020.

- Under-five child mortality rate decreases to about 42 per thousand (by 2000) and 20 per thousand by 2020.

- Rate of newborns weighing less than 2500 grams decreases to 8% by 2000 and 5% by 2020.

- Rate of children under five suffering from malnutrition decreases to 30% by 2000 and 15% by 2020, with no severe malnutrition.

- Average height of Vietnamese youth reaches 1.65 meters by 2020.

- Eliminate iodine deficiency disorders by 2005. Goiter rate in children aged 8-12 years old remains at 5%.

2- Significantly reduce the incidence and death rates due to infectious diseases and parasitic diseases, fundamentally improving the health situation of our people by 2020.

During the period from 1996 to 2000 and 2020, in addition to continuing to control infectious diseases and parasitic diseases, it is necessary to proactively control diseases characteristic of industrialized countries. Specifically:

Eradicate polio and neonatal tetanus through vaccination in the period from 1996 to 2000. Reduce to the lowest possible levels the incidence and death rates of cholera, typhoid fever, plague, hepatitis B, and Japanese encephalitis. By 2020, eradicate rabies, malaria, and the aforementioned diseases.

Strengthen monitoring, detection, and limiting the impact of diseases that are increasing in prevalence in our country, such as cancer, cardiovascular diseases, traffic accidents, mental illnesses, occupational diseases, etc., following the disease patterns of developed countries.

By 2000, eliminate leprosy, limit helminthiasis, and control tuberculosis to the maximum extent possible.

Strive to minimize the spread of HIV/AIDS. Reduce the impact of AIDS in the community to the maximum extent possible.

3- Expand, improve the quality and effectiveness of healthcare, implement a fair social policy in healthcare:

Consolidate and develop the national healthcare system towards modern technology and convenience for the people. Establish high-tech centers. Utilize healthcare resources effectively.

a) Develop high technology:

- Gradually modernize medical equipment and develop advanced medical technologies so that by 2000, there will be no need to send patients abroad for treatment.

- Develop and apply new scientific and technological achievements from around the world. Strive to become a regional center in some fields by 2020.

- Developing biotechnology in the direction of industrialization and modernization to produce medicines, vaccines...

Clearly delineate organizational and technical specialties to avoid overloading higher-level facilities with patients, create favorable conditions for staff and equipment, apply appropriate techniques at each level to improve the quality of health care services right at the local level. Provide provincial-level facilities with stone-breaking techniques, diagnostic ultrasound, laser treatment...

Expand the application of techniques to enhance the quality of health care activities closer to the people. By the year 2000, all pregnant women should have three prenatal check-ups to detect and prevent obstetric complications early, have childbirth assistance from healthcare professionals with the appropriate technical qualifications, and increase home health care.

Ensure social equity in health care. Implement appropriate policies and measures so that everyone, especially those who have rendered service to the country, policy families, the poor, ethnic minorities in mountainous areas, and remote regions, can access health care services, including primary health care and higher-level medical examination and treatment services. End the situation where the poor cannot receive medical care due to lack of funds.

Ensure conditions for serving patients at medical facilities, particularly essential issues such as organizing meals, clothing for patients, and maintaining hygiene and order within medical facilities.

b) Conditions to ensure the achievement of objectives:

Regarding investment: Health care and protection of public health must rely on various resources including state investment, contributions from the public, support from economic and social organizations, and assistance from other countries and international organizations, with state investment playing a leading role.

Regarding human resources: Ensure sufficient medical personnel in terms of structure, quantity, and quality. Emphasize training high-skilled personnel to meet the needs of developing medical technology in line with regional standards, while also training personnel knowledgeable about community health to meet the needs at grassroots levels. Consider medical ethics as an important quality equal to the professional competence of medical practitioners. Enact appropriate policies and incentives to encourage creative work and dedicated service to patients among medical personnel.

Regarding medicine and medical equipment: Provide adequate and quality medicines and medical equipment, particularly essential medicines, specialized medicines, and medicines for children. Strengthen propaganda and guidance on rational drug use among the public, doctors, and medicine suppliers to prevent drug abuse. Develop the pharmaceutical industry to ensure the supply of 70% of the population's medicine needs. Promote, selectively inherit, and safely use traditional medicine and medicines derived from domestic raw materials to serve the health care of the public in communities.

III- MAJOR POLICIES AND MEASURES:

1- Streamline organization and develop the health care network for the public:

Strengthen the health system at local levels under the management of local authorities for health activities within their jurisdictions. The health sector will guide professional and technical work through budgeting and personnel management. Local health programs will be directed by local authorities, organized and implemented by the health sector and other relevant sectors, and widely mobilized participation from the public.

Develop primary health care. By the year 2000, all primary health stations will be built and fully equipped with basic medical tools. Strive for 40% of village health stations to have doctors, 100% of village health stations to have midwives or pediatricians, and 100% of hamlets and villages to have community health workers. Improve the working methods of primary health stations to focus on implementing preventive health work and family health care with increasing community participation. In mountainous, highland, and remote areas, continue to consolidate and develop mobile health teams that not only conduct health education and disease prevention but also provide medical services to the public.

Strengthen the preventive health system in terms of organization, training, and upgrading specialized facilities. Restore and develop health and environmental sanitation movements.

Reorganize the medical examination and treatment system according to residential areas and efficiency. Reorganize the network of specialized medical institutions to operate more effectively and integrate into the general health network (except for some special sectors like defense and internal affairs). Diversify medical examination and treatment models: public hospitals, joint venture hospitals, private hospitals, and others. For some hospitals with suitable conditions, organize certain departments or wards to charge full fees to serve patients who have the need and ability to pay.

Continue to build two specialized health centers in Hanoi and Ho Chi Minh City, followed by a center in Central Vietnam. By 2020, establish additional high-tech centers in Northern Mountainous Areas, Northwest, Central Highlands, and Mekong Delta. These centers need to develop fields of medicine that practically serve the health care needs of the people in their respective regions.

2- Training, deployment of human resources, and development of science and technology:

* Improve teaching programs to align with community health requirements, focusing on training managers and technicians capable of using and repairing modern medical equipment.

* Have a reasonable structure in terms of the number of doctors, nurses, and pharmacists at medical facilities to ensure effective patient service. Increase training targeted at difficult areas and implement policies to encourage more medical personnel to work in highlands, remote areas, and regions with many difficulties. Diversify training forms but ensure quality.

* Plan and implement a network of medical personnel training, with annual training targets and refresher courses. Develop and promulgate specific policies to ensure living conditions for medical personnel, especially those working in difficult areas.

* Vigorously promote scientific research and technological development: Study unique diseases in Vietnam and improve traditional medicine while researching the application of global scientific achievements in medicine and pharmacy to the field of health care.

3- Strengthen investment and manage resources effectively:

* The State shall increase investment in activities for health care and protection of people's health, while mobilizing and using other resources such as contributions from the public, production and business establishments, foreign aid, and international cooperation effectively.

* Continue to implement the collection of partial hospital fees and develop health insurance to increase financial sources for medical services for the public. Implement full payment of hospital fees from those who have the ability to pay for demand-based medical services to provide additional conditions to support medical services for the poor. Reorganize and transform the operation mode of health insurance to achieve voluntary health insurance so that by 2005, most hospital fees will be covered through health insurance.

* Promote international cooperation, encourage the mobilization of capital in the form of aid or cooperation, joint ventures, associations, and investments, including 100% foreign capital. Focus on areas such as disease prevention, treatment, pharmaceutical production, and medical equipment, support, and national health programs.

4- Socialize health care and protection of people's health:

State agencies, people's organizations, in coordination with the health sector, shall implement health programs at local levels, promote and mobilize the public to understand and voluntarily participate in health care activities at home and in the community.

The Health Sector shall attach importance to socializing its activities, proactively coordinate and cooperate with other sectors and organizations to play a leading role in health care and protection of people's health.

The Culture and Information Sector: Through media such as newspapers, radio, television... regularly promote and educate about health care and protection, mobilize the public to respond and participate in health care activities.

The Sports and Physical Education Sector: Organize and mobilize the public to participate in physical training movements to improve health.

The Education Sector: Incorporate health education into the regular curriculum of general schools, educate students about civilized lifestyles and hygiene practices, and encourage students to participate in activities to maintain their own and their family's health.

The Population and Family Planning Sector: Effectively implement population planning campaigns to reduce birth rates quickly, contributing to the successful implementation of reproductive health programs.

The Labor, Invalids, and Social Affairs Sector: Coordinate with the health sector to implement social policies in medical services for war veterans, the poor, and other policy beneficiaries. Prevent and combat social evils that negatively affect health such as drug addiction, narcotics, prostitution...

The Construction, Agriculture, Rural Development, and Local Sectors shall implement environmental sanitation programs, clean water programs, and green city movements, actively address issues of latrines in rivers and ponds in rural areas, ensure safety in the use of pesticides in agriculture. 5- Vigorously implement target programs:

Implement the National Health Program to achieve set goals regarding expanded immunization, malaria prevention, goiter, tuberculosis, leprosy, upgrading hospitals, and building commune health centers.

Synchronize the implementation of health programs to achieve the following goals:

* Programs: Diarrhea control, acute respiratory infection control, nutrition improvement, rheumatic heart disease prevention in children...

* Health education programs, environmental health, school health, food safety, occupational health.

* Programs to prevent cancer, cardiovascular diseases, traffic accidents...

* Rehabilitation programs, prevention of disease sequelae, promoting community-based rehabilitation.

* Programs to prevent and mitigate disaster consequences; integrate health facility planning with socio-economic development planning in disaster-prone areas.

* Programs to improve women's health care conditions, prioritizing working conditions for women.

* Reproductive health care, including maternal and child health, family planning, and other reproductive functions.

Ensure safe childbirth. Rapidly reduce reproductive tract diseases and sexually transmitted infections, including HIV/AIDS, viral hepatitis.

* Elderly health care. Improve the physical, mental, and social life of the elderly, developing various forms of care for the elderly in terms of living and health both at home and in the community.

6- Promote and develop traditional medicine, combining traditional medicine with modern medicine:

* Fully implement the target program of the health sector on traditional medicine.

* Increase investment in research, application, and modernization of traditional medicine in aspects such as scientific research, staff training, diagnosis, treatment, drug production, and raw material production.

* Vigorously train a team of practitioners of traditional medicine. Establish Traditional Medicine Departments at Hanoi Medical University and Ho Chi Minh City Medical and Pharmaceutical University.

The health sector shall coordinate with the Vietnam Association of Traditional Medicine and other mass organizations to mobilize the public to develop medicinal plants.

7- Ensure medicines, develop the pharmaceutical industry and medical equipment.

a) Implement the national policy on medicines of Vietnam with basic objectives of ensuring a continuous and adequate supply of quality medicines to the public, and implementing safe, rational, and effective drug use.

(There is a separate document for the national policy on medicines).

b) Regarding medical equipment:

Standardize medical equipment at all levels, strengthen inspection and supervision of medical equipment import and export activities.

Expand the medical equipment industry to meet domestic needs for common types of medical equipment. Leverage the scientific and technological potential of various economic components, expand international cooperation to create conditions for producing high-tech medical equipment.

Enhance training for officials on the use and maintenance of modern equipment to ensure long-term usage and maximize the operational capacity of such equipment.

8- Integrate military medicine and civilian medicine in healthcare services for the people.

Closely integrate military medicine and civilian medicine to enhance the health of the entire medical sector in serving the cause of healthcare for the people, supporting national defense tasks, safeguarding political security, and protecting public health in areas with significant challenges in disease prevention and disaster relief.

9- Administrative reform, enhancing the effectiveness of state management in the field of healthcare.

Amend and improve administrative procedures in diagnosis and treatment to facilitate patients. Eliminate negative phenomena in healthcare services. Reform the management mechanism of healthcare services, linking responsibilities with benefits based on the functions and duties of units and individuals, thereby increasing responsibility and autonomy in healthcare facilities.

Train managers at all levels in organizational and management knowledge in the healthcare sector. Strengthen legal work in healthcare management agencies, enhance the activities of health inspection from central to local levels; ensure order and discipline in the operations of the healthcare sector, strictly implement state laws in protecting public health.

Strengthen relations between the State Management Agency under the Ministry of Health and the Trade Union of Healthcare, with the General Associations of Medicine and Pharmacy, Traditional Medicine Association, Vietnam Red Cross Society in the work of caring for and protecting public health.

NATIONAL POLICY ON MEDICINES OF VIETNAM YEAR

I. NECESSITY FOR A NATIONAL POLICY ON MEDICINES (NATIONAL POLICY ON MEDICINES)

Medicines are one of the important factors in the provision of healthcare for the people. The pharmaceutical industry has the responsibility to ensure adequate supply of reasonable medicinal needs for the people and to carry out all related activities to ensure good supply, including production, purchase, export, import, distribution, storage, quality assurance, rational and safe use of medicines.

In recent years, the pharmaceutical industry in many countries and in our country has developed strongly; the number of drug products introduced to the market and used in treatment has increased significantly, creating difficulties in drug management. Drug costs have been rising in health budgets, especially in developing countries. Each country has its own economic, social, and cultural characteristics, thus requiring specific solutions to address drug issues. The World Health Organization also recommends that developing countries need a national policy on medicines.

In Vietnam, over the past years, the State has issued many policy documents related to medicines, but they are still not synchronized. Currently, the amount of medicines supplied to the people has increased significantly, with a wide variety of types and improved quality. However, there are still limitations such as uneven distribution networks, overuse of drugs in treatment leading to waste and harm, and state management not keeping up with current requirements. Therefore, the Government has issued a national policy on medicines as a basis for the pharmaceutical industry and the healthcare sector to effectively fulfill their functions of caring for and protecting public health in the new period.

II- OBJECTIVES OF THE NATIONAL POLICY ON MEDICINES OF VIETNAM. YEAR.

The objectives of the National Policy on Medicines of Vietnam are:

+ Ensuring regular and sufficient supply of quality medicines to the people.

+ Ensuring rational, safe, and effective use of medicines.

Specific objectives include:

+ Ensuring sufficient supply of quality medicines at appropriate prices. Implementing fairness in the supply of medicines to patients. Prioritizing essential medicines, focusing on traditional medicines.

+ Utilizing resources to develop the Vietnamese pharmaceutical industry to meet most of the country's medicinal needs.

+ Developing and improving the network of medicine supply to the community, prioritizing difficult mountainous, remote, and far-flung areas.

+ Ensuring the quality of medicines in production, storage, and circulation.

+ Enhancing the effectiveness of state management in pharmaceuticals based on completing legal systems and regulations.

+ Reorganizing the pharmaceutical sector in line with new mechanisms.

+ Developing a rational pharmaceutical workforce in terms of structure, sufficient in quantity, improving professional competence, and ensuring ethical standards for pharmaceutical staff.

+ Promoting pharmaceutical scientific research, applying scientific and technological advancements in production, supply, and management.

+ Promoting inter-sectoral cooperation, joint ventures, and international cooperation in the pharmaceutical sector.

Timeframe: From 1996 to 2010.

Divided into three stages:

. Stage 1: 1996 - 2000.

. Stage 2: 2001 - 2005.

. Stage 3: 2006 - 2010.

III- SPECIFIC POLICIES:

1. Essential Medicines - Rational and Safe Use of Medicines

To ensure rational and safe use of medicines, minimize adverse events due to improper prescription, sale, and use of medicines, it is necessary to have:

+ Policies on essential medicines.

+ The State directs relevant Ministries and Departments to coordinate with the Ministry of Health to implement the national policy on essential medicines. Implement support measures so that all people, including the poor, ethnic minorities in remote and mountainous areas, can be adequately supplied with essential medicines for disease prevention and treatment.

+ The healthcare sector is responsible for establishing and issuing lists of essential medicines, periodically reviewing and supplementing them every 3 to 5 years to suit the disease model, economic and social conditions of Vietnam, and advances in science and technology in treatment.

+ Issue a national list of medicines based on criteria suitable for the disease model and treatment methods in the country, highly effective, safe, easy to use, and suitable for treatment at each level.

+ Policies on antibiotics.

Antibiotics play a very important role in treatment, especially for the disease situation in a tropical climate country like ours. Standardizing the prescription and use of antibiotics, determining the antibiotic resistance of certain pathogenic bacteria, creating conditions for medical facilities to be able to perform antibiotic susceptibility testing. The Ministry of Health together with the Ministry of Agriculture and Rural Development promulgates regulations on the use of antibiotics for livestock to avoid the increase in drug resistance of certain pathogenic bacteria to humans.

+ Establishing a Drug and Treatment Council at hospitals along with the issuance of standard treatment protocols. Issuing the National Pharmacopoeia as a legal document for drug use, implementing the prescription and sale of drugs according to prescriptions, drug names recorded on prescriptions, printed on drug labels.

2- Ensuring drug quality.

Ensuring that drugs reach patients meeting quality standards and technical standards.

+ Modernizing Institutes and Branch Institutes for inspection to fulfill the function of managing drug quality and raw materials for drugs, while upgrading some inspection stations in key areas to form a system for evaluating drug quality, creating conditions for provincial-level inspection stations to effectively perform their tasks of supervision, inspection, control, and detection of counterfeit drugs.

+ The health sector strengthens the Drug Codex Council to undertake the task of compiling and publishing the Drug Codex periodically, including both modern and traditional medicines, issuing quality control regulations for drugs, establishing a regime to protect patient rights when trying new drugs, strengthening inspection and supervision work, and strictly handling cases of violation regarding drug quality.

3- Production, supply, import, and export of drugs.

Developing, perfecting, and modernizing the Vietnamese pharmaceutical industry and drug supply network to meet the drug needs of the people conveniently, timely, with high quality, reasonable prices, and performing well the work of drug import and export.

+ Planning and restructuring the pharmaceutical industry from central to local levels based on concentration, specialization, focused investment, cooperation among state-owned, collective, and private economic sectors, developing the production of various types of drugs according to plans suitable for requirements in each stage, combining drug formulation plans with raw material production plans. Reorganizing drug production and distribution units under the state sector, forming strong pharmaceutical business organizations.

+ Directing and supporting drug manufacturing facilities to strive to meet Good Manufacturing Practice (GMP) standards. Encouraging domestic production of essential drugs, specialized drugs, raw materials for drugs from various sources (cultivation, processing, extraction), chemical, and biological.

+ Protecting copyright and industrial property rights in drug production.

+ Developing the drug supply network from provinces and cities to communes and villages, focusing on mountainous areas, remote regions. Encouraging various economic sectors to participate in the retail drug network, contributing to drug sources and raw materials for drugs.

+ Only importing types of drugs suitable for Vietnam's disease model and drug policy, implementing measures to protect domestically produced drugs. Cooperating closely with the World Health Organization to obtain necessary information about drugs imported into Vietnam.

+ The Ministry of Health develops and promulgates Good Storage Practices (GSP) standards, encouraging and eventually requiring drug business establishments to meet these standards.

4- Traditional medicine.

+ Promoting and developing traditional medicine. Selectively exploiting family hereditary prescriptions and traditional folk remedies that have been tested and recognized over time. Encouraging and rewarding appropriately in spirit and material terms individuals and units that contribute valuable prescriptions and medicinal ingredients. Strengthening investment and scientific research in the field of traditional medicine, standardizing techniques for preparation, processing, and use of traditional medicine.

+ Planning the development of medicinal plant resources, building cultivation zones for medicinal plants, combining forest conservation with medicinal plant cultivation.

+ Selecting, conserving, and developing medicinal plant varieties and genes, establishing national parks for medicinal plants.

+ Strengthening training and capacity building for traditional medical practitioners, those who produce and prepare traditional medicine, to build a high-quality team of traditional medical and pharmaceutical professionals.

5- Training pharmaceutical personnel.

+ Strengthening pharmaceutical training institutions, primarily universities of medicine and pharmacy, to meet the requirements of improving training quality and expanding training scale reasonably. The Ministry of Education and Training and the Ministry of Health unify quality standards for pharmaceutical personnel training at all levels, expanding postgraduate training.

+ The Ministry of Health, together with relevant sectors, organize the distribution and utilization of pharmaceutical personnel after graduation. Standardizing ethical and professional requirements for healthcare and pharmaceutical practitioners.

6- Information on drugs.

+ Providing accurate drug information through mass media and other appropriate means to healthcare staff, patients, and the public.

+ Incorporating necessary knowledge about drugs into school curricula. Healthcare facilities and medical and pharmaceutical staff must perform their advisory duties on drugs for users.

+ Strictly managing drug promotion and advertising, severely handling organizations and individuals promoting and advertising drugs inaccurately and unethically.

7- Strengthening pharmaceutical management work.

+ Reviewing and assessing existing pharmaceutical legal documents to supplement, amend, and gradually systematize drug-related laws.

Preparing to draft a pharmaceutical law.

+ Strengthening the specialized pharmaceutical inspection force, enhancing the quality of pharmaceutical inspectors.

+ Consolidating state management agencies for pharmaceuticals from central to local levels, strengthening management of drug production, import, export, distribution activities, and drug quality inspections.

+ Coordinating closely the activities of state management agencies with social and occupational organizations to enhance the effectiveness of management.

8- Scientific research, cooperation both domestically and internationally on pharmaceuticals.

+ Promoting scientific research activities on medicines, focusing on researching raw material sources for medicines, formulation techniques, pharmacodynamics, traditional medicine, and encouraging the importation and transfer of modern technologies in medicine production.

+ Establishing scientific research centers for Pharmaceuticals in Hanoi and Ho Chi Minh City. Encouraging state-owned enterprises and private businesses to conduct research on medicines. Implementing appropriate policies for the training, encouragement, and rewarding of scientists who have valuable works in pharmaceuticals.

+ Strengthening cooperation with other countries, primarily those in the region, in scientific and technical research on pharmaceuticals. Taking advantage of support from international organizations, governments, and non-governmental organizations in the development of the pharmaceutical industry and the pharmaceutical sector.