Vietnam Moves to Mandate Chronic Disease Screening to Ease Healthcare Strain
Vietnam is poised to implement sweeping changes to its healthcare system, prioritizing preventative screening for chronic illnesses like lung cancer, COPD, and cardiovascular disease in an effort to alleviate mounting pressure on hospitals and improve patient outcomes. The move, championed by leading medical professionals and government officials, aims to shift the focus from reactive treatment to proactive prevention.
A growing burden of non-communicable diseases is straining Vietnam’s healthcare infrastructure, mirroring a global trend. According to Associate Professor Dr. Vu Van Giap, Deputy Director of Bach Mai Hospital, these conditions – including lung cancer, chronic obstructive pulmonary disease (COPD), and asthma – are placing an increasing strain on the entire health system.
“These diseases usually arise from risk factors that have appeared many years ago, such as smoking, air pollution, or the aging process,” explained Dr. Giap. A particularly concerning statistic is that over 70% of patients are diagnosed at a late stage, when serious complications have already developed. At Bach Mai Hospital, many lung cancer patients arrive with tumors that have already metastasized, eliminating the possibility of curative surgery. However, early diagnosis dramatically increases the chances of a complete cure.
Dr. Giap highlighted a recent case where a small, potentially malignant nodule – less than six millimeters in size – was detected during routine monitoring over two years. Surgical removal revealed stage T1A lung cancer, localized and highly treatable. “In this case, a complete cure was noted without the need for chemotherapy or radiotherapy, only regular monitoring was required,” he stated. “This shows the effectiveness of early detection screening. Patients have the chance of cure, even in diseases that seem like a ‘death sentence’ for cancer.”
The consequences of delayed diagnosis are severe. Without early intervention, patients often face debilitating and costly treatments like chemotherapy and radiotherapy, accompanied by significant side effects such as hair loss, weight loss, and potential organ failure.
To address this critical issue, experts are advocating for a legal mandate requiring screening and early detection of chronic diseases. This would provide a framework for insurance coverage and ensure broader access to preventative healthcare services. Le Thai Ha, deputy director of the Disease Prevention Department, emphasized the importance of early detection alongside comprehensive risk factor assessment. “By identifying risks, we can better understand the factors that can lead to respiratory illnesses, from common to more severe illnesses,” she said.
The proposed measures align with guidelines set forth by the World Health Organization (WHO), focusing on early detection, proactive prevention, and timely intervention. While acknowledging budgetary constraints – even developed nations like Australia, the US, and Europe struggle to screen entire populations – Dr. Giap stressed the need to prioritize individuals with high-risk factors, particularly those related to smoking, a major contributor to lung disease, cancer, cardiovascular disease, stroke, and heart attack.
A key component of the strategy involves strengthening healthcare at the grassroots level, as outlined in Resolution 72. This decentralized approach aims to bring preventative care closer to communities, empowering local healthcare providers to identify and address risk factors early on. For those already exhibiting risk factors, a range of early detection methods are available, but the overarching principle remains: prevention is more effective and economical than treatment.
Ms. Ha echoed this sentiment, stating, “Early detection combined with risk assessment is the key to controlling chronic lung diseases. If we identify risk factors, we can proactively prevent and intervene early – as suggested by the World Health Organization.” This integrated approach will be formalized in the upcoming Disease Prevention Bill and implemented in accordance with Government Resolution 72, signaling a fundamental “shift from treatment to disease prevention.”
Improving screening capacity at the grassroots level, linking health data through electronic health records, and leveraging digital health care technologies are also crucial steps. Dr. Giap envisions a collaborative model where central hospitals provide technology, training, and remote support to local healthcare facilities, ensuring accessible and direct care for all citizens.
The Ministry of Health has identified several priority disease groups, including chronic lung disease, cardiovascular disease, diabetes, cancer, stroke, and chronic kidney disease. To standardize screening, diagnosis, and disease management, the Ministry is developing professional guidelines and collaborating with hospitals like Bach Mai to train grassroots health workers. The goal is to equip every health unit in every municipality and district to monitor population health, identify at-risk individuals, and facilitate timely referrals to higher-level facilities.
By 2035, Vietnam aims for 100% of health facilities to possess the capacity to screen and treat common non-communicable diseases. Effective implementation of the chronic disease prevention program hinges on clear and accessible communication, according to Ms. Ha. “We should not exaggerate to scare people, but give them the reality so that they understand the dangers and can proactively protect themselves. Communication is the first and most important factor for people to understand themselves and their risks.”
Dr. Giap added a crucial element: lifestyle modification. “People need to adopt a healthier lifestyle – eating moderately, exercising more, and controlling their weight. In doing so, they not only protect themselves but also take responsibility for future generations, as cigarette smoke and pollution directly affect children, even in the womb.”
