Vietnam receives $1.5M to counter opioid addiction harms

Vietnam would receive US$1.5 million out of the total of $31 million, Kiira Gustafson, technical director at global healthcare non-profit PATH, said Tuesday.

PATH, which has been working in Vietnam since 1980, is a grantee of Unitaid and will work with local governments and partners in Ho Chi Minh City and the central province of Nghe An to manage the fund.

The money will be used to support the integration of hepatitis C testing and treatment into harm reduction programs and trial the use of two products to prevent infection, low dead space syringes and new, long-acting formulations of buprenorphine, a medicine used in opioid agonist therapy for people with addiction to substances such as heroin.

Low dead space syringes are designed to reduce the amount of blood that remains in the syringe after it has been used, which helps lower the risk of spreading infections when needles are shared.

Slow-release formulations of buprenorphine, an injectable medication that helps reduce cravings and withdrawal from opioids, could be a helpful option for patients who struggle with taking daily oral treatments due to issues like high costs, police harassment and discrimination, according to Unitaid.

According to Gustafson, typically for a person who seeks opioid agonist treatment for drug use disorder, there are two kinds of standards of care, daily methadone and daily sublingual buprenorphine.

But she said this usually means a person has to walk to or get to a clinic every day to take a pill in front of somebody, and this needs a lot of time and energy, which could be challenging for drug users with limited resources and fears of stigma and criminalization.

“So [for] these long-acting formulations, there are weekly and monthly injections. They can completely change people’s lives,” she told VnExpress International, adding that her organization wants to build evidence to understand how to deliver the treatment and its effectiveness, acceptability and feasibility in low- and middle-income settings.

Other recipients of the aid are Egypt, India, Kyrgyzstan, Nigeria, South Africa, Tanzania, and Ukraine.

Unitaid said Ukraine is the only low- or middle-income country that uses the long-acting injectable buprenorphine.

There are various reasons why access to and availability of this treatment is limited in countries like Vietnam, including price and lack of governmental awareness of the product, Karin Timmermans, senior technical manager at Unitaid, said.

“It can be the fact that the product isn’t registered in the country, so it’s not legally available. Or [drug companies] may not have the capacity to produce enough for the whole world, or they may want to focus intentionally on high-income countries where they can have a higher margin.’’

According to official estimates made in 2021, over 900,000 people live with chronic hepatitis C infection in Vietnam, while 6.6 million people live with chronic hepatitis B infection.

Hepatitis, a liver inflammation, is a leading cause of liver cancer.

The health ministry said cirrhosis and liver cancer will continue to rise if diagnosis and treatment of hepatitis B and hepatitis C is not rapidly expanded. It is estimated that over 50,000 people living with HIV have chronic hepatitis C.

Medicines for hepatitis C are still very expensive in Vietnam, and very few have access to treatment covered by health insurance.