Discussion
With Việt Nam’s many recent achievements in combatting malaria come different challenges in the present decade. In line with a successful intervention effort, coordination between different levels of organization, from municipalities down to villages, is required – an issue faced in the latter of the two phases of the NMCEP’s current 5-year plan. From a MoH report, organizational problems stem from budgetary issues arising from delayed government approval. This is often responsible for the obstacles to providing necessary interventions like ITNs and supplying insecticides that are encountered by communities residing in highly endemic areas. Apart from financial constraints, suboptimal communication and management at the local authority level led to ineffective delivery to the community, especially minority groups living in mountainous and other remote locations (MoH, 2020). For the studied region in the catchment of the Mekong River, declaration of a malaria-free status might also have the undesired effect of desensitizing people to the potential severity of the disease. Perhaps counterintuitively, therefore, the success of the elimination strategy may negatively affect the long-term prevention efficacy.
Recognizing these shortcomings, the MoH has set more aggressive goals for the current 5-year period to combat malaria: to “eliminate locally acquired P. falciparum by 2023” (MoH, 2020). The most effective methods in use at present are ACT, vector control interventions, ITNs, and insecticide IRS. Thus, intensifying these efforts are crucial to enabling the introduction of new strategies for screening and detection that aim to address the challenges of the previous phase. Since the budget shortfall over that period placed a noticeable strain on resources, the approved financial support for 2021–2025 is approximately US$30.7 million per year, doubling the previous plan of US$17.6 million annually (Table 5). In order to raise efficiency further, the plan should be adjusted annually so that flexible funding is available to increase staffing numbers, vector control interventions and treatment provision.
This extra budgetary commitment displays the Vietnamese Government’s intention to assure adequate resources and equipment are made available for all communities to combat malaria. Aside from ITNs and insecticides, extra facilities and appropriately trained staff are also key assets essential for comprehensive coverage and further scientific research (Hung et al., 2002). Additionally, the NMCEP also strives to ensure a more cohesive and unified prevention effort from local authorities by means of thorough instructions to refine, replace and remove the program’s drawbacks (MoH, 2020). Better public education and community engagement can also encourage ethnic groups to participate and thereby suppress malaria transmission.
Since most Mekong Delta provinces have now reached the phase of preventing malaria re-establishment, specific initiatives should be designed and adopted to maintain this status. Considering the influx of short-term, seasonal workers and predicted distraction of residents from malaria prevention, greater emphasis should be placed on educational activities. These outreach activities will not only nurture local authorities’ and inhabitants’ competency to tackle unfavorable situations but also protect high-risk, vulnerable laborers from malaria infection.
