National and Regional Program Overview
Initiated in partnership with the WHO in 2017, the Mekong Malaria Elimination (MME) Program is the most wide-ranging and detailed action plan ever instigated to target malaria in the region. This program is followed by all six countries of the GMS, with the vision of each becoming free of malaria and recurrent threats by antimalarial drug resistance (WHO, 2015). Its primary goal is eradication of P. falciparum by 2025 and of all malaria by 2030. The rationale behind the urgency to eliminate P. falciparum is the emergence of multidrug resistance by this species, particularly to the first-line artemisinin-based combination therapy (ACT), that has been spreading throughout Southeast Asia (Ashley et al., 2014; Packard, 2014). To emphasize this point, up to 55% of P. falciparum-infected cases in GMS are fatal, while P. vivax is also considered a potent threat as it is identified in most malaria-endemic GMS districts (WHO, 2015). At the outset of the program, two other objectives were to minimize infection rates to less than one case per 1,000 exposed individuals in high-transmission areas by 2020 and to prevent the reintroduction of malaria in areas where it has been already eliminated. In order to achieve these targets, regional and country-level interventions have been customized predicated on local epidemiology, with two successive phases: transmission reduction; and elimination. The WHO provides a framework for communication between GMS partners, advocates cross-country collaboration, facilitates training, offers technical support, and enables monitoring and evaluation of national malaria plans.
North Vietnam initiated its first unofficial Malaria Eradication Program between 1958–1975 (MoH, 2011). After the 1975 reunification with South Vietnam, the program was expanded nationwide. Thereafter, it underwent several amendments to its targets, from eradication to elimination due to post-war effects, then downgrading to a control strategy after several malaria outbreaks in 1991 (Hung et al., 2002). Subsequent to these emergency responses, the program was given its current name – the NMCEP – by the Ministry of Health (MoH), with an aim to eliminate malaria by 2020 through strict adherence to WHO guidelines. This program applied vector control, combining long-lasting insecticide-treated bed nets (LLINs), long-lasting insecticide-treated hammock nets (LLHNs), conventional insecticide-treated nets (ITNs), and indoor residual spraying (IRS) (WHO, 2018). Recently, under the supervision of the 2017 MME Program, the MoH revealed an extension of the NMCEP to operate from 2021 to 2025, targeting new goals and building on to the accumulated successes of previous years. With five specific objectives and 13 targets, this program is devoted to eliminating locally-acquired P. falciparum by the end of 2023, which demands more intensive interventions and necessitates additional proactive measures (MoH, 2020).
