In July, zinc for the treatment of diarrhea was officially listed as an essential drug by the Ministry of Health in Vietnam. This capped a two year effort of policy consultations, evidence review and advocacy.  As a result of this listing, by law, zinc must now be made available free of charge to children under five through both the public sector and the private insurance systems.  This should tremendously increase the coverage and availability of this critical intervention.

In 2009, PATH and the Ministry of Health assembled a technical working group to review the evidence for zinc and began the process of educating and mobilizing key stakeholders in the country to build awareness for zinc.  This included leading pediatricians, provincial health authorities, and several division leaders within the Ministry of Health, as well as media outreach.

But establishing a policy was only part of the puzzle.  We also needed to demonstrate how zinc could be effectively scaled-up. Working with public health leaders in Binh Dinh province, in Vietnam's central coast region, we conducted a project to demonstrate approaches to raising awareness and access. To do so, we established oral rehydration therapy (ORT) corners in the hospitals and the commune health centers where mothers and providers were taught the proper use and administration of  zinc, oral rehydration solution (ORS) and other appropriate preventive and treatment behaviors.  This was combined with mass media and public health outreach measures.  The evaluation of the demonstration indicates a tremendous increase in the awareness of zinc and in proper diarrhea management practices.

The policy and the demonstration are both aimed at influencing demand, but we will need to meet demand with supply.  As it happens, a reputable pharmaceutical manufacturer has indicated that now that zinc is listed as an essential drug, they will begin manufacturing and distributing zinc.  They had put in place the necessary manufacturing systems, and were merely waiting for the listing in order to start production.  We believe it has already started.

This project has been successful because of our close collaboration with the National Pediatric Hospital, the Ministry of Health and the Provincial Health Department in Binh Dinh Province.  PATH is grateful for their collaboration and leadership.

-- Evan Simpson, Program Officer for the Enhanced Diarrheal Disease Control Initiative, PATH

For more information:

-- How does zinc help defeat diarrheal disease?

-- DD program implementers, this new WHO resource is for you: "Introducing Zinc in a Diarrhoeal Disease Program"

-- Read more success stories from the field to see how Vietnam is making strides in diarrheal disease control.

Photo credit: PATH