Nguyen Khoi Quan, Andrew W. Taylor-Robinson
This article discusses key social determinants of health and how they have shaped infectious disease patterns in Vietnam from 1975 to 2025. It suggests a “paradox of progress”: the country’s transition from post-war poverty to dynamic middle-income economy has driven a shift from diseases of deprivation to a more complex profile linked to development itself. Economic growth reduces malnutrition and poverty-related illnesses, yet rapid urbanization, lifestyle changes, and inequality fuel rising chronic diseases and some infection risk factors. Vietnam now faces a “triple burden” of communicable, non-communicable, and climate-related threats, underscoring the need for intersectoral approaches beyond biomedical interventions. Vietnam has undergone a social and economic transformation since the end of the war in 1975. In this Perspective, the authors describe how the progress that has alleviated infectious disease burdens burdens associated with absolute poverty has generated new challenges linked to urbanisation, inequality, and lifestyle changes.