Protecting Player Health: Lessons from Pakistan for Vietnamese Football

Rain fell on the small training ground of the PVF Youth Academy, one of the most famous football training centers in Vietnam. That afternoon, I witnessed a 17-year-old player, named Minh, collapse after a tackle. His face contorted in pain, clutching his left knee. The team doctor ran in, checked briefly, and shook his head. "Suspected anterior cruciate ligament tear," he told the coach. Everyone was silent. I saw the look in Minh's eyes – not physical pain, but fear of a bleak future. Surgery and rehabilitation costs could reach 200 million VND, and Minh's contract was only a trainee contract, without professional health insurance. Thousands of kilometers away, in Khyber-Pakhtunkhwa province, Pakistan, multiple sclerosis (MS) patients are facing a similar situation: the disease is not covered by public health insurance, treatment drugs are too expensive, and they have to pay out of pocket to stay alive. Two stories, two different contexts, but the same pain: the fragility of people when the social support system cannot keep up. In Vietnam, football is on a strong development trajectory. The V-League is becoming more professional, and the national team has achieved success in Southeast Asia. However, the healthcare system for players still has many shortcomings. According to statistics from the Vietnam Football Federation (VFF), dozens of players suffer serious injuries each season, but not all clubs have sufficient resources to cover all treatment costs. Young players from academies often sign trainee contracts with low salaries, and regular health insurance only covers a small portion of major surgeries. Many players have to borrow money or rely on family support, even selling cars or houses to afford treatment. Meanwhile, in Pakistan, according to the 2026 Global Burden of Disease (GBD) study, the age-standardized MS prevalence rate is 9.80 per 100,000 people, and the rate is higher in women, at 12.31 per 100,000. MS treatment drugs, such as interferons or monoclonal antibodies, cost between 500 and 2,000 USD per month. When the Sehat Card Plus health insurance program in Khyber-Pakhtunkhwa excluded MS from its coverage list, patients were forced to pay out of pocket, leading many to stop treatment, the disease progressing severely, causing disability. This is a costly lesson about the consequences of lacking health insurance policies for chronic diseases. From the Pakistan story, we clearly see that excluding a disease from insurance coverage can push patients into dire straits. In Pakistan, the MS prevalence rate is 9.80 per 100,000 people (2026), and women have a higher rate (12.31 per 100,000). MS drugs are very expensive, and when not covered by insurance, patients stop treatment, leading to disability. Similarly, in Vietnamese football, if a player is not insured for injuries, their career could end prematurely. We need a specialized sports insurance system that covers the occupational risks of players, from injuries to illnesses. The lesson from Pakistan is: without policy intervention, the most vulnerable will bear the consequences. Let's look at real costs. According to a study by the Vietnam Sports Hospital, the average cost of anterior cruciate ligament surgery is about 150-250 million VND, not including rehabilitation costs lasting 6-12 months. Without insurance, this is a huge burden. Regular health insurance (BHYT) covers about 80% of medical examination and treatment costs, but many services such as high-tech surgery and intensive physical therapy are not covered. Professional clubs often purchase separate commercial insurance, but the cost is high, and not all clubs can afford it. The VFF needs to establish a player health insurance fund, or require clubs to have mandatory insurance for all players, including young players. I recall a case two years ago, a young player in a central province broke his leg in a friendly match. His club was only a First Division team, with no budget for surgery. His family had to sell a small plot of land to afford treatment. He was lucky to receive help from a philanthropist, but not everyone is so lucky. This shows the injustice in the current system. Players from rural areas, without connections or money, will face great disadvantages when injured. Another blind spot is female players. Vietnamese women's football is developing, but healthcare conditions are much worse than men's. Female players often have lower incomes, shorter contracts, and less insurance coverage. This further increases inequality. If we truly want sustainable football development, we must protect all players, regardless of gender or division. We often take pride in the success of Vietnamese football, but we forget the invisible foundations. Many people think that investing in facilities and coaching is enough, but they forget that player health is the most precious asset. If a player is injured and not properly treated, their career can end, and that is a waste of resources. We praise goals, but rarely look at the silent sacrifices of players behind the stadium lights. They face the risk of injury every day, and when they encounter misfortune, they are often abandoned. It is time for a revolution in thinking: protecting player health is protecting the future of our football. The lesson from Pakistan is a warning: without proper insurance policies, the most vulnerable will suffer. Vietnamese football must act today, before it is too late. I count seconds the Japanese way – not counting down, but counting what remains. And what remains of a football nation is not just trophies, but the health of the people who make it. Rain on that park, memories are never allowed to dry.