Ethical Failures in the Digital Age: Social Media’s Role in Vietnam’s Herbal and Dietary Supplement Crisis

The Hidden Toll of Digital Misinformation

Vietnam’s cultural reverence for traditional herbal remedies, combined with the pervasive reach of social media, has created a dangerous surge in self-medication with herbal medicines and dietary supplements. Over 52.8% of Vietnamese purchase health products online, with 35.8% engaging in self-medication influenced by social media advertisements. ¹ This trend has led to a growing epidemic of liver and kidney damage, driven by unethical marketing and regulatory lapses. Public figures and unqualified “wellness coaches” often promote these products without accountability, further eroding consumer trust. This editorial analyzes the drivers, health consequences, and ethical failures of this crisis, while proposing urgent, multi-sectoral interventions to safeguard Vietnam’s population.

Vietnam’s Vulnerability: A Perfect Storm

Vietnam’s susceptibility to this crisis stems from a confluence of cultural, technological, and regulatory factors.

Cultural Trust in Traditional Medicine

In Vietnam and many Southeast Asian countries, the longstanding reliance on herbal remedies – valued for affordability, minimal side effects, and natural origin – makes consumers especially vulnerable to misleading health claims. Many products are adulterated with undeclared steroids, heavy metals, or toxic compounds like aristolochic acid, posing severe health risks. ²

Social Media as a Catalyst for Misinformation

Social media platforms like Facebook, Youtube and TikTok amplify unverified health claims through engagement-driven algorithms. A 2017 study found that 72.87% of Vietnamese youths engage with health-related content on Facebook, with 10.93% acting on such advice. ³ Compounding the issue, consumers tend to place trust in user-generated content that appears personal and relatable, even when it lacks medical basis. This misplaced trust leads many to try supplements without professional guidance, reinforcing a cycle of misinformation and risky self-medication.

Public Awareness and the Role of Medical Staff

Many Vietnamese consumers struggle to distinguish between licensed and unlicensed products, leading to unsafe self-medication. Subjective impressions – such as personal trust or spontaneity – often replaced evidence-based judgement. This underscores the urgent need for improved health education led by clinicians.

Devastating Health Consequences: Hepatorenal Toxicity

The unregulated use of herbal medicines and supplements is causing severe organ damage.

Clinical Evidence

Global studies show that herbal and dietary supplements contribute to 20% of drug-induced liver injury cases – a trend mirrored in Vietnam. ² Ingredients such as green tea extract (EGCG) and Garcinia cambogia, often sold online, have been linked to severe hepatocellular damage, sometimes requiring liver transplantation. ² A recent report from Thống Nhất Hospital in Ho Chi Minh City, documented several cases of acute kidney injury in patients with chronic kidney disease who consumed unverified herbal products purchased online—such as rhino horn powder or unlabelled herbal mixtures—leading to acute tubular inflammation and, in one instance, permanent renal impairment despite emergency dialysis. ⁴

Diagnostic and Reporting Challenges

Misconceptions surrounding the safety of herbal products have contributed to diagnostic delays and clinical complications. In several reported cases, patients admitted to Thống Nhất Hospital presented with severe liver and kidney injury but only admitted to prolonged supplement use after extensive clinical investigation. ⁴ Furthermore, the lack of standardized toxicological screening protocols for herbal compounds complicates causality assessment, resulting in diagnostic uncertainty and treatment delays. These barriers significantly undermine timely intervention and increase the risk of progression to multi-organ failure.

Ethical and Policy Failures

The herbal and dietary crisis stems not only from individual misuse but also from systemic failures among public figures, tech platforms, and regulators.

Celebrity Endorsers: A Breach of Trust

Celebrities and social media influencers hold substantial sway over public opinion, yet many endorse unverified products without disclosing financial ties. In May 2025, police arrested the 2021 Miss Grand International winner on charges of misleading consumers: she co-owned and promoted “Kera SuperGreens” fibre gummies that tests found were <1% fibre and functioned mainly as a laxative, harming more than 30 000 buyers. ⁵ Such endorsements exploit public trust, constituting significant ethical violations that directly endanger consumer health.

Tech Platforms’ Negligence

Social media platforms have failed to enforce advertising standards effectively, allowing unverified health claims to circulate widely. Engagement-driven algorithms prioritize popularity over accuracy, inadvertently amplifying dangerous misinformation. While the use of artificial intelligence has been proposed to detect and remove misleading content, this approach faces challenges such as algorithmic bias and lack of transparency – underscoring the need for strong human oversight and ethical safeguards in its deployment.

Regulatory Gaps

Vietnam’s current regulatory framework on supplement advertising remains weak and inconsistently enforced. Although Vietnam’s Decree 115/2018/ND-CP specifically prohibits false health claims, only 19.9% of consumers are aware that online medicine sales are illegal, reflecting major gaps in public awareness and implementation. ¹ Unscrupulous vendors capitalize on these weaknesses, operating anonymously, rebranding frequently, and often avoiding substantial penalties. Compared to stricter oversight in some neighbouring ASEAN countries, Vietnam’s fragmented enforcement leaves its population especially vulnerable.

Solutions: A Multi-Sectoral Approach

Addressing this crisis demands coordinated interventions across regulation, technology, clinical practice, and public education to mitigate risks.

Regulatory and Enforcement Reforms

One of the key and long-term approaches is filling in the gaps of Vietnam’s legal framework. Supplement advertisements should be required to include clear disclaimers, such as “Not evaluated by the Ministry of Health. Consult a doctor before use,” as mandated by Australia’s Therapeutic Goods Administration, to ensure informed consumer decision-making. ⁶ Holding influencers accountable through fines and public blacklisting for promoting unsafe products without transparency, as practiced in Australia, will deter unethical endorsements. ⁶

Tech Platform Accountability

Social media companies must be held responsible for amplifying unverified health claims. Partnerships with tech platforms can enable development of AI tools that flag misleading content in local languages. However, ethical safeguards and human oversight are essential to prevent algorithmic bias and ensure fair enforcement.

Healthcare Provider and System Enhancedments

Clinicians should be trained to routinely inquire about supplement use, enabling early detection of adverse events such as liver or kidney damage. Incorporating supplement-related screening into clinical workflows could reduce delays in diagnosis and treatment.

Public Education and Awareness

National awareness campaigns should use both traditional and social media to promote critical thinking and share real patient stories. Empowering the public to recognize health misinformation is essential to breaking the cycle of self-medication and harm.

Conclusion

Vietnam’s herbal and dietary supplement crisis, driven by social media misinformation, cultural trust in traditional medicine, and weak regulatory enforcement – threatens public health with rising liver and kidney damage. Celebrities and influencers exploit public trust, while tech platforms amplify unverified health claims. Meanwhile, consumers lack awareness, and clinicians often face diagnostic delays due to undisclosed supplement use.

Urgent, coordinated action is needed. Regulatory frameworks must be strengthened with clear advertising rules and accountability for unethical endorsements. A comprehensive response – combining strong laws, responsible tech design, clinical awareness, and informed public engagement – is essential to safeguard consumer health. Vietnam can protect its population from this digital-age epidemic. The time to act is now to ensure health advancements serve well-being, not harm.

Huynh Tran Bao Chau
Faculty of Medicine, VinUniversity, Hanoi, VietnamOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan

Dang Phuc Vinh
Online Research Club (http://www.onlineresearchclub.org), Nagasaki, JapanTaipei Medical University, Taipei, Taiwan

Tran Thanh Long
Online Research Club (http://www.onlineresearchclub.org), Nagasaki, JapanHo Chi Minh City ENT Hospital, Ho Chi Minh City, Vietnam

Tran Thi Anh Thu*
Online Research Club (http://www.onlineresearchclub.org), Nagasaki, JapanPham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam

Truong Ngoc Tham*
Online Research Club (http://www.onlineresearchclub.org), Nagasaki, JapanFaculty of Medicine, Nam Can Tho University, Can Tho City Vietnam

Van Mai Do
Faculty of Pharmacy, Nam Can Tho University, Can Tho City, Vietnam

Nguyen Tien Huy
Institute of Research and Development, Duy Tan University, Da Nang, VietnamSchool of Medicine and Pharmacy, Duy Tan University, Da Nang, VietnamSchool of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
*These authors contributed equally to this work.