<p>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.</p>