US embassy cable - 05HANOI223

UNCLAS SECTION 01 OF 03 HANOI 000223 
 
SIPDIS 
 
SENSITIVE BUT UNCLASSIFIED 
 
DEPT PASS USAID FOR ANE/KUNDER AND ANE-SPO BRADY 
DEPT PASS USAID FOR ANE/KENNEDY 
 
E.O. 12958: N/A 
TAGS: EAID, ECON, OSCI, VM, HIV/AIDS 
SUBJECT:  VIETNAM'S PRIME MINISTER CHAIRS NATIONAL CONFERENCE 
ON HIV/AIDS 
 
1.   (SBU) Summary:  On December 31, 2004 in Ho Chi Minh 
City, Prime Minister Phan Van Khai chaired a National 
Conference on HIV/AIDS, the first such meeting he had ever 
attended.  Co-chairing the conference were Deputy Prime 
Minister Pham Gia Khiem and the Ministers of Health, Labor 
and Public Security.  Representatives of provincial health 
departments and of international organizations working in 
HIV/AIDS also joined ministry officials in discussing 
achievements from 2004 and strategic plans for 2005. 
Following presentations by the ministries and representatives 
from the international donor and NGO community, the Prime 
Minister delivered a strong statement supporting HIV/AIDS 
activities, calling on all ministries and sectors to make 
2005 a year of focused action on HIV/AIDS.  Coordination on 
this complex issue remains a problem for the GVN.  End 
Summary. 
 
HIV/AIDS Context in Vietnam 
--------------------------------------------- --- 
 
2.   (U) Minister Tran Thi Trung Chien of the Ministry of 
Health (MOH) began with a presentation on HIV/AIDS 
epidemiology in Vietnam, including prevalence, distribution 
and projections.   According to MOH data, 56 percent of HIV- 
infected cases are among intravenous drug users (IDU) and the 
number of HIV-infected people between the ages of 20 and 39 
accounts for almost 80 percent of total cases.   MOH 
estimates also indicate that by the end of 2004 there were 
198,000 - 284,000 infected persons in Vietnam.  By 2010, MOH 
estimates that there will be 267,000 - 356,000 people living 
with HIV/AIDS in Vietnam. The fifteen provincial level 
entities with highest HIV prevalence rate (in descending 
order) are Ho Chi Minh City; Quang Ninh; Hanoi; Haiphong; An 
Giang; Dong Nai; Baria-Vung Tau; Nghe An; Can Tho; Dong Thap; 
Hai Duong; Lang Son; Thanh Hoa; Khanh Hoa; and, Kien Giang. 
 
3.   (U) Minister Chien also reviewed GVN successes and 
challenges in its effort to control HIV/AIDS.  She described 
as a key achievement the Prime Minister's approval of the 
first National Strategy on HIV/AIDS Prevention and Control 
and subsequent coordination of different ministries and 
sectors to develop the nine Programs of Action of the 
National Strategy.  She reported that MOH had primary 
responsibility for coordinating the national program under 
its new HIV/AIDS Prevention and Control General Department. 
Minister Chien reviewed programs and funding that Vietnam has 
or intends to implement with international assistance, citing 
the USAID-supported Policy Project, CDC's Life-GAP program, 
and funding from the President's Emergency Plan for AIDS 
Relief (Emergency Plan) as separate resources that have been 
mobilized. 
 
4.   (U) The key challenges and opportunities presented by 
Minister Chien included:  the improvement of the legal 
framework supporting policies and activities in prevention, 
intervention, care and support; the participation of and 
consensus among different ministries and sectors; and the 
lack of sufficient human resources to implement the National 
AIDS Program.  She also highlighted the limited 
antiretroviral treatment currently available to AIDS 
patients. 
 
Current Situation in 05/06 Rehabilitation Centers 
--------------------------------------------- ---------------- 
--------------------------- 
 
5.   (U) Minister Nguyen Thi Hang of the Ministry of Labor, 
Invalids and Social Affairs (MOLISA) reported on the HIV/AIDS 
situation among drug users and sex workers currently in the 
GVN's 05/06 rehabilitation centers (Note:  These 
rehabilitation centers are mostly under the management of 
MOLISA through their relevant provincial Department of Labor, 
Invalids and Social Affairs (DOLISA) although some are 
managed by local Provincial People's Committees.  The 05 
centers detain commercial sex workers and the 06 centers 
detain IDUs.  Although not in all cases, residence in these 
centers is for the most part involuntary.  Rehabilitation 
programs last for one to two years.  End Note.)  Minister 
Hang shared concern over the fact that the number of 
individuals detained in the 05/06 centers has been 
increasing, and HIV infection among IDUs in the 06 centers 
had increased from 7.8 percent in 1996 to 50 percent in 2004. 
She also noted with concern the high rate of infectious 
diseases among HIV infected persons in the centers.  Hang 
stressed the need for increased training to raise awareness 
and improve understanding about HIV prevention and 
intervention among local leaders and 05/06 center staff.  She 
emphasized the importance of eliminating stigma and 
discrimination against persons living with HIV/AIDS (PLWHA). 
(Note:  MOLISA's Department of Social Evils Prevention (DSEP) 
has primary responsibility for combating "social evils" such 
as prostitution, drug use and trafficking of women and 
children.  Until recently, government policy defined HIV/AIDS 
as a social evil.  While this ordinance has not officially 
changed, the GVN stance has and leaders are now beginning to 
address social perceptions of persons with or affected by 
HIV/AIDS. End Note.) 
 
The Development Challenge 
--------------------------------------------- 
 
6.   (U) Jordan Ryan, UN Resident Coordinator in Vietnam, put 
MOH estimates in context, reporting that by 2003 year-end 
estimates, one in every 75 Vietnamese households had a family 
member living with HIV/AIDS.  Ryan warned of the real threat 
to future development if the spread of HIV/AIDS in Vietnam 
remains unchecked.  He also praised the GVN for the quality 
of the National Strategy for HIV/AIDS, for the President Tran 
Duc Luong's highly publicized meeting with a group of PLWHA 
in late 2003 and for continued attention focused on HIV/AIDS 
by PM Khai.   In addition to general recommendations for 
continued development of HIV/AIDS management and leadership 
in all sectors and all levels, Ryan underscored MOLISA 
Minister Hang's appeal for addressing stigma and 
discrimination, especially in three key areas:  employment, 
education and health services. 
 
Conclusions of the Prime Minister 
--------------------------------------------- --------------- 
 
7.   (U) Prime Minister Khai spoke at length about the 
HIV/AIDS problem in Vietnam, acknowledging the seriousness of 
the situation.  Noting the rapid gains Vietnam has made in 
economic growth, improvements in the quality of life and in 
poverty reduction since adopting its "Doi Moi" policy in 
1986, he emphasized weaknesses in Vietnam's HIV/AIDS 
prevention efforts and interventions.  He openly acknowledged 
that educating young people on their sexuality and HIV/AIDS 
is necessary to improve the effectiveness of HIV prevention 
efforts.  He also spoke frankly about commercial sex, 
recognizing its expansion as a problem and remarking upon the 
lack of health services and prevention and treatment efforts 
dealing with that population.  He stressed that as an 
effective method for prevention of the HIV infection, condoms 
should be cheap and very widely available.  Finally, he 
stressed the problem of stigma and discrimination against 
PLWHA, and called for further action in this area. 
 
8.   (U) The Prime Minister went on to acknowledge that 
HIV/AIDS prevention and control must be considered as a 
social development priority in order for Vietnam to preserve 
the gains it had made.  He proclaimed 2005 as the Focused 
Year for HIV/AIDS Prevention and Control.  He stressed that 
the response to HIV/AIDS was not a matter limited to the 
health sector or the MOH, and called for mobilizing the 
entire political and social system, including all ministries, 
mass organizations and communities, to participate in 
HIV/AIDS activities. 
 
9.   (U) Comment:  The Prime Minister's participation in this 
conference and his remarks clearly place HIV/AIDS as a top 
priority for the GVN.  USG increase in HIV/AIDS funding this 
year under the Emergency Plan is timely and the USG HIV/AIDS 
strategy and proposed activities in Vietnam match well the 
priorities that PM Khai mentioned.  Under the Emergency Plan, 
funding and support will be targeted in the most affected 
provinces and at the highest-risk groups, including sex 
workers and intravenous drug users.  In particular, new 
partnerships will be crucial to assist the GVN with its ARV 
treatment goals and with care and support of vulnerable 
children and people infected and affected by HIV/AIDS. 
 
10.  (U) Comment continued.  The Mission's Emergency Plan 
team shares the GVN's concerns about the high prevalence of 
HIV in the 05/06 rehabilitation centers and the care and 
treatment needed for persons in the centers living with 
HIV/AIDS.  This year, the USG plans to coordinate with 
organizations that are working in the centers and is 
preparing to start programs that will address the care, 
treatment and prevention needs of persons transitioning out 
of the centers.  Another critical area raised by the Prime 
Minister that is a priority in the USG's HIV/AIDS strategy 
for Vietnam is the need to address stigma and discrimination 
issues for persons living with or affected by HIV/AIDS. 
 
11.  (SBU) Comment continued. While the Prime Minister 
thanked the UN, bilateral and international NGO partners for 
their continuing support in HIV work in Vietnam, Health 
Minister Chien's presentation of international HIV/AIDS 
assistance revealed a continuing misperception of the 
Emergency Plan as a new program that is separate from 
previous USG-supported HIV/AIDS partnerships and activities. 
Post has been working to stress the message that the 
Emergency Plan is an increase in funding to existing partners 
with an emphasis on coordination across agencies and an 
expansion to new activities.  Another priority emphasized by 
GVN officials was the participation of different ministries 
in HIV/AIDS activities and the need for increased support and 
planning within ministries.  The Prime Minister's call for 
HIV/AIDS education in the secondary school curriculum 
underscores his point that HIV/AIDS is not a health sector 
problem alone.  At present, however, the role and active 
participation of ministries and agencies outside the health 
sector is still limited. The Emergency Plan team at post 
continues to push for greater involvement of and 
communication with an inter-ministerial body to facilitate 
planning and implementation and to coordinate HIV/AIDS 
activities across agencies.  End Comment. 
 
MARINE