VIETNAM'S PRIME MINISTER CHAIRS NATIONAL CONFERENCE

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
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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