UNCLAS SECTION 01 OF 03 HANOI 000912

SIPDIS

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: KHIV TBIO PREL PGOV VM

SUBJECT: HIV/AIDS: AMBASSADOR HANDS OVER FY 2007 VIETNAM OPERATIONAL
PLAN TO GVN


1. (SBU) Summary: On May 9, the Ambassador formally presented to
Minister of Health Tran Thi Trung Chien the President's Emergency
Plan for AIDS Relief (PEPFAR) Vietnam Operational Plan for fiscal
year 2007. The Ambassador urged greater GVN coordination to ensure
that HIV-positive individuals residing in "06 centers" (camps for
former intravenous drug users) have access to comprehensive HIV
services; expressed hope that the collaborative development of the
methadone program moves forward; and, expressed appreciation for GVN
efforts under the new HIV/AIDS law to address issues related to
stigma and discrimination, cautioning that much work remains to be
done in this area. Minister Chien responded that the MOH will soon
submit a methadone treatment plan to Prime Minister Nguyen Tan Dzung
for his consideration and agreed with the Ambassador on the
importance of reducing stigma. End Summary.

Handing Over the Plan
--------------


2. (SBU) On May 9, the Ambassador formally presented to Minister of
Health Tran Thi Trung Chien and her colleagues the PEPFAR Country
Operational Plan for fiscal year 2007. The plan calls for improved
counseling, testing and treatment of those suffering from HIV/AIDS
as well as stepped up efforts to prevent the disease's spread.

Counseling and Testing Services
--------------


4. (SBU) In his remarks to those assembled at the ceremony, the
Ambassador highlighted how the plan addresses these areas. For one,
access to quality counseling and testing services is limited
throughout Vietnam in part due to the lack of availability of same
day, rapid testing for HIV diagnosis. PEPFAR is working with the
Ministry of Health (MOH) on rectifying this, and the Ambassador
urged Minister Chien to support the approval of rapid testing for
HIV diagnosis in Vietnam. (Note: Currently, most Vietnamese who go
for HIV testing have to wait days before they get results back. For
its part, the MOH reportedly has hesitated to approve rapid HIV
diagnostic testing because of anecdotal reports that, following

false positive diagnosis, some patients have suffered physical abuse
at home. End Note.) PEPFAR is also helping the MOH to provide HIV
counseling and testing services, as well as working with the
ministry to develop the necessary technical and legal documents,
including national guidelines, and a national training curriculum,
the Ambassador added. These processes are important to ensure
development of standardized national procedures for all programs,
regardless of the source of support.


5. (SBU) The Ambassador urged the MOH to assist the Ministry of
Labor, War Invalid and Social Affairs (MOLISA) and the Voluntary
Youth Force to collaborate more closely on ensuring that
HIV-positive individuals residing in '06 centers have access to
comprehensive HIV services, including antiretroviral treatment.
This includes ensuring that patients who have started treatment in
the community continue to have access once they enter the '06
centers.

Treatment of PLWHA
--------------


6. (SBU) Turning to the subject of treatment, the Ambassador said
the operational plan contains ideas for innovative collaboration
between PEPFAR and the Global Fund. During last year's operational
planning, PEPFAR and Global Fund representatives in Vietnam
negotiated an agreement whereby each donor funds specific services
that combine to form a well-planned package of comprehensive
services in 11 provinces. This model would make optimal use of
donor resources to provide higher quality, more comprehensive
services to more people in more provinces than either program could
do alone, the Ambassador told his MOH counterparts.


7. (SBU) PEPFAR is doubling our financial support for treatment of
HIV/AIDS, with over USD 21 million allocated for the treatment
program, nearly USD 10 million of which will be used to purchase,
import, distribute and effectively manage storage of antiretroviral
drugs, the Ambassador noted. PEPFAR is committed to support the
GVN's goal of providing treatment for 70 percent of people living
with HIV/AIDS (PLWHA) in need by 2010, the Ambassador added. In
addition, the plan provides for an expansion of pediatric treatment
to at least 1,200 children by the end of this fiscal year in
collaboration with other organizations, such as the Clinton
Foundation. To achieve this goal, the capacity for early infant
diagnostic testing in Vietnam must be expanded as soon as possible.
This standard of care, used worldwide, will save children's lives by
allowing for earlier care and treatment of those infected with HIV,
the Ambassador said.


8. (SBU) The 2007 plan provides increased funding for care of
persons infected with both HIV and tuberculosis in PEPFAR focus
provinces and expansion of services that aim to prevent mother to
child transmission in the highest prevalence provinces in Vietnam,

HANOI 00000912 002 OF 003


the Ambassador continued. On methadone treatment plans, our hope is
that the collaborative development of the methadone program moves
forward so that by the fall, we can start the first person on the
treatment program. The Ambassador told Minister Chien that we see
this program as a crucial milestone for the HIV program in Vietnam
and are pleased to be a part of this groundbreaking work because it
will help bring down drug addiction rates and, in turn, HIV
infection rates. Minister Chien responded that the MOH will soon
submit a methadone plan to Prime Minister Nguyen Tan Dzung for his
approval.

Prevention
--------------


9. (SBU) Since the HIV epidemic in Vietnam remains largely
concentrated among "most at risk" populations, effective HIV
prevention through community-based outreach, programs for youth and
successful substance abuse treatment remain critical to the control
of HIV/AIDS in Vietnam, the Ambassador said.


10. (SBU) The PEPFAR team in Vietnam remains committed to ensuring
that HIV prevention outreach not only raises awareness, but results
in actual behavior change, he stressed. The team is working with
Boston University to launch an evaluation of PEPFAR-supported
outreach in six focus provinces. The information from this
evaluation will help strengthen PEPFAR-supported peer outreach
programs in Vietnam, ensuring behavior change for more "most at
risk" populations.


11. (SBU) Multiple sources indicate that clients of commercial sex
workers comprise the greatest number of new HIV cases in Vietnam,
the Ambassador continued. To lessen potential for such a shift in
the epidemic, PEPFAR remains committed to working with local and
international partners to reduce potential clients' risky behavior.
This summer, multiple health and development agencies will launch
integrated behavior change communication programs targeting
potential clients. This work will stress the importance of men
avoiding risky behaviors, yet will not add to the considerable
stigma already applied to commercial sex workers.

Stigma and Discrimination and Administrative Costs
-------------- --------------


12. (SBU) The Ambassador relayed the USG's appreciation for GVN
efforts under the new HIV/AIDS law to address issues related to
stigma and discrimination. He pointed out that we presently support
two legal clinics to assist HIV/AIDS sufferers with legal services
and are looking to expand these services in fiscal year 2007.
Minister Chien concurred that much work remains to lessen stigmas
associated with HIV/AIDS.


13. (SBU) The Ambassador congratulated Minister Chien for the GVN's
success in bringing the various ministries involved in the fight
against HIV/AIDS together. The "road to success" lies in improving
coordination between the GVN and donors and among the donors. On
administrative costs associated with the fight against HIV/AIDS, the
Ambassador stated that the PEPFAR program is working hard to reduce
the USG's administrative costs for the program in Vietnam, and that
in this plan these costs are 11.5 percent of overall expenditures;
PEFPAR Vietnam's aim is to decrease administrative costs to under
ten percent in fiscal year 2007. Minister Chien responded that she
appreciated these efforts.


14. (U) After the event, the Embassy released a press statement that
received good local coverage. Full text of this statement follows
in paragraph 15.


15. (U) Begin Text.

"US Provides $59 million To Support Vietnam's Efforts to Counter
HIV/AIDS"

In a ceremony at the Ministry of Health this afternoon, Ambassador
Michael W. Marine presented the 2007 Country Operational Plan (COP)
to Minister Chien in support of the Government of Vietnam's HIV/AIDS
prevention, care and treatment efforts. In his remarks, Ambassador
Marine renewed the commitment of the United States to work as
Vietnam's partner in fighting this dreaded disease. "The bilateral
relationship and myriad areas of cooperation our two countries share
are enhanced by our partnership in battling the terrible disease of
HIV/AIDS and its many consequences," the Ambassador said.

The 2007 annual plan lays out how we will spend 59 million dollars
to carry out a joint U.S. and Government of Vietnam vision to
support prevention, care and treatment. The activities described in
the plan have been developed in coordination with the Ministry of
Health and other partners to provide support for priority programs
of action within the Vietnam National Strategy for HIV and AIDS
Control. To strengthen HIV prevention programs, the Office of the
Global AIDS Coordinator has also approved more than $1,000,000 in

HANOI 00000912 003 OF 003


additional 2007 funds that will be used to support different
partners to expand outreach efforts, train more Vietnamese drug
abuse counselors and support programs for youth.

End Text.

MARINE