(SBU) PEPFAR supports Vietnam's Deputy Prime Minister

UNCLAS SECTION 01 OF 03 HANOI 001374 SENSITIVE SIPDIS STATE PASS TO OGAC EGOOSBY, MMALONEY-KITTS AND JHOLLOWAY AMEMBASSIES PASS TO PEPFAR COORDINATORS, ESTH, HEALTH ATTACHES, CDC DIRECTORS, AND AID HEALTH OFFICERS HHS/OSSI/DSI PASS TO HHS/OGHA JMONAHAN, MABDOO, ACUMMINGS, CMCCLEAN),NIH/FIC RGLASS, SAMHSA WCLARK, RLUBRAN AND FDA LVALDEZ, BCOREY) USAID FOR ANE CJENNINGS, AND GH GSTEELE, RCLAY BANGKOK FOR USAID/RDM/A OCARDUNER, MSATIN CDC FOR COGH SBLOUT, AND GAP DBIRX, RJSIMONDS, JTAPERO E.O. 12958: N/A TAGS: TBIO EAID SOCI SNAR KHIV VM SUBJECT: (SBU) PEPFAR supports Vietnam's Deputy Prime Minister Trong's Visit to United States to review medication-assisted therapy and methadone production REF: HANOI 578 SENSITIVE BUT UNCLASSIFIED REF: Hanoi 578 ¶1. (U) Summary. With support from the President's Emergency Plan for AIDS Relief (PEPFAR),Deputy Prime Minister Trong of Vietnam visited the United States on November 5-14, 2009 to explore medication-assisted therapy (MAT) for heroin addiction, including the manufacturing of methadone. The visit concentrated on areas of policy development related to illegal narcotic supply and demand reduction, licensing of narcotic medications, and oversight and diversion control of methadone. He returned enthused about expanding MAT services and announced intentions to manufacture methadone in Vietnam. ¶2. (SBU) Comment. In addition to MAT, the PEPFAR Vietnam program currently supports most components of a comprehensive package of interventions for those who inject drugs as recommended by the World Health Organization and United Nations Office on Drugs and Crime (REF). Services currently supported include peer education, voluntary counseling and testing, drop-in centers for social support, drug and HIV education and other community services, palliative care and support. Two of the cornerstones of the prevention package are needle and syringe exchange and distribution (NSED) and MAT services. NSED also helps reduce the impact of other blood-borne diseases (including syphilis, hepatitis B and C). In Vietnam, needle exchange, specifically, is one of the weaker aspects of non-USG-supported NSED efforts by multilateral partners because persons who inject drugs fear being arrested and placed in detention on turning in used syringes. PEPFAR Vietnam is ready to support programmatic improvements and aid with Vietnamese policy development as soon as USG policy is clarified. Though cooperation has come a long way since 2004, developing and implementing MAT programs in Vietnam is extraordinarily challenging and requires patience, perseverance, and political sensitivity. These efforts have aided Vietnam in effectively preventing the spread of HIV while assisting those already suffering from infection. Post remains confident and committed to our overall direction. Further, through these PEPFAR-supported efforts, our team is building lasting bilateral trust and contributes substantially to overall cooperation. End Summary and Comment. ¶3. (U) Vietnam has a real opportunity to prevent the spread of HANOI 00001374 002 OF 003 HIV/AIDS into the general population through drug abuse and addiction prevention and treatment, including advancing harm reduction strategies such as the expansion of MAT. As part of Post's approach to promoting effective interventions to heroin addiction and commitment to further expansion and sustainability of MAT, PEPFAR Vietnam sponsored a visit by Deputy Prime Minister Truong Vinh Trong, Chairman of the National Committee of HIV, Drugs and Prostitution Prevention and Control, to the United States, November 5-14. ¶4. (SBU) The delegation included Vice Minister Trinh Quan Huan of the Ministry of Health (MOH); Major General Vu Hung Vuong of the Ministry of Public Security; Dr. Truong Quoc Coung, Director of the Vietnamese Drug Administration (MOH); Madame Hoang Thi Hien, Deputy Director of the Office of Science, Education and Social Affairs, Office of Government; and Mr. Hoang Van Ke, Vice Chairman of the Hai Phong Peoples Committee. The visit focused on MAT for heroin addiction and manufacturing of methadone. The delegation visited various USG and community-based agencies involved in drug treatment and methadone manufacturers in Washington, DC and New York City, meeting with officials at the White House, State Department, and Department of Health and Human Services to examine all components of methadone production, including policy, licensing, and oversight (from diversion control to clinical implementation, as well as manufacturing, storage and distribution). An overarching goal was to explore the feasibility of methadone manufacturing, thereby increasing political commitment and the sustainability of MAT. According to returning members of the delegation, one of the highlights of the trip was the visit to the Brooklyn Drug Treatment court they met with the presiding Supreme Court Justice. The delegation reported learning about an alternative approach to incarceration and detention, observed cases being adjudicated in court and had the opportunity to ask questions. ¶5. (SBU) The delegation reports that the White House Office of National Drug Control Policy offered continued assistance to the Government of Vietnam with policy development and improvement of coordination functions across ministries on drug issues. Vietnam and Covidien-Mallinckrodt Division, the methadone manufacturer, agreed to initiate discussions on a joint venture for the local production of methadone in Vietnam. The Deputy Prime Minister has assigned Mr. Cuong, Director of Vietnam Drug Administration as point of contact. PEPFAR Vietnam will orchestrate the first meeting by January's end. Vietnam in meeting with other parties agreed to initial mutual interest for future cooperation. The Food and Drug Administration offered to assist the Vietnam Drug Administration in development of policies and protocols regarding methadone licensing and oversight. The Drug Enforcement Administration offered to assist Vietnam's Ministry of Public HANOI 00001374 003 OF 003 Security to address issues related to diversion control and oversight of drug manufacturing facilities. The National Association of Drug Court Professionals offered to assist Vietnam and the Supreme People's Procurators with the development of a drug court in Vietnam. Our PEPFAR Vietnam Team, in consultation with our partners, will explore possible next steps. ¶6. (SBU) On return to Hanoi, Deputy Prime Minister Trong hosted the annual end-of-year celebratory meeting and dinner for the Ambassadors Informal HIV Group. There was an impressive number and diversity of GVN officials represented. He repeatedly praised technical assistance and funding from the USG, with specific mention of his productive recent mission to the United States to study comprehensively policy issues for medication-assisted therapy. He also mentioned both during his speech and at dinner, Vietnam's plans to develop its own methadone manufacturing capacity, asking Ambassadors in attendance for their countries' help with building facilities and to sell them the raw materials at a reasonable price. ¶7. (SBU) PEPFAR currently supports the GVN's MAT program at six sites in two provinces, and the expansion of this service has begun. On World AIDS Day, December 1, Hanoi, the political capital of Vietnam, joined the list as the third province to offer this service. Adding to six others in two provinces, the first site in Hanoi was opened in Tu Liem District and another five Hanoian district sites will open within the next year. The Government is planning to open clinics in 10 more provinces by 2012 and an additional set of clinics in 17 provinces by 2015. Our activities and continued advocacy for this evidence-based program has been successful. The GVN has ambitious plans to offer MAT to 80,000 IDU within three years. MINIMIZE CONSIDERED Michalak