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Cablegate: (Sbu) Pepfar Supports Vietnam's Deputy Prime Minister

VZCZCXRO8971
RR RUEHHM
DE RUEHHI #1374/01 3511107
ZNR UUUUU ZZH
R 171105Z DEC 09
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 0598
INFO RHMFIUU/DEPT OF JUSTICE WASHINGTON DC
RUEABND/DEA HQS WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHAD/AMEMBASSY ABU DHABI
RUEHBJ/AMEMBASSY BEIJING 0079
RUEHBK/AMEMBASSY BANGKOK 0150
RUEHC/USAID WASHDC 0028
RUEHDR/AMEMBASSY DAR ES SALAAM 0027
RUEHDS/AMEMBASSY ADDIS ABABA 0027
RUEHGE/AMEMBASSY GEORGETOWN
RUEHHI/AMEMBASSY HANOI
RUEHHM/AMCONSUL HO CHI MINH CITY 0276
RUEHKM/AMEMBASSY KAMPALA
RUEHLGB/AMEMBASSY KIGALI 0027
RUEHLS/AMEMBASSY LUSAKA 0027
RUEHNE/AMEMBASSY NEW DELHI 0027
RUEHNR/AMEMBASSY NAIROBI
RUEHOR/AMEMBASSY GABORONE 0027
RUEHPF/AMEMBASSY PHNOM PENH 0049
RUEHPH/CDC ATLANTA GA
RUEHPU/AMEMBASSY PORT AU PRINCE
RUEHSA/AMEMBASSY PRETORIA 0027
RUEHSB/AMEMBASSY HARARE 0027
RUEHTO/AMEMBASSY MAPUTO 0027
RUEHUJA/AMEMBASSY ABUJA 0027
RUEHWD/AMEMBASSY WINDHOEK
RUEKJCS/SECDEF WASHINGTON DC

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

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