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Cablegate: (Sbu) Vietnam's Seventh Pepfar-Supported Methadone Clinic

VZCZCXRO0089
RR RUEHHM
DE RUEHHI #1400/01 3521031
ZNR UUUUU ZZH
R 181029Z DEC 09
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 0627
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 0086
RUEHBK/AMEMBASSY BANGKOK 0158
RUEHC/USAID WASHDC 0035
RUEHDR/AMEMBASSY DAR ES SALAAM 0030
RUEHDS/AMEMBASSY ADDIS ABABA 0030
RUEHGE/AMEMBASSY GEORGETOWN
RUEHHI/AMEMBASSY HANOI
RUEHHM/AMCONSUL HO CHI MINH CITY 0300
RUEHKM/AMEMBASSY KAMPALA
RUEHLG/AMEMBASSY LILONGWE 0027
RUEHLGB/AMEMBASSY KIGALI 0030
RUEHLS/AMEMBASSY LUSAKA 0030
RUEHNE/AMEMBASSY NEW DELHI 0030
RUEHNR/AMEMBASSY NAIROBI
RUEHOR/AMEMBASSY GABORONE 0030
RUEHPF/AMEMBASSY PHNOM PENH 0052
RUEHPH/CDC ATLANTA GA
RUEHPU/AMEMBASSY PORT AU PRINCE
RUEHSA/AMEMBASSY PRETORIA 0030
RUEHSB/AMEMBASSY HARARE 0030
RUEHTO/AMEMBASSY MAPUTO 0030
RUEHUJA/AMEMBASSY ABUJA 0030
RUEHWD/AMEMBASSY WINDHOEK
RUEKJCS/SECDEF WASHINGTON DC

UNCLAS SECTION 01 OF 03 HANOI 001400

SENSITIVE
SIPDIS
STATE PASS TO OGAC AMBASSADOR GOOSBY, MMALONEY-KITTS, JHOLLOWAY
AMEMBASSIES FOR TO PEPFAR COORDINATORS, ESTH, CDC DIRECTORS, AID HEALTH OFFICERS, AND HEALTH ATTACHES
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, OHA 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 PGOV PHUM SNAR KHIV VM
SUBJECT: (SBU) Vietnam's seventh PEPFAR-supported Methadone Clinic
Opens in Hanoi

REF: A. HANOI 578, 406 (2008), 1082 (2007); B. HANOI 1374

SENSITIVE BUT UNCLASSIFIED

REF: A. Hanoi 578, Hanoi 406 (2008), Hanoi 1082 (2007); B. Hanoi
1374

1. (U) Summary. The Ministry of Health of Vietnam (MOH) in
conjunction with the Hanoi Peoples Committee opened a
medication-assisted therapy (MAT) "Methadone Clinic" in Hanoi on
World AIDS Day. U.S.-led innovations, such as the provision of MAT
(including treatment with methadone which is currently serving 1500
patients), are regarded by the government and the international
community as state-of-the-art prevention modalities. End Summary

2. (U) The HIV situation in Vietnam is distinctive because the
behaviors of those who inject drugs drive transmission, which feeds
spread to two other most-at-risk populations: sex workers and men
who have sex with men (REF A). Due to a high degree of stigma and
discrimination, these hard-to-reach populations require well
planned and executed prevention-oriented programs. An estimated
60,000 persons who inject drugs are involuntarily detained in over
100 residential rehabilitation centers, with HIV infection rates
estimated at over 60 percent in some centers. Addressing the
health and social needs of this population remains essential for
effective HIV/AIDS prevention in Vietnam. After the PEPFAR Vietnam
team expended tremendous diplomatic effort and providing
substantial technical assistance to get MOH to operate one center,
which houses 400 injecting drug users, for the last two years. MOH
is poised to expand the MAT approach to 24 centers in southern
Vietnam. PEPFAR supports a comprehensive package of care, in
collaboration with partners.

3. (U) In Vietnam, most view addiction as a moral issue. Our
PEPFAR-supported work concentrates on reducing stigma and
discrimination through promotion of the understanding that drug
addiction is a medical condition. The MAT clinic program is the
first community-based model drug addiction treatment program in
Vietnam. Successful treatment not only helps the individual with
the addiction, but enables family and the community to better
support the person addicted, while reducing crime. This integrated
treatment approach was approved by the Vice Minister of Health, Dr.

HANOI 00001400 002 OF 003


Trinh Quan Huan, on December 12, 2008.

Seventh Methadone Clinic Opens, First in Hanoi

--------------------------------------------- -

4. (SBU) On December 1, 2009 the MOH's Minister of Health Nguyen
Quoc Trieu officially opened Vietnam's seventh "methadone clinic,"
and the first one in Hanoi. This marks the expansion of the MAT
program, using the approved integrated approach to prevention,
care, and treatment. Integration and getting ministries to work
together is a major challenge in Vietnam. The clinic is located
within the Tu Liem district's Preventive Medicine Center and
integrates HIV care and treatment, primary care services, and
methadone in one location. This integrated program is run
according to current international standards of practice. Tu Liem
methadone clinic is one of six clinics to be opened in Hanoi and
will operate seven days a week, including holidays, for dispensing
methadone. Counseling and integrated services will be available
Monday through Friday.


5. (U) For the past year, Hai Phong Province and Ho Chi Minh City
have provided MAT as part of a program of comprehensive services
for persons who inject drugs. These services have been integrated
into the health system of six district locations. Because the HIV
epidemic in Vietnam is driven primarily through injection drug use,
other areas of an individual's life (e.g., medical, emotional,
family and social relations, and employment) are affected, so
additional services need to be available. These clinic services
include counseling, psychosocial support, medical care and
treatment (e.g., for HIV, tuberculosis, sexually transmitted
diseases), including antiretroviral therapy, requiring cooperation
among different service providers. MAT, using methadone, works
well with peer support groups and with other existing prevention,
care, and treatment services.

6. (U) Comment: Although expansion of MAT has been gradual,
requiring persistent technical efforts, backed by vigorous
diplomatic work, we may be at a tipping point, as indicated by
recent signs of increased political commitment from Deputy Prime
Minister Truong Vinh Trong, Chairman of the National Committee of
HIV, Drugs and Prostitution Prevention and Control (REF B). Post
anticipates that being able to directly integrate needle and
syringe distribution and exchange (currently done by partners

HANOI 00001400 003 OF 003


without USG funding) into our prevention activities will increase
program effectiveness. End Comment.

MINIMIZE CONSIDERED
Michalak

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