Viet Nam urged to build up coalition against HIV/AIDS

03 Apr 2002

Ha Noi - Health experts and social workers called for the building up of a coalition including Government and UN agencies, NGOs and people living with HIV/AIDS to reverse the disease during a conference from 2-3 April in Ha Noi.

The conference brought together policy-makers and health experts to discuss the outcomes of the first-ever independent Evaluation Report on the National AIDS Programme (NAP) from 1996 -2001 and recommendations for new strategy to fight HIV/AIDS over the coming years. This evaluation was conducted last year with the support from the UN Development Programme (UNDP) and Australia.

"The major shortcoming of the NPA is the lack of a legal framework and multi-sectoral coordination", noted Vice-Minister of Health, Tran Chi Liem at a conference on HIV prevention last week.

"HIV/AIDS is not just a serious public health concern. It is a vital development issue that requires a comprehensive and multi-sectoral response. The battle against AIDS can be won in Viet Nam but it requires a combination of prevention, education, behavioural changes, appropriate care and support for people living with HIV/AIDS", said Jordan Ryan, UNDP Resident Representative. He emphasized the need for mobilisation of all members of society for a comprehensive national response.

Participants agreed that the number of infections is constantly raising since the first HIV infection was reported in 1990 in Viet Nam, According to official statistics, as of December 2001, 46,334 people in Vietnam have tested positive for HIV, including 6708 who have developed full-blown AIDS and 3691 who have died from the disease. But the real figures might be much higher.

Infections have increased not only among drug addicts, sex workers but also pregnant women and new military groups. This trend has caused concern among health experts that the HIV/AIDS transmission is not just concentrated in high risk groups but has started to spread among the general population.

The Report identified legal environment and social perception as two major barriers to prevention efforts. "Condom use has a great potential to growth in Viet Nam", noted Prof. Pham Bich San, co-author of the Report. "40 million condoms were sold last year but only met about one third of the demand". Although condoms are widely advertised through media, they still suffer a poor image in the public eyes, being associated with prostitution, an illegal activity in Viet Nam. Sex education has started making its way to school but meets resistance from many parents who fear it encourages early sexual activity. "Condom should not be seen as a dirty thing but our saviour", said a representative of Viet Nam's Women Union.

It is estimated that 60% of all new HIV infections in Viet Nam are occurring among injection drug users (IDUs). Concern with arrest for carrying needle has been associated with sharing syringes and other injection supplies.

The Report recommended the NAP develop a country-wide harm reduction programme. The need for a separation of HIV/AIDS issues from "social evils" - drug use and prostitution - was voiced strongly by many participants. "The Government should review and adjust its policy on condom use and clean needles for groups with high risk behaviours", said Prof. Pham Bich San. "NGOs, especially national NGOs should be part of a coalition against HIV/AIDS because they are in best position to reach out to these groups".

AIDS prevention should be not only primary - aimed at reducing the prevalence of new HIV infection- but also secondary - enabling those infected to avoid infecting others and to postpone serious illness. Mobilizing support to those who are ill is crucial to AIDS prevention. Discrimination against various groups in society is a major "risk factor" for HIV transmission, said experts. First, where a disease is associated with retribution and victim blaming, there is a danger of public resistance to funds being spent on it. Second, where intolerance and prejudice exist there is a tendency for groups to be driven underground, making prevention and treatment more difficult.

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