VZCZCXRO7812
PP RUEHCHI RUEHDT RUEHNH
DE RUEHHM #0739/01 1910950
ZNR UUUUU ZZH
P 100950Z JUL 07
FM AMCONSUL HO CHI MINH CITY
TO RUEHC/SECSTATE WASHDC PRIORITY 2866
INFO RUEHHI/AMEMBASSY HANOI PRIORITY 2044
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHHM/AMCONSUL HO CHI MINH CITY 3068

UNCLAS SECTION 01 OF 02 HO CHI MINH CITY 000739 
 
SIPDIS 
 
SENSITIVE 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: PGOV PREL PREF PINR KREF KHIV VM
SUBJECT: AMBASSADOR VISITS PEPFAR SITES IN SOUTHERN VIETNAM 
 
 
HO CHI MIN 00000739  001.2 OF 002 
 
 
¶1. (SBU) Summary:  During a June 6-8 visit to the Cambodian 
border provinces of Dak Nong, Binh Phuoc and Tay Ninh, the 
Ambassador reviewed local efforts to combat HIV/AIDS and the 
impact of projects funded by the President's Emergency Plan for 
AIDS Relief.  Officials at the Vietnam Youth Corps Drug 
Rehabilitation Center in Dak Nong told the Ambassador that: (a) 
80 percent of the Center's residents are from HCMC; (b) the 
Center follows the HCMC five-year "rehabilitation" plan (versus 
the national mandate of 24 months); and (c) 50 to 60 percent of 
the residents are HIV-positive.  Although roughly 250 of the 
Center's residents have been released within the past year, 
there is no system for tracking and following up these releasees 
to ensure that they are well reintegrated into their 
communities, do not relapse, and receive appropriate medical 
care and counseling.  In contrast, the PEPFAR-funded Life Gap 
Outpatient Clinic in Tay Ninh located in Tay Ninh General 
Hospital appeared to be relatively successful in providing 
community-based services to the province's HIV/AIDS community. 
However, its future is uncertain as the Vietnam Administration 
for HIV/AIDS Control (VAAC) has proposed a "regional" approach 
to AIDS control that may jeopardize future support to this site. 
 End Summary. 
 
Drug Rehabilitation Center in Dak Nong 
-------------------------------------- 
 
¶2. (SBU) During a June 6-8 visit to the provinces of Dak Nong, 
Binh Phuoc and Tay Ninh along Vietnam's border withCambodia, 
Ambassador Marine reviewed local efforts to combat HIV/AIDS and 
the impact of projects funded by the President's Emergency Plan 
for AIDS Relief (PEPFAR).  Established in 2001, Educational, 
Vocational, and Employment Center Number 5 (commonly referred to 
as a 05/06 center) in Dak Nong serves male drug addicts and some 
sex workers; the Dak Nong Center is one of 21 such centers in 
and around HCMC housing drug addicts who are primarily from 
HCMC.  Following the model in HCMC's other drug-treatment 
centers, the Center's program consists of a four to five month 
detoxification course followed by training, educational and 
vocational courses over four to five years.  Eighty percent of 
the Dak Nong center's addicts are from HCMC.  The remaining 
patients are from Dak Nong and neighboring provinces.  Their 
average ages range from 25 to 30.  The Center has a capacity of 
1,750 patients, but currently houses 1,347.  As of June 2007, 
235 residents have been released as part of a release program 
that began in the second half of 2006.  Administrators of the 
facility reported that they plan to release 600 to 700 patients 
this year.  The Center is administered by Dak Nong Province, but 
receives the VND equivalent of USD one million per year from the 
Central Government to cover operational costs. 
 
¶3. (SBU) According to Center administrators, between 50 and 60 
percent of the center's patients are HIV-positive.  The Center 
offers a non-compulsory three-part HIV/AIDS program of 
education, testing and voluntary counseling for its HIV-positive 
inmates.  The initiative is partially funded by the World Bank. 
However, administrators said that the USD 14,000 in assistance 
they receive is insufficient to provide anti-retroviral therapy 
(ART) to participants with AIDS. Center patients infected with 
opportunistic diseases are sent to local hospitals for 
treatment.  Center administrators reported that they do not keep 
statistics on the number of HIV/AIDS deaths amongst Center 
patients, as they are sent to other facilities once they exhibit 
severe symptoms.  They claimed not to have "readily available" 
the number of patients who have been sent away for medical 
treatment. 
 
¶4. (SBU) According to the administrators, after the four to five 
year rehabilitation program is complete, patients have the 
option of returning to their home provinces, or participating in 
job programs at industrial complexes and enterprises with which 
the Center has signed agreements.  Continuing education at an 
HCMC university is also an option if the Center patient meets 
admission requirements. 
 
¶5. (SBU) A Vietnam Youth Corp official based in HCMC claimed 
that of 6,000 individuals released from HCMC's twenty-one 06 
centers thus far, only 43 relapse cases have been recorded. 
However, she acknowledged that follow-up programs are based on 
voluntary participation in social work groups and 
community-based centers.  She could not provide information on 
the number or percentage of releasees who participate in these 
programs. 
 
A Successful Local Program in Tay Ninh 
-------------------------------------- 
 
¶6. (SBU) The PEPFAR-supported LIFE-GAP HIV/AIDS Out Patient 
Clinic (OPC) in Tay Ninh General Hospital offers HIV/AIDS 
counseling, testing, treatment, and peer education, clinic 
Director Truong Thi Dung told the Ambassador.  Its seven-member 
 
HO CHI MIN 00000739  002.2 OF 002 
 
 
staff consists of doctors, nurses, a data manager and a 
pharmacist.  The program also has a doctor stationed at the 
province's 06 center to refer patients who have shown some 
success during the rehabilitation program to the OPC. 
 
¶7. (SBU) The Tay Ninh OPC has been in operation since September 
¶2004.  However, in the center's first year of operation only 60 
per cent of clients tested for HIV returned for their results. 
Subsequently, a team from the Tay Ninh OPC was selected to 
attend the Hanoi School of Public Health's Total Quality 
Management (TQM) training in Hanoi.  Upon completion of the 
training, the number of clients returning for their confirmatory 
tests increased to 95 per cent, which exceeded the clinic's goal 
of 85 per cent.  The Tay Ninh project is one of 23 similar 
initiatives in Vietnam, and showcases the potential improvements 
in HIV/AIDS healthcare after quality management training of 
public health personnel. 
 
¶8. (SBU) Since beginning operations in September 2004, the 
clinic has served 411 HIV-positive clients. (Note: There are a 
total of 1,466 HIV infected cases in Tay Ninh Province, of which 
699 are AIDS cases.  There have been 502 deaths out of 699 AIDS 
patients in the province. End note.) For Fiscal Year 2007, 
PEPFAR is providing USD 300,000 funds for the OPC program.  In 
addition, PEPFAR indirectly provides technical assistance 
through the Hanoi School of Public Health and LIFE-GAP, a 
Ministry of Health organization which was established to 
coordinate, manage and monitor the CDC HIV/AIDS project.  During 
the Ambassador's visit on June 8, the OPC staff reported that 
their current challenge is to obtain sufficient funding for all 
its activities.  Although ART is one of the program's 
components, OPC staff explained that due to a lack of sufficient 
funding, currently only 24 of the 80 ART candidates identified 
by the clinic receive the treatment.  The staff explained that 
traditional/cultural barriers present an additional challenge to 
AIDS testing and treatment, as patients tend to exhibit a 
pessimism that limits their willingness to return for counseling 
and treatment.  The center staff added that stigmatization 
dissuades many from getting tested in the first place. 
 
¶9. (SBU) In his meetings with provincial government leaders as 
well as his visits to the HIV/AIDS and drug treatment centers, 
the Ambassador noted that government leadership on this issue 
needs to be stronger.  More attention needs to be paid to the 
HIV/AIDS epidemic, not only in terms of funding, but also in 
terms of changing public opinion and ending the stigmatization 
of persons suffering from HIV/AIDS.  People living with HIV/AIDS 
need to be brought into the national dialogue on how best to 
approach problems related to care and treatment of the disease. 
He noted that the 06 centers must make HIV/AIDS prevention, 
counseling and treatment programs an integral part of the 
overall rehabilitation program.  Furthermore, tracking and 
follow-up programs to ensure the well-being of those released 
from 06 centers must be better designed, as they are essential 
for the prevention of drug abuse relapses as well as for 
ensuring the safety and health of an HIV/AIDS high-risk group. 
Provincial government officials assured the Ambassador that they 
are fully committed to the fight against HIV/AIDS and to greater 
efforts to minimize the stigma faced by persons living with 
HIV/AIDS. 
 
¶10. (SBU) Comment:  Although the Tay Ninh project is successful, 
its future is in doubt.  PEPFAR and the Ministry of Health (MoH) 
are engaged in negotiations regarding current HIV/AIDS 
programming strategies.  In order to have a more comprehensive 
approach at the systems level, as well as to augment the efforts 
to date, the Vietnam Administration for HIV/AIDS Control (VAAC) 
has proposed to focus on a "regional" geographic approach as 
opposed to a province-specific approach.  The number of 
VAAC/LIFE-GAP sites could be reduced and the Tay Ninh program 
may be a casualty. 
 
¶11. (SBU) Comment continued:  The inability of the Dak Nong 06 
Center to provide comprehensive data on the status of persons 
released from the center is not unusual.  In fact, it reflects a 
broader problem that HCMC and other provincial governments face 
in monitoring and ensuring the well being of former drug abusers 
-- many of them HIV-positive -- once they are released into the 
community.  End Comment. 
SCHWENK