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DE RUEHHI #1400/01 3521031
ZNR UUUUU ZZH
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FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 0627
INFO RHMFIUU/DEPT OF JUSTICE WASHINGTON DC
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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