Prior to 2004, the Vietnamese government’s key approach to drug use and sex work was to ‘rehabilitate offenders’ by placing them in compulsory detention centres for up to two years.
Since 2004, a large-scale harm reduction programme, supported by UK aid and World Bank, has been providing clean needles and syringes for drug users and condoms to sex workers in 32 of Vietnam’s 64 provinces. This has proven to be successful in reducing the number of new HIV infections among key populations.
An independent evaluation† of the programme showed that in the provinces reached by the programme, between 2-56% of new infections were averted between 2004-2009.
The key factor affecting the extent of the success is the level of coverage.
In Hai Phong, one of Vietnam’s largest metropolitan areas, and which had one of the highest level of programme coverage for needle and syringe provision, an estimated 56% of new infections were averted among drug users.
In the same province, the estimated effect (of both needle and syringe and condom provision) is a 39% reduction in the number of new infections among the total population.
Given Vietnam’s rapid development – Vietnam attained middle-income status in 2010 – the UK’s Department for International Development (DFID) is phasing out its aid to Vietnam and plans to conclude Millennium Development Goal related programmes, such as this, at the end of 2013.
If support ends in 2013 without ensuring the programme's continuity, it risks not just leaving a void, but unravelling the progress made on reducing the number of new infections among key populations. Overall HIV infections in Vietnam continue to rise, showing there is a need for scale-up of these evidence-based programmes.
Our 2012 World AIDS Day report recognises the significant contribution the UK government has made to the global HIV response, and how it has been a champion for harm reduction approaches since the 1980s. It calls for a UK blueprint to achieve an HIV-free generation. This current programme in Vietnam is a textbook example of the types of programmes that rely on international aid, and with continued support would help achieve an HIV-free generation – in our generation.
Read the report here and call for a UK blueprint for an HIV-free generation here.
Somebody’s mother, somebody’s brother shows how harm reduction programmes, including needle and syringe provision and methadone maintenance therapy (MMT) are improving lives. This Alliance film features somebody’s mother – Alyona from Ukraine – and somebody’s brother – Nga from Vietnam. View here.
† Wilson.D (2011) Evaluation of the Epidemiological impact of harm reduction programs on HIV in Vietnam, UNAIDS, World Bank