From 2013 onwards, foreign aid for Vietnam’s HIV/AIDS Prevention and Treatment programs is to be cut back, with no sign of ‘recovering’ after 2015, which greatly concerns those involved and affected by it.

With Vietnam’s apparatus of HIV/ AIDS prevention and treatment relying almost entirely on foreign financial support in the past many years, this cutback can have a big impact.

Tuoi Tre reporters had an interview with Bui Duc Duong, deputy head of the Health Ministry’s HIV/AIDS Prevention and Treatment Bureau on this issue.

According to Duong, several other countries also face this setback.

Vietnam’s long-time sponsors include the US President’s Emergency Plan for AIDS Relief (PEPFAR), the Asian Development Bank (ADB), the World Bank (WB) and the British government.

These sums have considerably aided the country in expanding its provision of antiretroviral (ARV) drugs to HIV/AIDS patients, keeping the number of new cases in check, thus slowing down the growth of the plague, with the number of new cases declining every year since 2008, Duong said.

However, PEPFAR, Vietnam’s major sponsor, recently announced that they would gradually cut down on its aid for Vietnam from 2013 onwards in antiretroviral (ARV) drugs and diagnostic bioproducts, and move towards providing only technical support.

Duong added that WB would have ended its aid in 2012 but later extended to next year.

The two projects that last to 2015 are those by the Global Fund and PEPFAR.

Asked about how to tackle this problem, Duong said that Vietnam has established its own HIV/AIDS prevention and relief programs, drawing its finance from central and local budgets apart from international assistance.

From now to 2015, the budget approved for the programs, which totals VND 3,700 billion (US$ 180 million), can only partially meet the demands, as the expenses are exorbitant, ranging from public propaganda to the use of methadone and other alternative therapy.

The HIV/AIDS Prevention and Treatment Bureau is also building its projects to boost the foreign financial support from 2015 on.

For the time being, efforts are currently made to maintain and increase patients’ access to ARV drugs and supply diagnostic bio-products among other things.

“With limited resources, we should minimize costs along with integrating the HIV/AIDS prevention and treatment programs into our current medical sector,” said Duong.

“The current shortcomings include lack of organization in the service providing system at a number of localities, as there are several projects with different goals simultaneously,” Duong added.

The Bureau recently cooperated with localities to make sure readily accessible, long term and low-cost services to patients.

Once indirect expenses are cut, priorities such as medicine for patients will be paid more attention to, along with support from the medical insurance system and policies to boost domestic medicine production and cut down on medicine prices.

“I think three years’ preparation is enough for us to develop our projects to mobilize resources for the post-2015 period,” Duong noted.

He further added that one of his major concerns involved human resources.

“As several projects are to be terminated, well-trained social workers distributing medicine and propagandizing will not be paid,” Duong explained.

Though public counseling centers now belong to local medical centers, their connection remains loose, and the personnel are paid by project sponsors, which means many of them with incomparable skills will lose their jobs,” Duong elaborated.

“For better results, we have to make sure the treatment of HIV/AIDS patients is paid as much attention as that of those with chronic illnesses such as diabetes and heart disease,” Duong said.

“To do so, local People’s Committees are to play a bigger role, dedicating to the tasks for the patients’ sake.”

Duong admitted the fact that the connection between the prevention and treatment of HIV/AIDS and the medical system at several localities remains loose and arbitrary, with the staff doing the job as a part time job only.

Patients comes to the Center for Preventive Medicine of Binh Thanh District in Ho Chi Minh City for professional consultation, examination and treatment of drug addiction by using methadone. Photo: Tuoi Tre.

Limited access

According to the Ministry of Health’s Bureau of HIV/AIDS Prevention and Treatment, there are currently over 200,000 Vietnamese having HIV.

Among them, 150,000 need ARV treatment.

As required by the national HIV/AIDS program, 70% of them, or 105,000 people, are supposed to gain access to the medicine.

However, in reality, till 2012, only 67,000 patients have this access.

Of the VND 3,700 billion (US$ 180 mil) dedicated for the prevention and treatment of HIV/AIDS in the 2012-2015 period, VND 1,700 billion came from the central budget, 980 local budgets, VND 705 billion in foreign aid and VND 245 billion from other legal sources, according to the statistics provided by the bureau.

The ultimate goals are to continue supplying ARV drugs to the current recipients and increase the number of new recipients, along with expanding provision of free, readily accessible HIV tests, training personnel and improving the treatment quality.

Also according to the bureau, the ratio of Vietnamese HIV/AIDS patients being treated with ARV is lower than other countries in the region.

Even in Cambodia, up to 90-95% of the patients can gain access to ARV.