Vietnam: Targeting HIV/AIDS and Avian Influenza

The United States Agency for International Development (USAID) began supporting HIV/AIDS programs in Vietnam in the mid-1990s.  In June 2004, Vietnam became the 15th focus country under the President’s Emergency Plan for AIDS Relief (PEPFAR).  Since then, USAID support for HIV/AIDS programs has become an integral part of the PEPFAR Vietnam program planned and implemented by four U.S. government agencies: USAID, Health and Human Services/Centers for Disease Control and Prevention, the U.S. State Department and the Department of Defense.  USAID works through implementing partners comprised of nongovernmental organizations, civil society groups, and mass organizations to deliver prevention, care and treatment services, and advocate for policies that will improve access to HIV/AIDS services and strengthen the health system.

Targeting At-Risk Populations
In coordination with the other U.S. agencies, USAID supports comprehensive HIV interventions to prevent HIV transmission among most at risk populations including injecting drug users, commercial sex workers, and men who have sex with men.  Clinical and home based care and treatment initiatives allow partners to extend lives, improve health and increase quality of life for those infected and affected by HIV, including orphans and vulnerable children.  USAID implements its HIV/AIDS program through six primary and 28 sub-partners. Based on epidemiology and collaboration with the host government, USAID’s HIV efforts are currently directed in seven provinces: Hanoi, Hai Phong, Quang Ninh in the North; Nghe An in the Central region; and Ho Chi Minh City, Can Tho and An Giang in the South and will expand in 2009 to the northwest provinces of Dien Bien and Lao Cai.  In 2008, USAID assistance was $48 million of the total $88 million PEPFAR Vietnam budget, or 54% of the total PEPFAR funding for the country. 

Key PEPFAR Results
PEPFAR has supported life-saving antiretroviral treatment for more than 15,000 people, and provided care to nearly 7,000 orphans and vulnerable children last year alone.   USAID’s HIV/AIDS programs reach more than 59,000 people affected by the virus in FY 2008.  In May 2008, after two years of planning, Vietnam launched six pilot methadone clinics in Hai Phong and Ho Chi Minh City, funded primarily by USAID, to combat heroin addiction.  Vietnam is the only country employing PEPFAR funds to support medication-assisted therapy.

Avian Influenza
Vietnam was one of the first countries in the world hit by avian influenza (AI) H5N1 outbreaks in 2003 and also reported the world’s first AI human case in that same year.  Since then, Vietnam has experienced more than 3,000 animal outbreaks across the country and has had more than 100 human cases, half of which have been fatalities.  While Vietnam is widely considered to be a model in terms of its response to AI, globally it ranks second behind Indonesia in terms of human cases and deaths.

Preventing H5N1 virus transmission within animals and humans
The United States Agency for International Development (USAID) began supporting AI programs in Vietnam in 2005 and since then has provided approximately US$28 million in assistance and technical support.  USAID works both nationally and in high-risk provinces in the Red River and Mekong River deltas. Specifically, the program helps strengthen national and regional preparedness, planning, and multi-sectoral coordination to prevent transmission of the H5N1 virus from animals to humans.  It also promotes early detection and warning of AI outbreaks and human influenza cases.  This is being done through improvements in the national surveillance system and development of quick-responding community-based surveillance.  When outbreaks occur, USAID has provided training in the public and private sector for rapid and effective response for animal and human cases while promoting public awareness and education on avian and pandemic influenza. Working closely with the Government of Vietnam, USAID’s AI efforts are focused on national level policy and programs as well as in five focal provinces: Can Tho, Ha Nam, Hung Yen, Kien Giang, and Quang Tri.  USAID also supports a large-scale, two-year provincial level operational research project to identify best practices and policy guidance on safe, effective, and sustainable poultry vaccination to limit AI transmission.

Key API Program Results
With USAID assistance, National Strategies and Standard Operating Procedures have been developed and refined and an AI national program monitoring and evaluation strategy was created.  Surveillance and response capacity to rapidly detect and control AI has also been strengthened through training, an upgraded animal health information system and laboratory diagnostic capacity and the sharing of best practices and lessons learned.  Furthermore, civil society is now engaged in communications activities; providing reliable, clear and consistent information about AI to the media and the general public. These activities help form the foundation upon which Vietnam’s successful program rests.