InterPress News Service (IPS); Monday, 27 October 1997.
Satya Sivaraman

Five years later, as interest of foreign investors in Vietnam is beginning to wane for various reasons, there are few signs of a letup in the march of the dreaded disease.

"The spread of the disease in Vietnam is still in its early stages compared to Thailand and Burma but the rate of growth is worrying," says a United Nations official based in Hanoi.

According to official Vietnamese estimates, about 100,000 Vietnamese would be carrying the deadly virus by the end of the year. And if the trend continues, Vietnam will have close to 350,000 people with HIV by the year 2000.

The estimates are based on voluntary and anonymous blood testing around the country--known as sentinel surveillance-- which is conducted twice a year. The first known HIV case in Vietnam was recorded seven years ago.

Peter Piot, executive director of the UN Joint Programme on AIDS, said between five and seven million people are estimated to be living with HIV in the region's 22 countries.

"This is fast becoming the region with the most HIV infections in the world," he said in his address at the Fourth International Congress on Asia and the Pacific in Manila.

"The AIDS clock in Asia's most populous countries is clearly ticking fast. These countries can afford the cost of preventive care today, but would not be able to afford a widespread epidemic," he said on Sunday.

In Vietnam, authorities worried about the rapid spread of the pandemic announced in August new measures to improve their ability to detect and control carriers of the HIV virus.

The official Vietnam News Agency said the National HIV/AIDS Committee had been tasked with new responsibilities "for controlling HIV/AIDS patients" and asked to exert greater efforts to detect and prevent the spread of the disease.

The report said that centres for treating patients would be established in provinces where incidence was high and trial treatment using the drug AZT conducted.

It said the number of affected persons had soared in some localities and pointed to Ho Chi Minh City, Hanoi, the central province of Khanh Hoa, and Quang Ninh province in the north as having the highest incidence of HIV.

"One of the reasons for public complacency till now in the fight against the disease in Vietnam has been the belief that only certain high risk and marginal groups are affected," says Ngo Thi Khanh of CARE International, based in Ho Chi Minh City.

According to the United Nations Development Programme (UNDP) in Vietnam, of the total reported cases of HIV infection in Vietnam last year 14.7 per cent were women, well below the global average infection rate of 42 percent for women.

Adding to the impression that only so called `socially deviant' groups are at risk is the fact that nearly 75 percent of Vietnam's HIV cases are intravenous drug users while another 13 percent are commercial sex workers.

Since opening up its formerly centralised economy to foreign investment in the mid-80s, Vietnam has seen billions of dollars pouring into the country but also undergone a spurt in drug abuse and prostitution.

As a corrective measure during the past year Vietnamese authorities have carried out campaigns against `social evils' but on the HIV/AIDS front, propaganda work does not emphasise enough the fact that the general population is also equally at risk.

Vietnamese officials admit that knowledge of HIV/AIDS is poor in the rural areas of Vietnam where 80 percent of the population and most of the country's 53 ethnic minorities live. The attitudes of local authorities is also a problem, with many of them seeing participation in AIDS awareness programmes as endorsement of `decadent' lifestyles.

In the case of intravenous drug users, for example, it was only very recently that authorities gave the green light for two `clean needles' pilot projects aimed at preventing dangerous sharing of needles in urban `shooting galleries'.

Until recently anyone caught with a needle or syringe was locked up in rehabilitation centres, and treated more as a criminal than a patient in need of help. Estimates of the number of addicts in Vietnam run to 180,000 a number that is rising, especially among the youth.

Apart from such cultural and social prejudices, a major constraint in the battle against HIV/AIDS in Vietnam is also the shortage of skilled health workers and financial resources to maintain them.

At a recent meeting of the National AIDS Committee, members called on the government to increase its annual budget for the anti-AIDS campaign to nine million dollars from the current 5.5 million dollars.

UNDP launched last year a two-year project aimed at enhancing Vietnam's capacity to mobilise, plan and co-ordinate its policies and programmes in HIV/AIDS prevention and care.

The one million dollar programme, apart from supplementing scarce government funds, will also provide technical assistance to key ministries, the national Women's and Youth Unions, provincial AIDS committees and NGOs.

Among the projects undertaken are the setting up of HIV/AIDS clinics, advice centres for use of condoms and needles and training in the safe handling and storage of blood.

"Strong government leadership on HIV/AIDS, an equitable, open and supportive social environment, and sound peer-group education programmes are three planks to a highly effective platform of response," says Steve Kraus from UNAIDS, which brings together efforts of the UNDP, WHO, UNICEF, UNFPA, UNENSCO and the World Bank in AIDs-related work worldwide.

It is estimated that actual deaths from full blown AIDS by the year 2000 will reach 17,000 from the 1989 recorded at the end of 1996.

For the Vietnamese government mustering the political will to launch an all out war against the HIV/AIDS pandemic is of paramount importance to protect its human resources already devastated by decades of conflict in the region.

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IP971008

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