Inter Press Service - September 27, 2002
Tran Dinh Thanh Lam

"I used to go out overnight and have sex with customers. Two years later, I discovered I was HIV-positive," Nhung said.

When Nhung became too weak to work, her boss got rid of her. These days, she lies motionless on a dirty bed in the middle of a small room in the outskirts of the city. "Doctors told me that my HIV is turning to AIDS," Nhung said.

Jobless and without a means of supporting herself financially, Nhung's future is grim.

The minimum cost of one month of palliative HIV/AIDS treatment in Vietnam is five million dong (330 U.S. dollars) per patient. Even though relatively cheap by western standards, the cost of hospitalisation in Vietnam is too expensive for Nhung and for the majority of people here living with the disease.

According to figures published by the Joint U.N. Programme on HIV/AIDS (UNAIDS) this year, 130,000 adults aged between 15 and 49 were living with HIV at the end of 2001 in this country of 80 million people. Vietnam recorded 6,600 AIDS deaths in 2001, UNAIDS reported.

Vietnam spends about 50 billion dong (3.3 million dollars) yearly to fight HIV/AIDS, a sum that experts say is well short of requirements.

The country at present has about 100 health centres handling HIV/AIDS clients. But inadequate investment and equipment means that most of them give priority to pregnant women, health workers or wealthy individuals, and ignore destitute people like Nhung.

The Institute for Clinical Research in Tropical Medicine is one of Vietnam's major centres for people with HIV/AIDS. It has a department specialising in providing care and support for the 20 patients who are in permanent treatment there.

"Our biggest concern is lack of funds for purchasing medicine for the treatment of HIV/AIDS patients," said Nguyen Duc Hien, the institute's deputy head.

This problem prevents the institute from receiving more patients, he said, limiting it to offering basic medical advice to people living with the disease.

The high cost of HIV/AIDS treatment using western drugs is also prompting more and more people with HIV here to turn to herbal medicines, with results that some doctors here say remain questionable.

People living in rural and mountainous areas, which have limited access to modern medical services, find in traditional herbs a more convenient, and certainly cheaper, way to treat their symptoms. Today, some traditional healers are saying they can use special kinds of herbal cures coupled with acupuncture to do away with HIV/AIDS.

"For almost twelve months, I have taken hundreds of recipes and endured hundreds of acupuncture sessions without seeing any amelioration," complained 38-year-old Nguyen Than, a HIV-positive man for the last two years who admits he no longer believes in these so-called cures.

Than was lured by a traditional healer who claimed that his cures were not only economical but had no adverse side effects, he said.

Health officials believe that once Vietnam is able to supply more of its own HIV/AIDS drugs, this will have a dramatic effect on the affordability of drugs.

Four companies -- Manufacture, Service and Trade Company (MST), ICA Pharmaceuticals, Medicinal and Biological Factory (MEBIFA) and Ben Tre Pharmaceuticals -- have applied for permission to produce drugs for HIV/AIDS.

Following approval from the health ministry, Ho Chi Minh City-based MST Pharmaceuticals began producing Lamizidivir, a patented drug, in May, although an unresolved matter over royalties has prevented the drug from going on sale. But, industry sources here say the public will have access to the drugs by the end of the year.

The drug, which costs 19,500 dong (1.27 dollar) per tablet, must be taken twice a day. This comes to 927 dollars for one year of treatment.

MST says the price will fall to about 400 dollars per year once the production process is running at full capacity.

"Lamizidivir has been used to treat HIV/AIDS patients in Thailand and India and been considered an effective medication," said Nguyen Vi Ninh, director of the drugs management department. "Its efficacy should be the same when produced in Vietnam," he added.

Luu Thi Minh Chau, deputy chief of the National Bureau for AIDS Control, was more circumspect, saying that the copyright issues relating to internationally patented medicines, protected under world trade rules, remained an unresolved matter for Vietnam and could jeopardise the production of patented drugs at affordable prices.

"The international community allows poor nations to disregard patents on life-saving drugs in emergency situations, but these nations must meet certain criteria such as having 10 percent of the population affected by HIV/AIDS," Chau said, referring to exceptions from intellectual property rights that countries can invoke under public health emergencies.

The HIV prevalence rate in Vietnam is 0.3 percent, which is way below 1.8 percent for Thailand or 2.7 for Cambodia, according to UNAIDS. (END/IPS/AP/HE/PR/TDTL/AAG/02)

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