BANGKOK—Vietnam must eliminate discrimination against HIV/AIDS patients and treat mothers who can transmit the virus to their children, the United Nations World Health Organization (WHO) representative in Vietnam said.
“We need to eliminate that discrimination because this disease is like many serious diseases. It can be treated,” Jean-Marc Olive, WHO-Vietnam representative, said in an interview on World AIDS day.
“The Vietnamese should change their opinion” of AIDS, he said.
“Nowadays, education and communication are very important, and should be…effective, as much as health care treatment and medicine."
In a case that generated an international outcry this year, more than a dozen children living with HIV in Vietnam’s southern Ho Chi Minh City were sent home on their first day of elementary school after other children's parents staged an angry protest at the school gates.
Officials told local media the government had a policy of nondiscrimination against HIV-infected children in schools. They added they had to make several requests for the Mai Hoa Center children's documentation to be processed before they were finally admitted.
Elsewhere in Ho Chi Minh City, Nguyen Thi Nguyet, leader of Thu Duc District's Morning Sun Team HIV/AIDS community education group, said it was common for HIV-infected children to submit school registration applications several times before being admitted.
Around 60,000 children are believed to be living with HIV in Ho Chi Minh City alone, according to the municipal Committee for the Prevention and Treatment of AIDS.
UNICEF representative Scott Damder said his agency is also working to raise awareness around HIV/AIDS.
UNICEF supports “key ministries in programming in schools—for example, a strong curriculum on HIV and sex education to make sure all children have access to knowledge and also understanding how HIV is transmitted,” Damder said.
The program also aims “to give teachers information on how HIV/AIDS is transmitted. So [they] can address the stigma and discrimination,” Damder said.
Vietnamese affected by HIV/AIDS and activists inside the country praised the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), expanded last year to provide U.S. $48 billion in funding around the world through 2013.
The initiative has provided nearly U.S. $88.9 million to Vietnam in fiscal year 2008 to support comprehensive HIV/AIDS prevention, treatment, and care, up from U.S. $65.8 million in 2007.
“Now we can have free medicine provided by the PEPFAR fund…for the rest of our lives,” one Vietnamese HIV patient who asked not to be named said.
“PEPFAR provides free antiretroviral (ARV) drugs for us, as well as medicine for other diseases caused by HIV/AIDS,” the patient said.
Dao Phuong Thanh, director of the Hanoi-based Milk Flower self-help group for people affected by HIV/AIDS, said members of his organization have benefited from the initiative.
“[For] anybody who joins my group, even if they bought ARV medication before, now they don’t have to because they are on the project list and can have medicine for free,” Dao said.
“Only some people who are still working and don’t want to reveal that they have HIV, or people who are unaware of this project, still buy medicine,” she said.
Dao said that in the five years since Milk Flower was established, all of its members have had access to free ARV medication.
“Right now in Dong Da hospital I have a list of 500 people who can have ARV medication for free. I myself have taken ARV medication for five years,” she said.
“My disease developed to stage four, but now I’m healthy like other normal people.”
Education for mothers
Jean-Marc Olive said that in addition to focusing on educating people on how HIV is transmitted, he hopes to help the government expand its program of treatment and funding of ARV medication.
“The programs to reduce the damage of the disease only reach about half of the number of provinces and cities,” Olive said, adding that the funds for such programs are “limited.”
He noted that an increase in the number of patients who require ARV medication is causing an overload for central and local health facilities.
“The priority should be for mothers and their children, because the virus can be transmitted from mother to child. Based on tests, children of 18 months old can also be positive with HIV,” Olive said.
Scott Damder said Hanoi recently approved a “strong” national plan of action to assist children affected with HIV/AIDS.
“[The] plan is to provide access to key support and treatment services for children affected by HIV/AIDS as well as prevention of HIV transmission to children…in terms of mother-to-child transmission,” Damder said.
He said that Vietnam’s rural provinces still lack basic health services, including prenatal care services, making it difficult to prevent mother-to-child transmission.
“That is what we are currently engaged in … reaching 40 out of 64 provinces by the end of next year and hopefully further, in order to enable all mothers with HIV access to measures that will prevent the transmission to their newborns,” Damder said.
High infection rate
According to a report in June 2008 by WHO, UNICEF, and UNAIDS, up to 470,000 of Vietnam’s nearly 86 million citizens are living with HIV.
The report stated that out of an estimated 3,900 pregnant women living with HIV in 2007, only 744, or about 19 percent, received ARV medication required to prevent mother-to-child transmission.
Some 789 children aged 15 years or younger received ARV medication that year.
The report provided no estimate for either the number of children 14 years old or younger living with HIV or the number of children 17 years old or younger orphaned due to AIDS.
Original reporting by Quynh Nhu, Do Hieu and Viet Ha for RFA’s Vietnamese service. Translated from the Vietnamese by Hanh Seide. Vietnamese service director: Khanh Nguyen. Executive producer: Susan Lavery. Written and produced in English by Sarah Jackson-Han and Joshua Lipes.