This post includes portions of the introduction, questions, and answers from the English edition of "Transition Forward, Issue 1, June 2013" (PDF). 

Vietnam has made significant progress in re­cent years responding to the country’s HIV & AIDS epidemic. Under the ongoing leadership of the Government of Vietnam (also known as Viet Nam), the interna­tional community has provided significant technical and financial support to the HIV & AIDS program. As country leadership and ca­pacity to address the HIV epidemic has been strengthened, and as Vietnam’s economy grows stronger, increasing emphasis is being placed on transitioning to a sustained country-led response.

This includes strengthening the health system and civil society, particularly to reach those most at risk.

The United States President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest sup­porter of Vietnam’s HIV & AIDS program. Through the United States Agency for Inter­national Development (USAID), PEPFAR recently established the Leadership, Manage­ment and Governance-Transition Support Project (LMG-TSP) to help inform an evi­dence-based approach to transition.

LMG-TSP is producing a series of papers, called “Transition Forward”, to highlight per­spectives, questions and achievements related to the transition process from the point of view of a variety of stakeholders.

In the first issue of “Transition Forward”, two people living with HIV (PLHIV) -- Dong Duc Thanh, community liaison officer of the USAID Pathways Project, and Huynh Nhu Thanh Huyen, founding member and leader of the Southern Network of People Living with HIV (SPN+) -- respond candidly to questions on sustaining an effective HIV & AIDS response in Vietnam. Here are excerpts of their answers:

What do you feel has been the major contribution of donors to the well-being of people living with HIV (PLHIV) in Vietnam over the last 10 years?

Thanh:

“For the past 10 years, international donors—particularly PEFPAR—have sup­ported us with programs such as anti-retroviral (ARV) treatment. When ARVs were not available, PLHIV had high rates of opportunistic infections, their health degraded quickly, and their mortality rate was high. This led to a bad image and reputation for PLHIV and resulted in stigma and dis­crimination.

When ARVs became available in Vietnam, we had opportuni­ties to prolong life and allow PLHIV to continue working and contributing to society and community. That was the strongest statement to help elimi­nate stigma and discrimination against PLHIV in the community, especially in nine provinces where PEPFAR funding is focused.”

How has donor support helped people with HIV address areas such as: HIV-related stigma and discrimination, and access to anti-retroviral therapy (ART), other health care services, and employment opportunities?

Huyen:

“Stigma and discrimination have been re­duced significantly in families, the community, urban areas, and health clinics which provide medical treat­ment to PLHIV and injecting drug users (IDUs). Since 2003… more and more PLHIV have gained access to anti-retroviral ther­apy (ART) programs and have improved their physical health and quality of life. HIV/AIDS deaths in the community have been reduced significantly. However, these positive effects are mainly in focus provinces with donor funding. PLHIV in other provinces which do not receive donor funding, and depend on the na­tional budget, have limited access to ART and encoun­ter many challenges and obstacles.”

What do you think the changes in donor support to the HIV & AIDS program in Vietnam will mean for PLHIV?

Thanh:

“We are afraid that in the future, once the international donors phase out of Vietnam, we will face many difficulties especially in accessing to ARV treatment and other related health services, including second-line treatment. In reality, stigma and discrimination have been reduced but still exist.

Competency of the PLHIV networks is limited and they are not equal partners with offices of the government and international donors. So these groups will have difficulties accessing necessary resources for maintaining their activities and enhancing linkages to local authorities. In the near future, we hope these groups will have greater capacity and will receive support from the Government of Vietnam. In the meantime we need technical support from international NGOs with funding from donors.”

Read Transition Forward, Issue 1, June 2013 in its entirety (PDF)

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Led by Management Sciences for Health (MSH), the global Leadership, Management, and Governance project consortium includes the African Medical and Research Foundation (AMREF); International Planned Parenthood Federation (IPPF); Johns Hopkins University Bloomberg School of Public Health (JHSPH); Medic Mobile; and Yale University Global Health Leadership Institute (GHLI).