Archived 02/02/2017

Until recently, Vietnam simply warehoused its injection drug users – many of them heroin users with HIV – in re-education centers. “They were four- to five-year stays in which the only treatment was detox for the first 15 to 30 days and labor the remaining time,” said Kevin P. Mulvey, Ph.D., who has been SAMHSA’s Substance Abuse Treatment Advisor in Hanoi since 2008. When people finally got out, they would often find themselves back in communities without support, use drugs again, and wind up back in the centers.

Now, said Dr. Mulvey, the country’s perception of addiction is shifting “from one of a social evil to a medical disease needing a public health response.” SAMHSA has helped facilitate that transition as a partner in the President’s Emergency Plan for AIDS Relief (PEPFAR), a U.S. government initiative that for more than a decade has helped strengthen health systems, train health-care providers, and enhance the delivery of life-saving HIV/AIDS services around the world.

As a PEPFAR partner, SAMHSA coordinates its work in Vietnam with other U.S. government agencies, including the Agency for International Development, Department of Defense, and Centers for Disease Control and Prevention (CDC). SAMHSA has helped CDC set up substance use treatment programs to complement CDC’s provision of antiretroviral drugs used to treat HIV, for example.

  • SAMHSA Administrator Pamela Hyde Meeting with Vice Minister Long VN MOH
  • SAMHSA Principal Deputy Administrator Kana Enomoto, UNAIDS Executive Director Sidibe, and SAMHSA Administrator Pamela Hyde
  • SAMHSA Administrator Pamela Hyde with Vice Minister Dam, Ministry of Labour, Invalids, and Social Affairs in Vietnam

SAMHSA’s biggest role, however, has been to help train Vietnam’s treatment workforce. “What we’re really trying to do is help Vietnam come up with a massive workforce education campaign,” said Winnie Mitchell, M.P.A., International Officer at SAMHSA, who traveled to Vietnam earlier this year with SAMHSA Administrator Pamela S. Hyde, J.D., and other SAMHSA staff.

SAMHSA has established two HIV Addiction Technology Transfer Centers, in Hanoi and Ho Chi Minh City, to provide training and technical assistance to primary care physicians, nurses, even community members who can help with early prevention and counseling efforts. SAMHSA also hired a primary care provider from the U.S. to provide hands-on training on how to administer methadone to personnel in clinics around Vietnam. “The Vietnamese are very pragmatic: When you show them that certain things work and don’t work, they get it,” said Ms. Mitchell. “They’ve now decided to change the detention centers into community-based treatment centers.”

That’s not the only sign of progress. Since PEPFAR’s work in Vietnam began a decade ago, the country has seen a 43 percent drop in new HIV infections. More than 52,000 patients got started on antiretroviral therapy with the program’s support, along with 30,000-plus patients who are now receiving treatment with methadone. New laws promote evidence-based practices in both HIV and substance use.

Building on those gains, SAMHSA will soon place a special expert on substance use in Hanoi who will be responsible for all of SAMHSA’s PEPFAR activities in Southeast Asia. SAMHSA hopes to follow suit with regional substance use experts in Ukraine and Africa.