July 31, 2013
In April of this year I visited Vietnam along with Jacques Normand, Director of NIDA’s HIV Research Program, to foster research collaborations between NIDA and Vietnamese scientists on issues of HIV and drug abuse in that country. Our visit grew out of discussions with the International AIDS Society during last year’s International AIDS Conference here in Washington, DC.
We had a packed schedule during the 10 days Jacques and I were in the country, meeting with numerous government officials and researchers in the fields of drug addiction and HIV. Among other engagements, I addressed a large group of addiction and HIV/AIDS researchers at Hanoi Medical University (photo), speaking about the importance of integrating HIV services with addiction treatment and about existing medication-assisted addiction treatments—buprenorphine, methadone, and naltrexone—as HIV prevention.
Asia is second only to Africa in its number of people living with HIV, and Asian countries stand to greatly reduce new infections over the coming years by improving access to early testing and treatment with antiretroviral therapy (ART). That is especially true of Vietnam, which is currently experiencing an HIV epidemic among injection drug users (IDUs) and groups that engage in high-risk sexual activity, making it a key battleground in the worldwide fight against HIV. Whereas infection rates among IDUs are declining in other Southeast Asian countries like Thailand, Vietnam is seeing an increase in HIV transmission in this and other high-risk groups. Vietnam is the only Asian country among the 15 countries designated as the most severely HIV-affected countries by PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief.
HIV treatment as prevention is an important strategy that is now being recognized as presenting a solution to the problem. A new article in the Journal of Acquired Immune Deficiency Syndromes shows that reaching IDUs and other high-risk groups with HIV testing and ART could effectively (and cost-effectively) eliminate new HIV infections in Vietnam within two decades.
NIDA already supports extensive research in the region. We are currently supporting 29 studies on HIV and drug abuse in Southeast Asia, and 14 of our grants have gone to support research in Vietnam. Also, NIDA provides funding to IAS to support four fellowships in HIV and drug abuse research; two of this year’s recipients, Anh Dam Tran and Bach Xuan Tran, are from Vietnam. Both will be working on projects related to methadone maintenance treatment, an effective opioid addiction therapy that has also shown promise in reducing HIV transmission but that has historically been underutilized in Vietnam.
The importance of collaboration with Southeast Asia in issues of HIV as well as other health risks is gaining wider recognition. Just last month, HHS Secretary Kathleen Sebelius led a delegation to Vietnam to meet with the Prime Minister, the Minister of Health, and other officials about global health and to sign an Agreement on Health and Medical Sciences Cooperation between our two countries.
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