HCMC Consultative Workshop to Develop Proposal on Sex Work Strategies 2010–2015, 9 June 2009

Good morning ladies and gentlemen. Thank you for inviting me to speak today on behalf of the Joint United Nations Team on HIV. 

I want to congratulate the Government of Viet Nam, and in particular MOLISA, on their commitment to listening to the needs of women involved in sex work, to respecting their rights and addressing the root causes of sex work through the revision of the Ordinance on Sex Work Prevention and Control. Thank you for welcoming inputs from the international community and civil society. I am especially pleased to see that women involved in sex work are attending this workshop. We will benefit very much from listening to them. 

Recently, a group of sex workers in Ha Noi got together to talk about their lives, their challenges and their hopes. Being a sex worker, they said, gives us power. We can live independently. We can support our families – our parents and our small children and maybe, if we keep hoping, one day our luck will change.

Because being a sex worker, they said, also takes our power away. People judge us. Our parents look down when our names our mentioned. Sometimes we’re beaten up. Sometimes we’re raped – by one man or many. Sometimes we’re scared and when we ask for help, no one comes. We know we can catch all kinds of diseases but how can we protect ourselves when we’re so worried about the police finding us with condoms and sending us to 05 centres that we often just don’t carry condoms with us?

When that same group of sex workers in Ha Noi was asked, ‘How would you like things to change? What do you wish for?’ Can you guess how they responded?

They said, allow us our humanity. 

Viet Nam is a progressive nation with an increasing international presence. Viet Nam is party to six of the eight core, legally-binding human rights treaties, including the Convention on the Elimination of all Forms of Discrimination against Women; the International Covenant on Economic, Social, and Cultural Rights; and the International Covenant on Civil and Political Rights. Viet Nam can also boast one of the finest HIV laws in the world. 

If we allow sex workers their humanity, we allow that these laws and treaties pertain to them. Sex workers have the right to access social and medical services without discrimination. They have a right to due process of law. They have the right to voice their opinions and ideas about the laws and policies that affect them.

I would like to focus for a moment on the idea of ‘access.’ Just recently, in last week’s Ambassadors and Heads of Agency Informal HIV Coordination Group meeting, the Minister of MOLISA, Madame Nguyen Thi Kim Ngan, requested that the international community assist MOLISA in reaching vulnerable populations with HIV prevention services. The Joint UN Team on HIV is more than happy to support MOLISA in this endeavour. We would like to propose that increasing access to services, increasing the involvement of civil society, and piloting new approaches are the best ways to do that.

First of all, sex workers, their partners and their clients have a right to access social and medical services without discrimination. According to Vietnamese law, these services are just as open to them as they are to anyone else. Furthermore, sex workers, their partners and their clients have the responsibility to access these services. Sex workers have a responsibility to themselves and their families to seek counselling, income generation support, vocational and other training, legal assistance and financial and nutritional help. Clients, partners and sex workers have a responsibility to one another and society to have regular health checks, including screening for HIV and other sexually-transmitted infections.  

Yet despite their rights and responsibilities, sex workers face many barriers to actually getting the services they need. Some of these barriers are due to expense, convenience and knowledge, but most are a result of stigma, discrimination and fear. 

Sex workers face substantial intimidation at the hands of public security officers. We need law enforcement officials to take care they are enforcing all the laws written for the protection of society. These include the Law on HIV/AIDS Prevention and Control, whose implementing decree (no. 108) explicitly guarantees protection of sex workers’ right to access HIV-related services. We need to focus on reducing stigma and discrimination related to sex work. We can do this by discussing sex work more openly. We can even do this by piloting new approaches, and by considering how to shift the punitive atmosphere around sex work. 

In the Netherlands, as Prime Minister Truong Vinh Trong and Vice Minister of MOLISA Bui Hong Linh recently saw on their study visit there, sex work is regulated by the government and the social stigma against it is quite weak. As a result, women have exceptional access to the services they need, and clients and partners can feel comfortable that the sex they engage in is very low risk.

One thing that can really increase access to services is the greater involvement of civil society in service provision. As MOLISA, whose mandate is to protect vulnerable populations, is aware, local non-governmental organisations are well-placed to support vulnerable populations and their track record with sex workers in Viet Nam is quite strong.

An approach that has been successful in various countries, including in the Netherlands, is the ‘one-stop shop’ approach. This model provides many different quality-ensured services in one user-friendly clinic. Based in the community, this clinic can be mobile, and it can also, on a pilot basis, serve as an alternative to 05 centres. This approach underscores the importance of MOLISA and MOH working in collaboration, and the importance of strengthening civil society organisations’ capacity and role. 

A great deal of work has gone into this revision process. I strongly encourage MOLISA not to slow the momentum now. Take the lead to coordinate the efforts of government agencies, civil society organizations, sex workers’ organizations and other partners in addressing sex work. Find a way to involve sex workers more. We need their voices. Build partnerships among those working in health, law enforcement, the judiciary and, again: civil society. Individuals do sex work to feed their families. We know, from what they tell us, that when they want to leave sex work they don’t always have an easy way out. Let’s address their socio-economic concerns, and the socio-economic conditions that are driving more people to enter sex work every day.

When sex workers were asked about the way forward, one request was at the top of their list. It is controversial. But it has been successful in other places and it is something that Viet Nam, a nation that is breaking records with its economic, political and social development, is well-placed to pilot. 

A regulated sex work industry. 

As we discussed back in March, it is very complicated to speak of eliminating sex work. Throughout the world, it has proven far more realistic to focus on scaling down sex work and reducing its harm. Regulation of the industry is one way to do that. We have seen the success of regulation in the Netherlands. 

A regulated sex work industry would mean better government control, less sexual abuse, human trafficking and corruption. It would mean less government spending on social programmes for sex workers, better health care, fewer cases of HIV and sexually transmitted infections. It would mean tax income from sex workers and related service providers. For regulation to be successful, it is essential to include in the proposal a clear definition of sex work – i.e., the voluntary sale of sex between consenting adults, without coercion or force of any kind.  

In the Netherlands, lifting the ban on brothels and legalizing sex work has not encouraged sex work. Since legalization, the number of brothels has actually decreased. Among sex workers, HIV prevalence ranges from 1.5% to 7% and condoms are used consistently 80% of the time. Sex workers are able to report violence to the police and quarterly tests for HIV and other sexually-transmitted infections are encouraged. 

As for what regulation would look like in Viet Nam, people involved in sex work – people with invaluable, first-hand knowledge – have shared literally dozens of ideas. I do hope that, rather than hearing them from me now, we will have the opportunity to discuss these ideas today with the empowered, and powerful, women who produced them. 

Because as the great Vietnamese monk Thich Nhat Hanh has said, ‘Shallow understanding accompanies poor compassion; great understanding goes with great compassion.’

Thank you very much for your kind attention and best wishes for a productive meeting.

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