UNAIDS address at Viet Nam Methadone Programme Review Meeting, 5 March 2009

Deputy Prime Minister Truong Vinh Trong, Vice-Minister of Health Mr Trinh Quan Huan, Ms Ha Thi Lien of the Fatherland Front, Party, National Assembly and international colleagues:

On behalf of the United Nations, I would like to congratulate Viet Nam on the successful implementation of the pilot methadone programme in Hai Phong and Ho Chi Minh City. 

I have had the privilege of visiting the pilots a number of times and agree with Dr Long that this programme has been extremely successful and the effectiveness of this medicine has matched experience in other countries. In some aspects, such as drop-out rate, Viet Nam has surpassed many other countries. As a result, we now hear many provinces requesting access to methadone as part of their comprehensive response to both heroin dependency and HIV.

Deputy Prime Minister Truong Vinh Trong, Vice-Minister of Health Mr Trinh Quan Huan, Ms Ha Thi Lien of the Fatherland Front, Party, National Assembly and international colleagues:

On behalf of the United Nations, I would like to congratulate Viet Nam on the successful implementation of the pilot methadone programme in Hai Phong and Ho Chi Minh City.

I have had the privilege of visiting the pilots a number of times and agree with Dr Long that this programme has been extremely successful and the effectiveness of this medicine has matched experience in other countries. In some aspects, such as drop-out rate, Viet Nam has surpassed many other countries. As a result, we now hear many provinces requesting access to methadone as part of their comprehensive response to both heroin dependency and HIV.

The positive outcomes we have seen so far are a testimony to the wise and careful planning of the National Committee (MOH, MOPS and MOLISA). Last year’s roll-out of methadone, done through closely monitored pilots, has provided us with a wealth of information. The resulting report, which we are reviewing today, will be invaluable to expanding the methadone programme in a Viet Nam-specific, evidence-based way.

Methadone treats the chemical effect on the brain from heroin dependency, but its effects are not just physical – as we heard in the presentations, methadone also assists with the social, economic and psychological aspects as well.

Methadone saves money. We have seen this in every country where it is used, and now we see it in Viet Nam. Methadone treatment is much cheaper than other treatment models, including detoxification and criminal and administrative detention, as we just heard from Ong Ke from Hai Phong.

Costs associated with the methadone programme must also be compared to the costs of opiate dependency. I am advised that a daily dose of methadone could cost less than 5,000 dong per patient – as opposed to hundreds of thousands of dong a day for heroin, expenses often covered by family resources or crime.

A patient on stable methadone is not normally injecting drugs, therefore he or she is much less likely to contract HIV or hepatitis C. Prevention saves families and Government the cost of diagnosis and treatment, particularly that of expensive anti-retroviral medicines.

We have just heard that the methadone pilots have saved money in Hai Phong and Ho Chi Minh City by reducing crime and healthcare expenses. The pilots have also raised money by making it possible for former opiate users to hold jobs and contribute to household tasks. On methadone, former opiate users have the chance to physically and psychologically recover. They are reunited with society and are able to rebuild relationships with their families and communities.

If costs truly are a concern, the price of the methadone programme could possibly be reduced by producing methadone domestically or by following less expensive programme models. Alternative models are something Viet Nam can look at for the next (scaling up) phase when expanding to other provinces. My colleague from WHO, Dr David Jacka, will address this in his presentation.

Deputy Prime Minister, the funding for methadone expansion already exists. Viet Nam’s successful Global Fund Round Eight project includes support for ten provinces. Several other donors, including those here and the World Bank and DFID joint programme, have budgeted to support methadone in new provinces as part of their comprehensive harm reduction programmes for Viet Nam. The start-up or running costs for new provinces can be covered by international partners and the Global Fund will remain one source of funds for sustaining the programme in Viet Nam when it becomes a middle-income country.

Of course, challenges remain. As Mr Tai from Ho Chi Minh City said yesterday, methadone by itself is not a magic bullet but it must be a core part os a comprehensive Harm Reduction programme, as it is in Hai Phong and Ho Chi Minh City. It will require us to use both our hearts and our brains in expanding the programme to other provinces.

The United Nations and the international community look forward to continuing to work with Viet Nam on expanding this important programme, and thank the Government for the excellent work done to date.

Chu suc khoe

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