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Total market strategy could fill gaps in int'l HIV/AIDS funding

Update: September, 07/2015 - 08:56
Viet Nam hopes to reduce the number of people with HIV to 0.3 per cent by 2020. — File Photo

HAI PHONG (VNS) — A conference held in Hai Phong City last week discussed the promise of a total market approach to Viet Nam's HIV prevention efforts now that foreign HIV-aid to the country will cease in 2017.

The cut in international funds comes now that Viet Nam has middle-income country status.

A ‘total market approach' means the Government would mobilise public and private stakeholders to enhance sustainable access to health products and services for all people, especially, people with HIV.

The approach enables government and private donors to prioritise finite resources for populations that need free or subsidised commodities and services, and allows the commercial market to provide options for those that are able and prefer to pay.

The approach is seen as key to Viet Nam's adaptation to rapidly changing HIV prevention and treatment structures, said Ngo Minh Trang from the United States' Agency for International Development (USAID).

Christopher Brady, a market dynamics specialist from PATH – an international non-profit organisation, said that the approach is especially important when government resources are limited and foreign aid declines.

He suggested that the Government assess the perspectives of different stakeholders to better attract interest. Secondly, it should evaluate the business environment and market segmentation. Thirdly, establish a technical support group under the Ministry of Health.

According to Ministry of Health statistics, over 227,000 people live with HIV in Viet Nam.

According to Trang from USAID, nearly 80 per cent of current funding for HIV prevention efforts in the country comes from international donors.

These donors have provided free anti-retroviral (ARV) treatments and free condoms to female sex-workers, but that funding would be dropped at the same time the foreign aid is cut.

"It is a challenge but also a chance for the private domestic sector to produce cheap condoms to meet the market demand," Trang said.

Engaging the private sector would have to play a big role to ensure the sustainability of HIV prevention efforts in Viet Nam, she said.

At the conference, a survey conducted across six provinces by Taylor Nelson Sofres Viet Nam – a market research provider - was released which shifted discussion to the topic of condoms, an important preventative measure.

The report estimated that a female sex-worker would be willing to pay VND2,000-4,000 (9 -18 US cents) to buy a condom and someone of the MSM group (men who have sex with men) could afford VND3,500-8,000 (15-35 US cents). A person who injects drugs would be willing to pay VND2,000-4,500 per condom.

Pham Duc Manh, deputy director of the Ministry of Health's Administration of HIV/AIDS Prevention and Control, said that the conference allowed international and domestic experts, policy-makers and private sector representatives to discuss how to effectively apply the total market approach.

Combating stigma

More than 18,000 people are estimated to be living with HIV in Ha Noi, and 5,000 people have died from AIDS, making it one of the highest HIV/AIDS localities in the country.

The information update came at another conference on combating stigma and discrimination against people living with HIV, co-organised by the Ministry of Health, the Ha Noi Health Department and USAID, last Thursday.

The city reported 434 new HIV cases and 75 AIDS-related deaths in the first half of the year.

Most of the HIV-infected people are between the ages of 20 to 39 and HIV transmission through heterosexual sex is increasing. The rate of HIV transmission through homosexual sex has also begun to rise in the last one to two years.

Stigma and discrimination against those suffering from HIV/AIDS hampers the progress of activities to tackle the disease.

The Viet Nam National Network of People Living with HIV in 2014 conducted a study of 1,600 respondents to assess stigma and discrimination faced by HIV-infected people.

The results revealed unacceptably high rates of many forms of stigma and discrimination. Gossip remained the most commonly reported form of stigma and discrimination, experienced by nearly one-quarter of respondents.

Insults and social exclusion were experienced by 5.8 per cent and 2.6 per cent respectively. A total of 6.7 per cent of respondents were refused employment, and 4.2 per cent of them lost their job or source of income. HIV-infected woman were the most likely to report physical assault with the figure hovering at 2.8 per cent.

Female sex workers, HIV-infected women and people who inject drugs are the groups whose rights are most often violated.

"HIV-related stigma and discrimination are synonymous with ‘death'," said Country Director of UNAIDS - Viet Nam, Kristan Schoultz.

Schoultz added that stigma and discrimination not only affected individuals with HIV but also increases HIV transmission in the community as fear keeps people from getting tested, treated or use preventative measures.

"We must act now, without delay to end the AIDS pandemic by 2030," said deputy head of the Ministry of Health's Administration of HIV/AIDS Prevention and Control, Hoang Dinh Canh. — VNS

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