The goal is to strengthen the capacity of The Ministry of Labor, Invalids and Social Affairs (MOLISA) in opiate addiction treatment; to provide social support services through effective evidence-based approaches that will contribute to the reduction of opiate use; and to improve the quality of life while reducing HIV infection and transmission among opiate users in Vietnam. This addresses and contributes to all three objectives of the Partnership Framework between the U.S Government and the GVN.

The cooperative agreement includes the following three strategies: 1) Strengthening MOLISA systems of surveillance and information management to improve health benefits to those addicted to opiates and sex workers; 2) Building capacity for MOLISA staff working in the addiction treatment system to ensure the provision of effective and qualified addiction treatment services at treatment facilities; and 3) Developing pilot models to provide evidence-based approaches for community-based addiction treatment. The first strategy was developed to strengthen the systems of monitoring and information management for MOLISA. The second strategy focuses on building capacity for MOLISA staff that provide opiate addiction treatment. The third strategy aims to change the approach toward one more solidly based on evidence and science. All staff supported by PEPFAR are current MOLISA staff, which will lead to a more sustainable transition to local ownership.

One of the two treatment sites is located in Thai Nguyen province and the other is in Ho Chi Minh City. Regular and ongoing monitoring will be conducted by the MOLISA team and staff at the sites, but evaluations will be conducted by an external team from Hanoi Medical University.

Global Fund / Programmatic Engagement Questions

1. Is the Prime Partner of this mechanism also a Global Fund principal or sub-recipient, and/or does this mechanism support Global Fund grant implementation? Yes2. Is this partner also a Global Fund principal or sub-recipient? Sub Recipient3. What activities does this partner undertake to support global fund implementation or governance?(No data provided.)

For the first two years, the activities include the rapid assessment of the MOLISA reporting system on opiate users and sex worker management; a review and revisions of the data collection form, as well as management and reporting processes, and pilot the upgraded software for online reporting. Using COP12 support, PEPFAR will support MOLISA to:- Continue data collection, management and reporting at 2 pilot sites.-Standardize Data Quality Assurance (DQA) procedures and pilot in select sites. Initiate mechanisms for data use at agreed upon levels.- Support capacity building with use of data collection, management and processing in accordance with MOLISA plan to expand the reporting system into other key provinces.

OHSS funding for this project will continue to expand the training system for Department of Labor, Invalids and Social Affairs (DOLISA) social workers to upgrade their capacity to deliver effective and evidence-based drug treatment counseling and support at the commune and provincial levels. A key activity for this phase of the project is evaluation and assessment of capacity development activities to date, with the aim of consolidating best practices and transferring the curricula to trainers within the DOLISA system.

In 2010 UNODC estimated there were about 200,000 opiate addicts in Vietnam, and similarly a 2009 report from the Ministry of Public Security gave an estimate of 150,000. In HCMC, the estimated number of addicts in 2011 was about 20,000, and an estimated 8,000 in Thai Nguyen province. The HIV prevalence among IDUs in Thai Nguyen and HCMC in 2009 was 36.1% and 42.1% respectively. The project prioritizes its interventions to focus on provinces where the number of opiate users and HIV prevalence are among the highest in the country.

1) Capacity building for MOLISA staff working in the opiate addiction treatment system: During the first two years, the activities include a training needs assessment, institutionalization of training material, and provision of training of trainers. In COP12, we propose to:- Continue to support the basic training courses on addiction and effective evidence-based methods of opiate addiction treatment, on case management and relapse prevention for staff providing addiction treatment services;- Monitor, supervise and evaluate the performance of training for trainers programs in meeting the demand for capacity building for staff;- Continue to support the implementation and supportive supervision of the curriculum application at MOLISA training institutions.

2) Develop pilot models providing evidence-based, community-based addiction treatment approaches: In the first two years, the activities will include a review of current opiate treatment services, establishing community-based models, develop SOPs with monitoring and evaluation frameworks for the model, and implement services for addiction treatment.

It is projected that approximately 500 clients per province will be enrolled in the pilot model. Since the pilot is under development, the exact enrollment criteria and quality assurance mechanisms are not yet finalized. The pilot model will include the following core package of services for addiction treatment and support: 1) Intake assessment and brief intervention; 2) Discussion of treatment plan and implementation; 3) Medication and non-medication therapies; 4) Substance use monitoring; and 5) Referrals and linkages. Patients will enroll in services voluntarily and both outpatient and inpatient services will be available.

In COP 12, we propose to:- Continue to provide clients with services at these sites;- Maintain regular monitoring, supervision and technical assistance;- Evaluate the pilot sites and report outcomes to advocate for the expansion of the model utilizing GVN funds.