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Front Page

CDC–Harvard Partnership Against HIV
Dampens Disease in Vietnam

Eric Krakauer created and directs the Vietnam-CDC-AIDS Partnership, an organization that trains Vietnamese medical workers to care for HIV/AIDS patients. (Photo courtesy of Massachusetts General Hospital)

Vietnam, a country famous for its history of war and poverty, is experiencing a growing HIV/AIDS epidemic. Although the first infection in the country was not documented until 1990, now an estimated 360,000 Vietnamese are living with HIV, and infections are expected to triple in the next five years. Most of the transmissions are caused by IV drug use. In June of 2004, President Bush designated Vietnam as the fifteenth country eligible to receive funds from the President’s Emergency Plan for AIDS Relief (PEPFAR), the only country outside of Africa or the Caribbean that qualified for the aid.

To help Vietnam prepare for the disease, Eric Krakauer, HMS instructor in medicine at Massachusetts General Hospital, created and now directs the Vietnam–CDC–HMS AIDS Partnership (VCHAP), an organization that trains health care workers in Vietnam to treat and work with HIV patients. Although the country has an adequate medical infrastructure, information about HIV is scarce and those afflicted are heavily stigmatized. The partnership provides training workshops for Vietnamese doctors and gives participants educational materials for teaching their colleagues.

Beginning in 1998 as a voluntary HIV training and technical assistance program, VCHAP is now funded by a $2.9 million cooperative agreement with the CDC. In 2000, VCHAP started sponsoring medical internships for students interested in studying HIV in Vietnam.

Since 2002, VCHAP has held national training conferences each year in Hanoi and Ho Chi Minh City, large urban centers with high rates of HIV. The conferences address HIV care and treatment, as well as issues like co-infection with tuberculosis, a growing problem in the small nation. VCHAP also leads local training workshops for the staffs of provincial or district hospitals. The two-to-four-week intensive training sessions teach general HIV/AIDS care and treatment, focusing on the application of antiretroviral therapy.

So far, VCHAP has trained 280 physicians from 40 provinces, and its graduates are now caring for 39 percent of Vietnam’s documented HIV cases.

VCHAP has trained 280 physicians from 40 provinces, and its graduates are now caring for 39 percent of Vietnam’s documented HIV cases.

There are limits to the amount of information and assistance that VCHAP can provide. The costs of prescription drugs present an obstacle to widespread treatment since PEPFAR has not yet approved the use of generic drugs. Brand-name antiretrovirals can cost $10,000 a year per patient, a price too high for Vietnam’s government and its people. In addition, the Vietnamese government’s response to widespread drug use has been to lock users in compulsory drug detoxification camps. These camps, where addicts are kept for several years without treatment, are breeding grounds for disease. As Krakauer explained, drugs still exist in the camps, but clean needles do not. VCHAP is limited by PEPFAR regulations, which do not allow recipients to enact programs in the camps since the camps themselves are considered a human rights violation.

Despite these barriers, Krakauer and his colleagues see Vietnam as an opportunity to stave off the type of health crisis that exists in Africa. With the AIDS epidemic in Vietnam still gathering steam, Krakauer hopes that education and medications can limit the harm the disease causes. In an interview with the Harvard Gazette, he said, “I stumbled upon a situation where there was a tremendous need and limited local ability to respond to it. It presented an opportunity to help alleviate a lot of suffering that is unnecessary, because the means to prevent it exists.”

—Rebecca Tinkelman

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