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Collaborators in the Vietnam-CDC-Harvard Partnership for AIDS Training
and Research (VCHAP). From left to right: Nguyen Duc Hien, MD, Bach
Mai Hospital, Hanoi, Vietnam, Eric Krakauer, MD, PhD Harvard Medical
School, Cao Thi Thanh Thuy, MD, Bach Mai Hospital, Candice K. Y. Kwan,
Harvard medical student.
Vietnam has a rapidly
worsening epidemic of HIV/AIDS, a disease closely associated with poverty.
In spite of the economic policy known as Doi Moi, Vietnam remains one
of the poorest nations in Asia. Vietnam’s poverty combined with
its proximity to the Golden Triangle, a drug cultivation and trafficking
route, have contributed to increased incidence of heroin addiction.
Recent government statistics estimate approximately 133,000 addicts
nationwide. In addition to drug addiction, growing numbers of women
and girls are turning to commercial sex work. According to the government’s
"Anti-Social Vices Department" there are an estimated 40,000
sex workers in the country, although the actual number is believed to
be much higher. Injection drug use has been identified as the dominant
vector of HIV infection in Vietnam. Commercial sex work
ranks second behind IDU as a cause for HIV transmission.
According to Dr. Eric Krakauer, lecturer in the Department of Social
Medicine, "the number of proven AIDS cases in Vietnam increased
from one in 1990 to more than 42,000 by the decade’s end."
More recent Ministry of Health statistics estimate that from 135,000
to 160,000 Vietnamese are now living with HIV throughout the country’s
61 provinces and it is predicted that this number will increase to nearly
200, 000 over the next five years.
Dr. Krakauer has been addressing HIV/AIDS in Vietnam since 1998 when
an introduction to Prof. Chung A, Director of the National AIDS
Standing Bureau of Vietnam led to his service as an informal advisor
on HIV/AIDS policy. The following year Dr. Krakauer, Prof. A, along
with Mr. Gary West, Deputy Director of the Global AIDS Program at the
U.S. Centers for Disease Control and Prof. Le Dang Ha, Chief of Infectious
Disease at the Hanoi Medical Faculty established the Vietnam-CDC-Harvard
AIDS Training Partnership (VCHAP). VCHAP supports collaborative NASB/CDC
research on HIV/AIDS epidemiology and prevention through the participation
of Harvard medical students. To date six Harvard medical students have
played important roles in a variety of projects
 "Vietnam’s
health care system must be mobilized to control the epidemic",
says Dr. Krakauer. "Unfortunately the country’s health care
professionals, including staff of the leading medical institutions,
have not had the benefit of training that would allow them to respond
to the challenge most effectively." In an effort to address this
need, Dr. Krakauer is currently making plans to expand VCHAP’s
scope to include extensive training in HIV clinical care for Vietnamese
physicians and community health workers.
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Reflections
of HMS student, Candice Kwan, on life and work in Vietnam.
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