Vietnam's drugs and Aids epidemic

Ho Chi Minh City has an estimated 20,000 drug users

By BBC News Online's Mangai Balasegaram

The Hy Vong Cafe (Cafe Hope) is one of Ho Chi Minh City's most unusual coffee shops.

Not only can you get a cup of coffee, you can also pick up free condoms, and needles to inject heroin.

Every day, a few hundred people drop in and 600 clean needles are given out.

Former drug injectors provide peer support and information about HIV, the virus that causes Aids.

The authorities do not just approve - they partially fund the cafe, which is housed in a public building.

Many Vietnamese drug users had little access to clean needles before

"We did have a lot of problems with the police and government," said Dr Le Thuy Lan Thao of the city's Aids Committee.

"But we had many meetings to persuade them, and now, it's finally OK."

The programme has helped remove seedy "shooting galleries" where a "professional" injector would use the same dirty needle on dozens of drug users.

The city also has another similar cafe and two more are being planned.

High priority

As Vietnam celebrates 25 years since the end of the war with the United States, it is redoubling its efforts to reduce prostitution and drug abuse, which are tied inextricably to its Aids epidemic.

The Communist Party's youth centre even supplies condoms

"They're extremely alarmed about the situation," said Jamie Uhrig, a United Nations consultant and an adviser on Aids to the Vietnamese Government.

"Drug use now has the highest priority [among] social problems."

The concern has even led to the Communist Party's Youth Cultural Centre in Ho Chi Minh City offering free condoms on tables in its cafe.

"What young people see from that is that here's the state, here's the party, saying this is OK. That has a huge propaganda impact," Mr Uhrig said.

Teenage addiction

The Asian Harm Reduction Network, which works on HIV prevention among drug users, estimates as many as 200,000 Vietnamese use opiate drugs, and of them, 50,000 inject heroin.

Heroin is now finding its way to Vietnamese villages on trafficking routes

In Ho Chi Minh City alone, an estimated 20,000 people use drugs, said Dr Thao.

"Most of them are young. Some are just 15 or 16 years old," she said.

"They start by smoking [heroin]. When they don't have enough money, they start injecting."

The UN's Drug Control Programme (UNDCP) has said about 75 per cent of all identified drug users in the country are under 23.

About two thirds of the 18,000 Vietnamese known to have HIV are drug users. Aids experts have estimated that by the year's end, up to 250,000 may carry the virus.

Rite of passage

The country's proximity to drug-producing areas means the problem is unlikely to disappear.

"Vietnam is on a major heroin trafficking route and heroin always leaks off the pipeline. That's the push reason," explained Mr Uhrig.

Vietnam has limited resources to fight the epidemic

"The pull reason? Unemployment. The collapse of a social system that had control on people's behaviour."

Mr Uhrig said heroin was "extremely available" in the north. "I suspect that among young men, it has become a rite of passage."

With few drug treatment programmes available, the relapse rate among addicts is very high.

A lack of funds is also a key factor hampering the government's efforts.

Money is also what lures people into the trade.

"All you have to do to get a lot of money is transport drugs to another city," said Aaron Peak, a UNDCP consultant and former adviser to the Vietnamese Government.

He explained that a kilo of heroin worth $3,000 in Burma rose to $6,000 in Laos and then $7,000 as it crossed the border to Vietnam's Ky Son district.

"Take it to Hanoi or Ho Chi Minh City and you can get $14,000."