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Viet Nam shares best practices on methadone maintenance therapy with Bangladesh

Hanoi (Viet Nam), 12 May 2016 - A high-level delegation from Bangladesh has conducted a study-tour of Viet Nam's opioid substitution treatment (OST) clinics from May 8-12, 2016. Participants included delegates from the Bangladesh Ministry of Home Affairs, Ministry of Health and Family Welfare, and the International Centre for Diarrhoeal Research, Bangladesh (ICCDRB) who were given the opportunity to learn more about the clinics' work in reducing drug dependency and decreasing the risk of HIV transmission.

Bangladesh implemented its first OST program in 2010, and there are currently four OST clinics in Dhaka operating under the Department of Narcotics Control and the national STD/AIDS programmes. However, despite more than 20,000 people estimated to be in need of OST, current services are only able to accommodate about 400 patients. In the face of growing need, ICDDRB undertook the study-tour to gain exposure to a successful scale-up initiative. "We hope this exposure will help Bangladesh expedite the process of a smooth scale-up" said Dr. Tasnim Azim, Director of Bangladesh's program for HIV/AIDS.

Viet Nam started its Methadone Maintenance therapy (MMT) program in 2008. Currently, there are more than 45,000 patients being treated in 240 clinics in 57 provinces. Recently, the OST program was scaled up through the implementation of a pilot MMT program in two prisons. While MMT is becoming more readily available in community-based treatment, prisoners do not have access to treatment while incarcerated. Scaling up OST services by providing MMT in prisons addresses this gap by providing continuity of care for prisoners before, during, and after incarceration, and also improves equal access to health services and reduces the risk of HIV transmission and other diseases. UNODC continues to provide information sessions for prisoners about HIV/AIDS, sensitivity training for law enforcement, and MMT equipment for the pilot program.

On May 9th 2016, the delegation visited the Viet Nam Authority of HIV/ AIDS control (VAAC), and over the next two days, visiting OST clinics in Vietnam, and then finished the study-tour with a presentation from UNODC and Lieutenant Colonel Duong Thu Hang, Deputy Head of Preventive Medicine Division, Health Department (Ministry of Public Security) on the achievements and challenges of implementing methadone maintenance treatment (MMT) in prison settings.

Despite the differing political, penal and regulatory framework, there are important general lessons from Viet Nam's experience", said Dr. Hang. "In our experience, efforts were most effective when approached from an evidence-based health perspective, as opposed to an administrative perspective."

Additionally, Dr. Hang identified unwillingness on the part of health care workers to work in prison, and the stigma attached to HIV, as surmountable challenges. Given the barriers, government backing and support for MMT service was crucial to Viet Nam's successful scale-up of OST services.

The Bangladeshi delegation was confident that upon their return, the valuable insights into a successful scale-up that the study tour had could help change perceptions and attitudes of the senior government officials towards adopting a more public health and rights based approach in dealing with drug use problems in prison settings.