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Partnership Framework between the Government of the Socialist Republic of Vietnam and the Government of the United States of America for HIV/AIDS Prevention and Control (July 2010)

The Government of the United States of America (hereinafter referred to as the “Government of the United States”) and the Government of the Socialist Republic of Vietnam (hereinafter referred to as the “Government of Vietnam”) (hereinafter referred to separately as “Side” or together as “the two Sides”) with the wish to collaborate in combating HIV/AIDS and supporting health care on the principles of collaboration, equity, and mutual benefit, hereby support the following principles and objectives:

Section 1

Strategic Overview and Principles of the Partnership Framework

In the past two decades, Vietnam has experienced unprecedented economic growth and a rapid rise in living standards. It has undergone a population boom with nearly two-thirds of the country’s 86 million people under the age of 35 years. Injecting drug use is the main behavior driving HIV transmission in Vietnam. Surveillance surveys estimate that nearly 41% of persons who inject drugs in high-prevalence provinces are living with HIV. While the prevalence rate is 0.43% among people between the ages 15 and 49, Vietnam continues to work hard to limit transmission into the general population. The Government of Vietnam and the Government of the United States work closely together to support policy reform as well as to continue to invest in training and quality assurance of technical strategies and health policies as part of PEPFAR Vietnam’s goal to strengthen the country’s healthcare systems.

This Partnership Framework recognizes that the national response to HIV/AIDS in Vietnam is led by the Government of Vietnam. The Partnership Framework follows on from the Action Plan under the Bilateral Agreement on HIV/AIDS prevention, care and treatment for 2006-2008, and supports the 2006 Bilateral Agreement on Health and Medical Sciences Cooperation.

This Partnership Framework is to provide a strategic approach for collaboration in combating HIV/AIDS and supporting health care for people living with HIV in Vietnam from October 2010 to September 2015.

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), in the context of this Partnership Framework, is to include both the Government of the United States’ bilateral support to Vietnam and, as its single largest donor, multilateral support provided through the Global Fund to Fight AIDS, Tuberculosis and Malaria (hereinafter referred to as the ‘Global Fund’).

The principles for collaboration under this framework aim to identify roles and responsibilities of the stakeholders involved in PEPFAR to support a mechanism for coordination, cooperation, implementation, and information exchange among all partners in the program; and to strengthen country ownership and sustainability in the fight against HIV/AIDS. 

Section 2

Purpose and Goals of the Partnership Framework

This Partnership Framework supports the Government of Vietnam to successfully implement the following priorities:

• The Strategy for Care and Protection of People’s Health of the Socialist Republic of Vietnam;
• The National Strategy for HIV/AIDS Prevention and Control of the Socialist Republic of Vietnam;
• The National Tuberculosis Prevention and Control Program;
• The National Drug Prevention and Control Strategy;
• The Action Plan on Prostitution Prevention and Control;
• Strengthening national leadership and inter-sectoral collaboration for a multi-sectoral response to HIV/AIDS prevention and control; and
• Strengthening coordination of programmatic and financial commitments for HIV/AIDS to support the Government of Vietnam in their response to the epidemic.

The overarching purpose of the Partnership Framework is to provide a strategic agenda for cooperation between the two Sides and continue a joint commitment for the reduction of new HIV infections, improved HIV/AIDS prevention, care, and treatment services, and mitigation of the impact in Vietnam, while contributing substantially to fundamental health systems strengthening.

Goals, objectives and commitments in this Partnership Framework are to be listed in the Partnership Framework Implementation Plan, which should also prospectively measure performance, as mutually determined by the two Sides.

The Partnership Framework is to address access to and the quality and sustainability of HIV/AIDS services, through three goals.

Goal 1: Strengthen the quality of and increase access to prevention services for people at risk, and prevention, care, and treatment services for people affected by or living with HIV.

Objectives

1. Improve the availability and quality of prevention, care, and treatment services for most at risk populations.
   1. Raise awareness of and promote behavior change among most at risk populations with regard to HIV/AIDS prevention, care, and treatment services in targeted geographic areas and in partnership with other donors to ensure appropriate program coverage with an aim to reach at least 100,000 men, women, and children with anti-retroviral treatment and 280,000 people affected by or living with HIV with care services;
   2. Support improved effectiveness and efficiency of multi-sectoral cooperation in HIV prevention, and care and treatment;
   3. Support implementation of models in HIV/AIDS prevention, care, and treatment in the work place and across borders;
   4. Support evidence-based harm reduction interventions recommended by the Joint United Nations Programme on HIV/AIDS, World Health Organization, and the United Nations Office on Drugs and Crime for persons who inject drugs, notably by enabling access to Medication Assisted Therapy/Opiate Substitution Therapy, including methadone, for 80,000 people by 2015;
   5. Through efficiencies, improve scale-up of access to HIV/AIDS prevention, care and treatment services;
   6. Strengthen the implementation of a minimum package of services for prevention, care, and treatment programs;
   7. Strengthen program integration, referrals and linkages across prevention, care, and treatment services to ensure a continuum of care within the broader health sector, with particular attention to issues of public health concern such as tuberculosis; and
   8. Strengthen the quality of prevention, care, and treatment services through the establishment and implementation of a system for monitoring, evaluation, management, and quality improvement of programs across all provinces, which support the national monitoring and evaluation framework.
2. Support continued progress toward effective interventions through advocacy and technical assistance for policy implementation.

Goal 2: Support the provision of sustainable HIV/AIDS services through strengthening systems for people’s health and related welfare.

Objectives

1. Strengthen selected areas of health service management.
   1. Support the development of standards for application of a national strategy for health management information systems and support relevant local institutions with its implementation;
   2. Support Vietnam’s laboratory systems through improved strategic planning and organizational management, quality assessment and improvement, including an accreditation system, referral systems, training, and an improved testing network;
   3. Support the development of a national HIV/AIDS procurement and supply system that could be expanded to include other related health commodities.
2. Increase collaboration across national programs to maximize the performance of health service and related welfare delivery.
   1. Develop and strengthen the integration of HIV/AIDS with related areas of health, including tuberculosis, drug treatment services as recommended by World Health Organization and United Nations Office on Drugs and Crime, sexual and reproductive health, family planning, ante-natal care, maternal and child health, pediatric care, child survival, and nutrition;
   2. Identify, review, and adopt effective models for health service delivery including community-driven health care; and
   3. Increase access to services for women and children, by seeking to ensure that the health system provides comprehensive health and reproductive services at existing service delivery points.
3. Strengthen the national system of workforce development for improved service delivery.
   1. Support the development and implementation of policies for human resource development for HIV/AIDS prevention and control; strengthen professional capacity of personnel working in HIV/AIDS and related health areas;
   2. Support capacity development of and the accreditation process for institutions;
   3. Support pre-service and in-service training based on identification of core competencies in important technical areas, including clinical care, harm reduction, drug treatment, counseling and testing, nursing, social work, public health program management, epidemiology, surveillance, and training for personnel dealing with most at risk populations;
   4. Strengthen capacity for personnel working at the community level to deliver HIV/AIDS prevention and control programs; and
   5. Strengthen capacity for ongoing on-site data collection and use, including data analysis related to performance measurement and continuous quality improvement of service delivery.

Goal 3: Broaden and strengthen the national response to HIV/AIDS to support people’s health and related welfare

Objectives

1. Strengthen country ownership in HIV/AIDS prevention and control.
   1. a. Support the adoption and implementation of policies and decisions that address emerging issues in the health system, such as health insurance;
   2. b. Support the review of policies, national guidelines, and their implementation to ensure they are harmonized, current, and effectively implemented;
   3. c. Strengthen inter-ministerial coordination around HIV/AIDS to support people’s health and related welfare; and
   4. d. Improve HIV programmatic and management capacity across all provinces and at least 65% of targeted district level health program management staff through a national standard of program delivery, including the development of mechanisms to link and support multi-sectoral services.
2. Strengthen the capacity and involvement of mass organizations, social organizations, non-governmental organizations, multilateral organizations, and the private sector, including Global Fund principal recipients and its implementing agencies.
   1. Promote appropriate engagement of non-governmental organizations to provide technical mentoring and training to build local capacity in areas including effective program management and implementation, monitoring and evaluation, clinical care, harm reduction, drug treatment, surveillance, health informatics, and laboratory;
   2. Support greater involvement of Vietnamese non-governmental organizations in implementing HIV/AIDS and related health programs; and
   3. Support greater involvement of the private sector in implementing HIV/AIDS and related health programs.

 

Section 3

Partners’ Roles and Responsibilities

The Government of the United States is to designate the Department of State as the coordinating agency for this Partnership Framework. The Ambassador of the United States to Vietnam is to be responsible for coordinating all United States Government programs. The Government of Vietnam is to designate the Ministry of Health as the coordinating agency for this Partnership Framework.

The implementing United States government organizations are to be the United States Agency for International Development; the Department of Health and Human Services, including Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, the National Institutes of Health, Food and Drug Administration, and Health Resources and Services Administration; Department of Defense, Department of the Treasury, and the Department of Labor.

The implementing Government of Vietnam organizations are to be members of the National Committee for AIDS, Drug and Prostitution Prevention and Control, including: Office of the Government, Ministry of Health, Ministry of Labor, War Invalids and Social Affairs, Ministry of National Defense, Ministry of Public Security, Ministry of Education and Training, Ministry of Planning and Investment, Ministry of Finance, Ministry of Culture, Sport and Tourism, Ministry of Justice, Ministry of Agriculture and Rural Development, Ministry of Industry and Trade, Committee for Ethnic Affairs, Vietnam Fatherland Front, Vietnam Women’s Union, Vietnam General Labor Federation (Trade Union), Farmer Federation, and People’s Committee of the provinces and cities directly under the central Government.

The development of annual work plans and of new programs should be reviewed by the two Sides and should be coordinated and harmonized with other donor programs in Vietnam. The two Sides should both be represented on teams to monitor and evaluate the program.

The Government of Vietnam is to be informed of the process for the selection of PEPFAR implementing partners and is to be invited to participate as permitted by U.S. government procurement regulations. PEPFAR implementing partners should be responsible for submitting semi-annual and annual reports to PEPFAR and the Government of Vietnam in formats mutually decided upon by the two Sides.

Drugs, commodities, and biomedical products required for prevention and control and other related health activities are to be exempted from value-added tax and from such other taxes as are stipulated by law.

The two Sides recognize that the resources of Government of the United States and of the Government of Vietnam are limited and investments are subject to the availability of funds. The achievement of the Partnership goals needs resource flows beyond the ability of any one partner. Constraints on the availability of funding from either Side or from other principal partners may lead to a review and revision of goals.

Over time, the Government of the United States intends to provide an increasing proportion of technical assistance to Vietnam as the financial contribution for service delivery is to be increasingly borne by the national budget and other sources in Vietnam. The Government of Vietnam’s contributions to its HIV/AIDS national program are to be increased annually. Additional details regarding each Side’s financial or in-kind contributions to programs under the Partnership Framework are to be stipulated in the Partnership Framework Implementation Plan.

Section 4

Development of the Partnership Framework Implementation Plan

The goals and commitments for the Partnership Framework should be expanded in an Implementation Plan that is to specify the activities, commitments, indicators, and targets to achieve the goals and objectives.

The Implementation Plan should be developed by a design team that includes representatives of the Government of the United States and the Government of Vietnam. It should include a process of consultation with ministries, Provincial AIDS Centers, Technical Working Groups, agencies of the Government of the United States and their partners, the Joint United Nations Team on HIV, the World Bank, the Country Coordinating Mechanism of the Global Fund, and other donors and social organizations involved in HIV/AIDS programs. The design team should meet on a regular basis to clarify expected contributions from both Sides, as well as other donors and organizations, to the Implementation Plan. Both Sides are to work in a concerted and transparent manner to support the harmonization of the Partnership Framework Implementation Plan with the National Strategy for HIV, Global Fund supported activities, and other donor programs to ensure that contributions support program sustainability.

The two Sides are to be responsible for accelerating the design and development of the Implementation Plan for it to be signed and approved by October 2010. The Implementation Plan is to be subject to changes when the new National Strategy for HIV/AIDS is approved.

Section 5

Implementation and Management

The Government of Vietnam and the Government of the United States have developed effective mechanisms for joint oversight of current PEPFAR interventions, within the context of mutual respect, shared responsibility, and collaboration.

A Partnership Framework Steering Committee is to be established to facilitate the collaboration process of the partnership. The Steering Committee should include officials assigned by the Government of Vietnam and the Government of the United States, as well as representation from the United Nations and other donors to assist with joint work planning and to optimize efficiency.

Using the Partnership Framework as a foundation, and based on input from the stakeholders referenced and the technical perspectives of all involved Government of Vietnam and Government of the United States agencies, the two Sides are to undertake monitoring of program planning, implementation, and financial management. The two Sides should have joint responsibility for sharing guidance, implementation, and evaluation of the program.

The Government of Vietnam and the Government of the United States are to designate Co-Chairs of the Partnership Framework Steering Committee. The Co-Chairs are to be responsible for coordinating communications and activities with agency counterparts and for ensuring that implementation is directed to fulfil the goals of this Partnership Framework.

The Steering Committee should carry out annual reviews to determine program progress, lessons learned, and best practices as a basis for performance feedback or revisions to the Partnership Framework Implementation Plan. The Steering Committee should also convene on a semi-annual basis to monitor results and re-align planned activities as needed.

Nothing in this Partnership Framework is to constitute an obligation of funds by the Government of the United States.

This Partnership Framework is not an international agreement and does not give rise to international legal rights or obligations.

Signed in two copies, in the English and Vietnamese languages, with each text being equally official.

This Partnership Framework is signed in Hanoi, Vietnam on the twenty-second day of July, in the year two thousand and ten, and is effective as of the date of signature.