The Rehab Archipelago - Human Rights Watch

At the same time, some international donor agencies and NGOs have provided drug
detention centers with capacity building assistance and the provision of HIV and drug
dependency treatment services—and continue to do so. Some organizations describe this
approach as “a two-track strategy.” One presentation at the 18th International AIDS
Conference by Abt. Associates Inc. (a PEPFAR-funded research organization that works on
health policy in Vietnam) described it as follows:
1) Build evidence base and advocate for systemic change—away from center-based
compulsory detoxification and toward voluntary, community-based treatment;
2) Realistically, the entire system will not change soon: in the meantime, work to
improve conditions and services for people caught in the system. 347
As part of the strategy to “improve conditions and services in the centers,” the
presentation recommended:
• Expand[ing] evidence-based substance abuse treatment in centers:
• [Methadone maintenance treatment]…
• Addiction counseling (FHI curriculum)
• Relapse prevention
• Meaningful vocational training
• Transitional programs. 348
Efforts to improve drug dependency services in the centers along such lines ignore the fact
that even if drug dependency treatment in such settings could be made more effective—
indeed, even if rates of relapse to drug use could be lowered to zero—what happens in
such centers is illegal under Vietnamese and international law.
Some external involvement in drug detention centers has—and continues —to build the
capacity of center staff in delivering drug treatment services, in matters as diverse as
counseling, relapse prevention, and “positive living” skills. In this way, these so-called
two-tracks work at cross-purposes: improving the current system undermines the need for
fundamental systemic change.
347 “Improving the drug rehabilitation system in Vietnam: a two-track strategy,” T. Hammett, Abstract no.
MOAF0204, presentation at AIDS 2010 - XVIII International AIDS Conference, July 18-23, 2010. Presentation on
file with Human Rights Watch. Abt. Associates Inc. does not work in Vietnam’s drug detention centers.
348 Ibid.
95 HUMAN RIGHTS WATCH | SEPTEMBER 2011