September 7, 2011

III. External Involvement

Overview

Although the Vietnamese government bears responsibility for the human rights abuses described in this report, the involvement of external organizations raises serious ethical concerns and, in some cases, may indirectly facilitate human rights abuses.

Several external organizations—bilateral and multilateral donor agencies, UN agencies, and international and national NGOs—provide detainees with HIV prevention information and/or HIV treatment and care in centers, or fund government authorities to do so. Some organizations provide drug dependency services for detainees. Other organizations fund training and capacity building for center staff on drug dependency services and/or HIV related issues.

The human rights concerns that some projects raise are particularly stark. For example, both the US government and United Nations Office of Drugs and Crime have funded training for government addictions counselors on the principle that drug treatment “does not have to be voluntary to be effective.”[262]

Implementing agencies and the donors who support them do not seem to have systems in place to report any human rights abuses that project staff would likely witness if present in the centers. More generally, different forms of involvement in centers (whether direct or indirect) build the capacity of such centers, thus undermining the need to close them. Funding the provision of healthcare services, irrespective of intention, also effectively has the impact of subsidizing the costs of detention, which means the centers can be more profitable.

In the course of researching this report, Human Rights Watch wrote to a number of external donors and implementing organizations requesting information about their involvement in the centers and specific information about their mechanisms for monitoring for human rights abuses against detainees. A number did not respond to Human Rights Watch’s correspondence by the time this report went to print.

While the exact content of their correspondence varied amongst those who did respond, organizations tended to provide a number of similar responses. Some correspondence did not address certain questions. Other correspondence denied awareness of reports of human rights abuses in the centers, and other correspondence did not identify any specific reporting mechanisms for human rights abuses experienced by detainees or witnessed by project staff in the course of implementing the projects.

Below is a table listing previous or current activities of donors and implementing agencies in drug detention centers in southern Vietnam.

Major Donors and Specific Projects

Donors

Implementing Agencies

Dates

Location (northern centers in parentheses)

US Government (President’s Emergency Plan for AIDS Relief/ Centers for Disease Control and Prevention/US Agency for International Development/Department of Labor)

Vietnamese government (Ho Chi Minh City Peoples AIDS Committee)

2006

Nhi Xuan center

US Government (President’s Emergency Plan for AIDS Relief/ Centers for Disease Control and Prevention/US Agency for International Development/Department of Labor)

Academy for Educational Development

2005 to 2008

Ho Chi Minh City (and Haiphong, Quang Ninh and other northern centers)

US Government (President’s Emergency Plan for AIDS Relief/ Centers for Disease Control and Prevention/US Agency for International Development/Department of Labor)

Family Health International (FHI)

2000 to 2011

Binh Dinh, Dong Nai, Nhi Xuan, Phu Nghia, Phu Duc, Binh Trieu, Duc Hanh, Binh Duc, Phuoc Binh, Phu Van, Bo La (and numerous in northern Vietnam)

US State Department (Bureau of International Narcotics and Law Enforcement Affairs)

Daytop International

1994, 2005 to 2006

Da Nang, Ba Ria- Vung Tau, Dak Lak, Dong Nai, Phu Van, Duc Hanh, Binh Trieu, Soc Trang, Kien Giang, An Giang (and 10 in northern Vietnam)

Global Fund to Fight AIDS, Tuberculosis and Malaria

Government of Vietnam

2008 to present

Currently 30-35 centers across Vietnam, proposed 65 centers

World Bank

Government of Vietnam

2005 to present

An Giang, Ben Tre, Hau Giang, 12 centers under Ho Chi Minh City administration, Khanh Hoa, Kien Giang, Tay Ninh, Tien Giang, Vinh Long, (Bac Giang, Hanoi, Haiphong, Lai Chau, Nam Dinh, Nghe An, Son La, Thai Binh,Thai Nguyen, Thanh Hoa, Yen Bai)

UNODC

Government of Vietnam/ Centre for Community Health and Development (COHED)

2006 to present

Numerous

Australian Agency for International Development (AusAID)

CARE Australia/ Government of Vietnam

2005 to 2008

Can Tho

Australian Agency for International Development (AusAID)

CARE Australia/ Government of Vietnam

2008 to present

An Giang, Can Tho

Royal Netherlands Embassy

COHED

2003 to 2004

Binh Dinh

Ford Foundation

COHED

2003 to 2005

Khanh Hoa, (Hanoi, Thai Nguyen)

Private

Living Values Education

2002 to present

Numerous

 

The US President’s Emergency Plan for AIDS Relief/ US Agency for International Development

Vietnam is one of 15 countries supported by PEPFAR, a program of the US State Department under the direction of the Office of the Global AIDS Coordinator (OGAC).[263] A number of US government agencies, including USAID, implement PEPFAR’s activities in Vietnam.[264] According to USAID:

Approximately $102 million in PEPFAR funding is expected to be available (for Vietnam) in FY 2011, and then annual allocations are expected to decrease steadily. Vietnam’s primary donor for HIV/AIDS programs is the [US government] through PEPFAR, which comprises over 85% of the total HIV/AIDS funding, and of the [US government] agencies managing PEPFAR funds in Vietnam, USAID is the largest implementer.[265]

In correspondence to Human Rights Watch, a USAID official noted that USAID “shares [Human Rights Watch’s] concerns about the lack of due process and treatment of detainees, and continues to regularly advocate with the Government of Vietnam for the centers’ closure.”[266]

Between 2003 and 2008, the Academy for Educational Development (AED) implemented the SMARTWork project in Vietnam with funding from USAID.[267] An abstract of a presentation regarding the project given at the 16th International AIDS Conference held in Toronto, Canada (2006), noted that:

Under the PEPFAR program, SMARTWork Vietnam responded to a long-standing request for comprehensive training assistance for the staff of these centres (designated 05 for sex workers and 06 for drug users) in 2005. The project designed and implemented this program for centres in Haiphong, Ho Chi Minh City and Quang Ninh provinces. Outreach training was also conducted for the staff of centres across a number of other northern provinces.[268]

A project description posted on the project website (now inactive) claimed that the AED project worked with a private garment manufacturing company in Ho Chi Minh City “to integrate and transition [injection drug users] from 06 centers into the workforce.”[269] Human Rights Watch wrote to AED seeking further information, but had received no response by the time this report went to print.[270]

Since 2006, PEPFAR has supported FHI to provide HIV and TB screening and care, as well as drug addiction and relapse prevention services, in the Nhi Xuan center (in Ho Chi Minh City) as part of its “transitions program.” FHI has trained center staff in case management and addiction counseling.[271] On its website, PEPFAR lists the Nhi Xuan center as a PEPFAR sub-partner.[272] Human Rights Watch wrote to FHI to request information on its projects in drug detention centers, but had not received a response by the time this report went to print.[273]

FHI’s training is discussed below, in the section entitled “Training in Compulsory Treatment.”

PEPFAR also funds the Ho Chi Minh City Provincial AIDS Committee to provide HIV counseling, testing and treatment, as well as “[Injection Drug User] peer education,” in the Nhi Xuan center.[274] Human Rights Watch wrote to the Ho Chi Minh City Provincial AIDS Committee seeking further information, but had received no response by the time this report went to print.[275]

In correspondence to Human Rights Watch, USAID confirmed it had funded capacity building for staff from 20 centers (in addition to the Nhi Xuan center) in Hanoi and Ho Chi Minh City, along the following lines:

Training on drug and society for leaders in 06 centers in HCMC and Hanoi… [and] [t]raining on drug addiction counseling for counselors in 06 centers in Hanoi and Ho Chi Minh City to provide them with counseling techniques and skills so that counselors and clients can work together in finding a way to solve a client’s problem. Relapse prevention skills have also been introduced.[276]

PEPFAR has stated plans to expand the model of the Nhi Xuan project to a further five drug detention centers.

The [Nhi Xuan] pilot, while achieving promising results, is limited in scope and coverage. With this in mind, PEPFAR has engaged the Vietnamese government to establish training and in-reach models using existing community-based staff to bring needed pre-release services to residents of five more centers without building additional center infrastructure… [277]

US Bureau of International Narcotics and Law Enforcement Affairs

In correspondence with Human Rights Watch, an official with the US Department of State’s Bureau of International Narcotics and Law Enforcement Affairs noted that in 1994 it funded the US-based drug treatment organization Daytop International to provide “one-time drug counseling training” for Ministry of Labor staff.[278]

In 2005 and 2006, INL funded Daytop International training for staff from 20 centers in a series of two month courses between November 2005 and October 2006.[279] The training addressed individual/group counseling methods and therapeutic community processes.[280]

An INL “Information Brief” reports that the 2005-2006 training led to reduced rates of drug use among detainees, measuring drug use prior to detention (100 percent) against drug use of those detainees with whom it apparently still had contact after six months, which was less than 65% of the detainees in the study.[281]It also reports increased staff capacity in the therapeutic community (TC) model and improvements in staff and resident behavior. It recommends that “[t]he TC model should be implemented in all Vietnamese drug treatment centers.”[282] However, certain defining characteristics of the therapeutic community model (people enter on a voluntary basis, people are free to leave, people are not held in government centers) are not present in practice in Vietnamese drug detention centers, a key fact apparently ignored in reaching this recommendation.

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Since 2008, the Global Fund to Fight AIDS, Tuberculosis and Malaria has funded Vietnam’s government to provide HIV and TB prevention, testing, and treatment services in drug detention centers.[283] GF resources have also funded the training of drug detention center staff on drug relapse prevention and HIV and TB prevention, treatment, and care.[284]

In correspondence to Human Rights Watch, the GF executive director summarized the fund’s support to the Vietnamese government in the following terms:

Funds from the Round 9 HIV grant support activities in approximately 30 detention centers, provide antiretroviral treatment to approximately 1,250 patients, and provide voluntary counseling, testing, and other services to 13,500 patients. Funds from the tuberculosis grants support activities in approximately 35 detention centers and provide direct services to 6,000 detainees.[285]

In 2010, Vietnam’s Country Coordinating Mechanism (CCM) sought additional GF money to expand support for training and services in 30 more centers, which would bring the total number of drug detention centers receiving GF support to 65 (over half the total number in Vietnam).[286]

In his correspondence the GF executive director stated, “We strongly reinforce our view that detention centers for drug users and sex workers do not provide effective treatment and rehabilitation and we do not support their use.”[287] He continued:

It is our view, however, that depriving detainees from accessing life-saving treatments and the means to protect themselves from HIV and other preventable conditions is inhuman. Until these centers are closed, the Global Fund will not exclude funding effective, evidence-based HIV prevention and AIDS treatment in the centers if detainees are otherwise unable to access these services.[288]

In the same correspondence, the executive director outlined a recent process of limiting GF funding to the Vietnamese government to a more restricted range of services in drug detention centers than previously funded.

In September 2010, the Global Fund took action to ensure that all activities implemented with funds disbursed under our grants in Viet Nam are compliant with human rights laws, norms and obligations and standards…. First, we reprogrammed existing grants in Viet Nam in late September 2010 such that they focus only on support, treatment and prevention of HIV and TB in detention centers. Second, at the signing of the Round 9 grants in early 2011, we committed to undertake a thorough review of activities conducted with grant funds in Vietnamese detention centers after six months’ implementation of the Round 9 grants. Finally, in early May 2011, we initiated a broad consultative process that will result in a further reprogramming of Global Fund grants in Viet Nam aimed at disallowing all peripheral activities in detention centers.

The letter did not provide detailed information about “support, treatment and prevention of HIV and TB in detention centers,” or how the GF would ensure the Vietnamese government abided by this limitation.

The World Bank

Since 2005, the World Bank has funded Vietnamese government authorities to provide HIV prevention, treatment, and care in drug detention centers. The project grant agreement (2005) provides $35 million to Vietnamese (mostly provincial) government authorities, of which $1.5 million has been used in drug detention centers.[289]

In correspondence to Human Rights Watch, the World Bank’s country director noted:

The World Bank targeted the centers because avoiding them would have resulted in serious public health risk, including many more infections and deaths. The overriding factor in our decision was the risk to the people in these centers and their right to lifesaving prevention and treatment.[290]

From 2005 to 2010 the World Bank project funded HIV clinics in three centers in what it described as a pilot program.[291] Under this component, funds were provided recruiting temporary consultants (doctors and nurses) and renovating health clinics and medical equipment. As a separate component of the same project, government authorities in 20 provinces were given funds to implement various HIV-related services in drug detention centers.[292]

United Nations Office of Drugs and Crime

In correspondence to Human Rights Watch, UNODC’s regional representative noted:

In co-operation with the Vietnamese government, UNODC is engaged to ensure improvements for the treatment of drug users, to protect the human rights of drug users, as well as for them to have access to basic healthcare, prevention and treatment services. UNODC also promotes a shift from compulsory drug treatment services to community-based services.[293]

UNODC has funded the training of drug detention center staff in Vietnam. For example, from 2006-2007 the UNODC country office in Vietnam oversaw a project (I66) training center staff and detainees on HIV prevention.[294] The project was funded to $55,866 and implemented by the Ministry of Labor and the Vietnamese nongovernmental organization COHED. The project involved training some 550 drug detention center staff and detainees on HIV prevention in over 20 centers.[295]

From 2007-2010 UNODC oversaw a separate project (H68) which aimed to build the capacity of drug treatment services (including counseling, communication, care, and social work) in the community and also in drug detention centers.[296] As part of this project $134,347 was spent on activities and equipment in drug detention centers. The project has involved training drug detention center staff from 10 provinces in drug addiction and treatment counseling, and also funded drug prevention workshops, films, performances and billboards in various centers.[297]The project also funded allowances and equipment for counselors working in seven centers, as well as study visits to Australia and Malaysia for Ministry of Labor staff and drug detention center staff.[298]

Project H68 is discussed in greater detail below, in the section entitled “Training in Compulsory Treatment.”

The Australian Agency for International Development

AusAID is the Australian government’s international development agency. In correspondence to Human Rights Watch, AusAID’s director general stated that “Australia believes compulsory drug detention centers should be closed. We have advocated for them to be replaced with community-based support centers.”[299]

AusAID’s director general also stated: “We will continue to provide services and support to detainees to help improve their circumstances and the spread of the disease [i.e. HIV]. We see this as an important and practical manifestation of harm reduction and human rights in Vietnam.”[300]

One of the organizations AusAID funds to work in drug detention centers is CARE Australia, an NGO that works in two southern centers (one near Can Tho city and the other in Ang Giang province).[301] CARE Australia outlined in correspondence to Human Rights Watch that the primary project objectives of this project are i) to reduce transmissible diseases in the centers and the community, ii) increase access to support services for those in the centers, iii) reduce violence (including gender based violence) in the centers and community, and iv) improve reintegration opportunities for people on release from the centers.[302]

Inadequate Attention to Human Rights Abuses

Based on the widespread and systematic nature of abuses in Vietnam’s drug detention centers, it is reasonable to assume that staff of organizations working in the centers will witness some forms of abuse.

Human Rights Watch wrote to donors and implementing agencies requesting, among other things, information on mechanisms for reporting human rights abuses witnessed in the centers or how such agencies would seek redress for victims of those abuses. Organizations either did not identify a specific mechanism in their correspondence or did not respond to the inquiry.

Human Rights Watch also sought information on whether organizations funding or providing services in the centers were aware of any reports of human rights abuses against detainees. In their responses, organizations either claimed that they were not aware of any human rights abuses or did not respond to the question.

Omitting any monitoring of the human rights conditions of detainees means that project descriptions, reports, and evaluations routinely point out the success of project activities in drug detention centers while failing to reflect any human rights abuses suffered by project “beneficiaries.” In this way, implementing agencies and the donors who support them risk ignoring the widespread and systematic human rights abuses that their project staff or “beneficiaries” witness.

The US President’s Emergency Plan for AIDS Relief/ US Agency for International Development

In July 2010 PEPFAR issued a policy to guide its HIV funding for people who inject drugs. The policy notes that PEPFAR-supported HIV prevention and intervention strategies “should be carried out in a manner consistent with human rights obligations.” [303] Further, according to US law, USAID, and State Department funds may not used to provide “assistance for any program, project or activity that contributes to the violation of international recognized workers rights.”[304]

USAID’s monitoring and evaluation indicators for projects in drug detention centers include indicators such as “the number of staff trained per training” and “[n]umber of trainees receiving [behavioral change communication] message[s],” but do not include any human rights indicators.

USAID did not provide any information in response to Human Rights Watch’s request in May 2011 for details on reports of human rights abuses in centers in which it has been involved.[305] Human Rights Watch repeated the request in July 2011 and USAID indicated it was in the process of preparing a response, although that response was not provided by the time this report went to print.[306]

As noted above, Human Rights Watch wrote to organizations that have implemented USAID-funded projects in drug detention centers (FHI, AED, and the Ho Chi Minh City Provincial AIDS Committee) requesting information on any existing mechanisms to monitor human rights abuses in the centers, or existing reports of human rights abuses against detainees. However, by the time this report went to print Human Rights Watch had not received a response from any of these organizations.[307]

US Bureau of International Narcotics and Law Enforcement Affairs

The US State Department’s “Information Brief” on the INL-funded project discussed above makes no reference to the existence of forced labor or other human rights abuses in detention centers.

INL's response to Human Rights Watch's letter did not include any information in relation to the request for details of reports of human rights abuses in centers in which it has been involved.[308] Human Rights Watch wrote to Daytop International to request information on its projects in drug detention centers, including whether it was aware of reports of human rights abuses against detainees. By the time this report went to print Human Rights Watch had not received a response.[309]

The Global Fund to Fight Aids, Tuberculosis and Malaria

The GF publishes detailed progress reports of the progress of its grants in Vietnam, including services in drug detention centers. For example, as evidence of successful use of the GF money for HIV/AIDS, a progress report notes that 99 percent of detainees in drug detention centers “correctly identify ways of preventing the sexual transmission of HIV and… reject major misconceptions about HIV transmission.”[310] Vietnam’s Country Coordinating Mechanism also reports regularly to the GF on progress made in the number of detainees who are tested for HIV or on HIV treatment.[311]

Vietnam’s CCM does not provide, nor does the GF require, any information on the human rights conditions of detainees. In correspondence to Human Rights Watch, the GF’s executive director stated, “We are fully aware of and share your concerns regarding the nature of activities being funded under our grants in these centers.”[312] He did not provide any information on whether GF had received reports of human rights abuses in drug detention centers in which GF funds have been used.

The World Bank

The World Bank has stated its support for the realization of human rights.[313] Its website notes that “[r]egarding forced labor, the Bank has repeatedly made it clear that it has not and would not support projects in which forced labor was or would be employed.”[314]

The World Bank claimed monitoring of projects in three drug detention centers in 2005 would “meet the highest ethical standards.”[315] However, human rights abuses were not identified as an indicator for monitoring.

[Monitoring and evaluation] indicators will include specific monitors of program activities (such as the numbers of residents tested, [anti-retroviral therapy] and medications dispensed, patient consultations performed and injecting equipment exchanged and appropriately disposed of) as well as indicators developed to gauge the efficacy of this model of harm reduction integrated with treatment and care (including rates of recidivism, and continuity of patient care).[316]

In correspondence to Human Rights Watch, the World Bank country director stated:

We are not aware of World Bank staff receiving any reports of human rights violations in the drug rehabilitation clinics supported by the Project. If we do receive such a report, we would make this a focus of a supervision mission to ensure all Bank policies are met and that any concerns are fully examined. [317]

United Nations Office on Drugs and Crime

With respect to UNODC, the Charter of the United Nations states that the UN shall promote universal respect for, and observance of, human rights and fundamental freedoms.[318] UNODC is one of six core UN agencies comprising an Inter-Agency Team that forms part of the governance framework of the “United Nations Global Compact on Human Rights, Labour, the Environment and Anti-Corruption” (the Global Compact).[319] Included among the Global Compact’s principles are “the elimination of all forms of forced and compulsory labor” (principle four) and “the effective abolition of child labor” (principle five).[320]

In correspondence with Human Rights Watch, UNODC’s deputy executive director noted that UNODC’s policy (on the handling of reports of human rights abuses witnessed or received by staff or those implementing UNODC projects) is that “any reports will be raised and addressed” and that “[a]n internal policy for UNODC, in the form of a guidance note for our staff, is being prepared and will be distributed to our field network when completed.”[321]

The correspondence notes that one of the purposes of UNODC’s dialogue with the Vietnamese government is to “improve the quality of treatment services and reduce the likelihood of human rights violations.” However, human rights abuses were not identified as an indicator for monitoring.

All UNODC projects have a monitoring and evaluation framework… In the case of the activities conducted in relation to the centers our process indicators have focused on the numbers of staff with improved knowledge about what constitutes effective drug treatment programmes, the number of quality treatment services for drug users, the extent of improved treatment outcomes, the improvement of existing structures and approaches, among others.[322]

Despite monitoring and evaluation of project H68 project sites by UNODC staff, neither UNODC’s project documents nor its mid-term evaluation of the project acknowledge that that forced labor occurs in the centers.[323] The sole reference to the issue of labor in the mid-term evaluation of project H68 is the observation that:

[Since the implementation of project activities in the Lao Cai drug detention center] communication between residents and staff has improved, with staff more willing to listen to the specific needs of residents and residents indicating a greater readiness to participate in education and labor programs within the centers.[324]

The deputy executive director’s correspondence noted that UNODC staff travel to various drug detention centers to monitor the implementation of project activities, such as counseling services. He also stated that “UNODC has not received any specific reports of suspected human rights violations [in Vietnam’s drug detention centers].”[325]

The Australian Agency for International Development

AusAID has stated its “strong support for civil and political rights throughout our aid work” and that it “seeks to maximise the benefits for human rights in all development assistance activities.”[326] In response to Human Rights Watch’s inquiry on reports of abuses, AusAID’s director general commented “AusAID expects officers that become aware of violations of human rights to report those activities to their supervisors,” and noted:

We are not aware of any reporting by AusAID staff or those implementing our programs of suspected human rights violations (such as torture and other forms of ill treatment, arbitrary detention, forced labour).[327]

In response to Human Rights Watch’s inquiry on reports of abuses, CARE Australia noted that its projects are guided by various codes of conduct, but that those codes do not specifically cover handling suspected human rights violations that staff witness or receive reports about while implementing projects.[328] CARE Australia confirmed that CARE staff routinely visit the centers in An Giang and Can Tho and that staff implementing and overseeing the project had not observed, or been made aware of, any human rights abuses.[329]

One of the stated project goals is to reduce violence (including gender-based violence) among center residents. CARE Australia reported to Human Rights Watch that an achievement of its project was that “there was no reported violence, including [gender-based violence] inside the 05/06 centers.”[330]

Training in Compulsory Treatment

Some of the principles of the technical assistance provided by external organizations are directly antithetical to the protection of the human rights of people who use drugs. As noted above, UNODC’s project H68 has involved training drug detention center staff from 10 provinces in drug addiction and treatment counseling, as well as funding allowances and equipment for counselors working in seven centers.[331] The H68 training manual is made up of five handbooks. The first handbook in the series includes a summary of “evidence-based drug treatment approaches.” As part of that section, the handbook notes:

Treatment does not need to be voluntary to be effective. Sanctions or enticements in the family, employment setting, or criminal justice system can significantly increase treatment entry, retention, and success.[332]

The “case management training manual” for government addictions counselors developed by FHI and funded by PEPFAR/USAID makes the same point.[333]

Human Rights Watch believes that, in a system that routinely forces drug users to undergo compulsory drug treatment in detention en masse, without due process, and subjects them to ineffective and abusive forms of drug treatment, training staff in the principle that “treatment does not need to be voluntary to be effective” will perpetuate those abuses.

FHI and USAID/PEPFAR did not respond to questions from Human Rights Watch regarding the use and rationale of their training manual.

In correspondence with Human Rights Watch, UNODC’s deputy executive director noted that “human rights principles, including those relating to privacy and client confidentiality, were included in the [H68] training progamme.” A question on whether the training discussed forced labor or “labor therapy” was answered “N/A” (i.e. not applicable).[334]

Neither training manual mentions labor therapy or forced labor. Neither training manual mentions the UNODC and WHO position that “only in exceptional crisis situations of high risk to self or others, compulsory treatment should be mandated for specific conditions and periods of time as specified by the law.”[335] While WHO and UNODC have stated elsewhere that, “neither detention nor forced labor have been recognized by science as treatment for drug use disorders,” that significant point is omitted from both training manuals.[336]

HIV-Focused Engagement

In 2009, adult HIV prevalence in Vietnam was 0.4%.[337] The HIV epidemic in Vietnam is concentrated among people who inject drugs, female sex workers, and men who have sex with men.[338] HIV prevalence among drug detention center detainees is hard to ascertain with any degree of accuracy. One study that measured HIV prevalence among detainees in six specific centers from 2000 to 2005 recorded rates between 30 and 60 percent.[339]

Many organizations base their involvement in drug detention centers on humanitarian grounds, with the stated position that external donors and their implementing partners have an obligation to relieve the suffering of detainees and provide access for them to life-saving treatment. For instance, the Vietnam CCM’s most recent proposal to the GF notes that the requested funding:

… is a humanitarian response to the circumstances of [people living with HIV] in these settings, and should not be interpreted as support for the policy of incarcerating [injecting drug users] and [female sex workers].[340]

The issue of HIV in the centers is a serious health and human rights concern. However, under Vietnamese law, ill detainees may be released to receive treatment when the center is unable to provide adequate healthcare services.[341] Thus, in practice, external provision of such services has the perverse impact of facilitating the continued detention of individuals who would otherwise be eligible for release from detention and transferred to a government hospital or returned home for treatment and care.

Responses from a number of donors indicated that this policy is indeed followed. The World Bank’s country director noted:

Upon the approval by the health staff at the district level, detainees can be referred to other government health facilities or be sent home for care and treatment if the illness of the detainee is outside the capacity of the clinic… Our understanding is that this policy is in effect. For example, in the 3 rehabilitation centers supported under the pilot program, a total of 221 detainees/patients were transferred for medical treatment in health facilities outside the rehabilitation centers during the period of 2007 to 2010.[342]

Human Rights Watch believes that people living with HIV currently detained in the centers should be released from detention and treated in the community where their HIV infection can be effectively managed and they do not face the abuses they face in detention.

In situations where torture and other forms of inhumane treatment, forced labor, and other human rights abuses are widespread and systematic, healthcare professionals operating there have an ethical obligation to address those human rights abuses.

The World Medical Association's Declaration of Tokyo states that:

The physician shall not countenance, condone or participate in the practice of torture or other forms of cruel, inhuman or degrading procedures, whatever the offense of which the victim of such procedures is suspected, accused or guilty, and whatever the victim's beliefs or motives.[343]

The International Council of Nurses’ position on “the care of detainees and prisoners” states:

Nurses who have knowledge of abuse and maltreatment of detainees and prisoners [are expected to] take appropriate action to safeguard their rights.… Nurses [are expected to] abstain from using their nursing knowledge and skills in any manner, which violates the rights of detainees and prisoners.[344]

The failure of donors and the implementing partners to monitor the human rights conditions of detainees renders impossible any accurate assessment of the impact of donor’s humanitarian assistance. Thus, while donors are driven by a stated intention to relieve detainee suffering, there is no adequate means to assess whether detainee suffering is indeed relieved.

Capacity Building of Centers

In recent years, some UN agencies and international organizations have begun to express concern about Vietnam’s drug detention centers. In a plenary address in July 2010 at the 18th International AIDS Conference (held in Vienna, Austria) the Executive Director of the Global Fund, Dr. Michel Kazatchkine, called for the closure of all compulsory drug detention centers, specifically saying that he had conveyed this message to Vietnamese delegates at the meeting.[345]

This call has been echoed by UNAIDS, UNODC, UNDP, Unicef, WHO, and the UN High Commissioner for Human Rights. The UN Special Rapporteurs on Torture and Health have also spoken out against abuses in drug detention centers; the Director of the Drug Policy Coordination Unit of the European Commission, said: “I believe that [these types of centers] are an abomination.”[346]

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.

Subsidizing Detention Costs

The current decrees governing drug detention centers explicitly list international aid among the possible sources of drug detention center budgets.[349] Studies have attempted to estimate the economic costs of operating drug detention centers in Vietnam. One such study reported that:

Annual cost per trainee was US$225 (Yen Bai) and $630 (Hanoi). Projected annual costs of government plans to place 75% of [injecting drug users] in 06-centres would rise, in Hanoi, from US$5 million in 2005 to $10-$15 million in 2015.[350]

Such studies have concluded that “drug rehabilitation in closed settings is not cost-effective and does not work.” In the course of such studies, it was noted that health-related costs vary greatly from center to center, but were around 10 percent of total costs.[351]

In effect, external involvement offsets many health-related costs of detaining people in drug detention centers, thus making the centers more economically profitable.

Non-Engagement by Donors

In the course of researching this report, Human Rights Watch wrote to some donors who stated in written responses that they were not engaged in Vietnam’s drug detention centers.

In 2009, the United Kingdom’s Department for International Development (DfID) announced that its existing HIV prevention program in Vietnam would merge with the existing World Bank-funded and government run project identified above.[352] In correspondence to Human Rights Watch, the UK secretary of state clarified that DfID has never funded projects in Vietnam’s drug detention centers and noted:

The UK government opposes the Vietnamese Government’s use of such centres, partly of the reasons you have outlined in your letter and partly because this type of approach to the issue of illegal injecting drug use has been found to be expensive, ineffective and often harmful.[353]

An official at the Embassy of Canada in Hanoi clarified that the Embassy of Canada had not conducted specific projects in Vietnam’s drug detention centers.[354] Similarly, United Nation Development Programme’s (UNDP) regional director for Asia and the Pacific made clear that UNDP has not provided any assistance or support to Vietnam’s drug detention centers.[355]

[262] UNODC, “Advanced Level Training Curriculum for Drug Counsellor,” 2008, Handbook 1, p. 31; Family Health International, “Case Management for Recovering Drug Users in Vietnam: A Training Curriculum Participants Manual” March 2009, p. 74. Both the World Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNODC) note, “only in exceptional crisis situations of high risk to self or others, compulsory treatment should be mandated for specific conditions and periods of time as specified by the law.” UNODC/WHO, “Principles of Drug Dependency Treatment,” March 2008, p.9.

[263] PEPFAR began funding projects in Vietnam in 2004.

[264]  Other implementing agencies include the US Centers for Disease Control and Prevention (CDC), Department of Defense (DoD) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

[265]  USAID, “Request for applications: Pathways for Participation: Strengthening the Civil Society Response to HIV in Vietnam Project,” February 2, 2011, p. 17.

[266] Letter from Gregory Beck, acting assistant administrator, bureau of Asia, United States Agency for International Development, to Human Rights Watch, undated [received by Human Rights Watch July 1, 2011].

[267] In June 2011, FHI announced it had acquired the programs, assets and other expertise of AED. “FHI and AED Sign Asset Purchase Agreement,” FHI and AED press release, June 8, 2011, http://www.aed.org/News/Releases/asset-purchase-agreement.cfm (accessed August 23, 2011).

[268]  “Addressing HIV/AIDS capacity needs in sex worker and drug user rehabilitation in Viet Nam: SMARTWork Viet Nam,” P. Burke, Abstract no. WEPE0510, AIDS 2006 - XVI International AIDS Conference, August 13-18, 2006. Copy on file with Human Rights Watch.

[269] SMARTWork, “SMARTWork/Vietnam,” undated, www.smartwork.org/programs.vn.shtml (accessed February 17, 2010). Copy on file with Human Rights Watch.

[270] Letter from Human Rights Watch to Gregory R. Niblett, president and chief executive officer, Academy for Educational Development, May 24, 2011.

[271] “HCMC PAC/PEPFAR 06 Center Program, Supporting Prevention, Care and Treatment for 06 Center Residents,” presentation to the Vietnam HIV Technical Working Group Meeting February 11 2009, http://www.unaids.org.vn/sitee/images/stories/pepfar_06_pilot_program_-_nhi_xuan_center_-_revised_10feb09.pdf (accessed August 23, 2011), presentation and minutes on file with Human Rights Watch; PEPFAR, “Populated Printable Country Operating Plan, 2009, Vietnam,” 2009, p. 115 www.pepfar.gov/documents/organization/140426.pdf (accessed August 123, 2011). In a frank assessment of its “transitions project” in the Nhi Xuan center, FHI reported that “90 percent [of detainees involved in the project] relapsed or were lost to follow-up within 6 months.” See Family Health International, “Evaluation of USAID/Vietnam’s support for HIV/AIDS: The FHI Program: HIV/AIDS Prevention, Care and Treatment in Vietnam, Final Report for USAID/Vietnam,” 2010, p. 20.

[272] According to the website, “A sub partner is defined as an entity to which a prime partner [in this case FHI] allocates funding.” See, for example, PEPFAR, “FY2008 Vietnam partners,” http://www.pepfar.gov/partners/2008/128099.htm (accessed July 28, 2011). Copy on file with Human Rights Watch.

[273] Letter from Human Rights Watch to Albert Seimens, chairman and chief executive officer, Family Health international, May 17, 2011. Human Rights Watch identified information on earlier projects implemented by FHI in drug detention centers. For example, USAID funded Family Health International (FHI) to implement projects in centers in Binh Dinh province (2000-2002) and Dong Nai (2002-2003). See Family Health International, “HIV/AIDS Prevention and Care in Vietnam: Lessons learned from the FHI/IMPACT Project 1998-2003,” 2004, pp. 74- 85, 124-131.

[274] PEPFAR, “Populated Printable Country Operating Plan, 2009, Vietnam,” 2009, p. 115. www.pepfar.gov/documents/organization/140426.pdf (accessed August 123, 2011).

[275] Letter from Human Rights Watch to Hua Ngoc Thuan, chairman, Ho Chi Minh City Provincial AIDS Committee, May 2, 2011.

[276] Letter from Gregory Beck, acting assistant administrator, bureau of Asia, United States Agency for International Development, to Human Rights Watch, undated [received by Human Rights Watch July 1, 2011].

[277] PEPFAR, “Vietnam Country Operational Plan Report: FY2010,” March 19, 2010, p. 18, www.pepfar.gov/documents/organization/145740.pdf (accessed July 28, 2011). “In-reach” refers to providing services in detention settings from outside the center.

[278] Letter from Gregory Stanton, demand reduction programme officer, Bureau for International Narcotics and law Enforcement Affairs, US Department of State, to Human Rights Watch, June 16, 2011.

[279] US Department of State, Bureau of International Narcotics and law Enforcement Affairs, “Information Brief: Vietnamese Drug Treatment Outcome study,” April 2009. Copy on file with Human Rights Watch.

[280] Letter from Gregory Stanton, demand reduction programme officer, Bureau for International Narcotics and law Enforcement Affairs, US Department of State, to Human Rights Watch, June 16, 2011. The project trained staff from a number of centers covered by this report, including the Duc Hanh center (the location of the photos presented in this report). Danya International, “Effectiveness of INL Drug Treatment Training in Vietnam: A 2008 Follow-Up Study,” February 2009. Copy on file with Human Rights Watch.

[281] US Department of State, Bureau of International Narcotics and law Enforcement Affairs, “Information Brief: Vietnamese Drug Treatment Outcome study,” April 2009. The “Information Brief” summarizes research on the training undertaken by Danya International. See Danya International, “Effectiveness of INL Drug Treatment Training in Vietnam: A 2008 Follow-Up Study,” February 2009. The study did not identify a control group. The study involved interviewing 615 residents at 30 days after release and (of this number) 392 at 6 months after release. The INL “Information Brief” only reports on the rates of drug use among the 392 people at the 6 month mark (with results showing that among this group, drug use fell from 100 percent “before treatment” to 27 percent six months after release). It appears that 223 former residents were lost to follow-up between 30 days and 6 months after release. If rates of return to drug use were high among these 223 former residents, then the overall rates of drug use at the six month mark could be considerably higher.

[282] Ibid., p. 2.

[283]  The funds have been provided to the Vietnamese government under HIV/AIDS round 6 (January 2008- March 2010), HIV/AIDS round 8 (beginning April 2010), TB round 9 (beginning January 2011) and HIV/AIDS round 10 (beginning January 2011). Note that Vietnam’s Country Coordinating Mechanism (CCM) and The Global Fund refer to Vietnam’s drug detention centers as “Treatment and Education Centers” or (more recently) as “Training, Education and Social Labor Centers.”

[284] The Global Fund and the Ministry of Health of Vietnam,” [TB round 6] Consolidated Program Grant Agreement,” undated, annex A; The Global Fund and the Ministry of Health of Vietnam, “[TB round 9] Program Grant Agreement,” signed November 25, 2010, annex A; The Global Fund and the Ministry of Health of Vietnam, “[HIV round 6] Program Grant Agreement,” signed October 29 and 30, 2007, annex A; The Global Fund and the Ministry of Health of Vietnam, “[HIV round 8] Program Grant Agreement,” signed November 5, 2009, annex A.

[285] Letter from Michel Kazatchkine, executive director, the Global Fund to Fight AIDS, Tuberculosis and Malaria, to Human Rights Watch, June 11, 2011.

[286] Vietnam’s Country Coordinating Mechanism, “Proposal Form, Round 10,” 2010. Country Coordinating Mechanisms (CCMs) include representatives from governments, multilateral or bilateral agencies, non-governmental organizations, academic institutions, private businesses and people affected by the diseases (HIV, TB and malaria) that the Global Fund focuses on. Country Coordinating Mechanisms develop proposals to The Global Fund and oversee implementation of Global Fund grants. The Ministry of Labor is represented on Vietnam’s CCM.

[287]  Letter from Michel Kazatchkine, executive director, the Global Fund to Fight AIDS, Tuberculosis and Malaria, to Human Rights Watch, June 11, 2011.

[288]  Ibid.

[289] Development Grant Agreement (Vietnam HIV/AIDS Prevention Project) between Socialist Republic of Vietnam and International Development Association,” IDA Grant Number 152- VN, May 26, 2005, Schedule 2 “Description of the project.” Project documents available via: http://web.worldbank.org/external/projects/main?Projectid=P082604&theSitePK=40941&pagePK=64283627&menuPK=228424&piPK=73230 (accessed July 28, 2011); Letter from Victoria Kwarka, Vietnam country coordinator, The World Bank, to Human Rights Watch, June 9, 2011.

[290] Ibid.

[291] The three centers under this component of the project are centers in Hanoi, Hai Phong and Khanh Hoa. See, for example, [World Bank] Procurement Plan 2007, Vietnam HIV/AIDS Prevention Project, document 41502, p. 5. http://web.worldbank.org/external/projects/main?pagePK=51351038&piPK=51351152&theSitePK=40941&menuPK=51351213&query=&fromDate=&docType=4&IRISF=&docTitle=&author=&aType=&owner=&origu=&colTitle=&displayOrder=DOCNA%2CDOCDT%2CREPNB%2CDOCTY&callBack=&siteName=PROJECTS&sType=&report=&loan=&trustfund=&projid=P082604&credit=&sourceCitation=&projectId=P082604&sortDesc=DOCDT&dAtts=DOCDT%2CDOCNA%2CREPNB%2CDOCTY%2CLANG%2CVOLNB%2CREPNME&startPoint=0&pageSize=10 (accessed July 28, 2011).

[292] Development Grant Agreement (Vietnam HIV/AIDS Prevention Project) between Socialist Republic of Vietnam and International Development Association,” IDA Grant Number 152- VN, May 26, 2005, Annex to Schedule 2; Letter from Victoria Kwarka, Vietnam country coordinator, The World Bank, to Human Rights Watch, June 9, 2011.

[293] Letter from Gary Lewis, regional representative, UNODC, to Human Rights Watch, June 30, 2011.

[294] UNAIDS, “United Nations Office of Drugs and Crime (UNODC) in Vietnam,” undated, http://www.unaids.org.vn/about/cosponsor/unodc.htm (accessed March 24, 2011).

[295] Letter from Sandeep Chawla, deputy executive director, UNODC, to Human Rights Watch, August 10, 2011.

[296] The project was slated to end in 2010 although of May 2011 it was listed as active on the UNODC Vietnam website. UNODC, “AD/VIE/H68 - Technical Assistance to Treatment and Rehabilitation at Institutional and Community Level,” http://www.unodc.org/eastasiaandpacific/en/Projects/2006_01/rehabilitation.html (accessed May 1, 2011).

[297] Letter from Sandeep Chawla, deputy executive director, UNODC, to Human Rights Watch, August 10, 2011.

[298] Ibid.

[299] Letter from Peter Baxter, director general, AusAID, to Human Rights Watch, May 30, 2011.

[300]  Ibid.

[301] AusAID/CARE, “Striving for Transformation through Empowered People (STEP),” undated. Copy on file with Human Rights Watch. See also CARE Australia, “Vietnam, Help her learn,” undated, http://www.care.org.au/Page.aspx?pid=222 (accessed April 12, 2011). AusAID previously funded CARE Australia in Vietnam for a three year project (2005-2008) in the Can Tho drug detention center. Vietnam HIV Research Network, “Peers Leading Understanding and Support for Positive Living and User- friendly Services (PLUS PLUS),” undated, http://aids.vn/AIDS_en/index.php?option=com_project&id=9&task=view&Itemid=70 (accessed April 12, 2011).

[302] Letter from Julia Newton-Howes, chief executive, CARE Australia, June 21, 2011.

[303] PEPFAR, Comprehensive HIV Prevention for People Who Inject Drugs, Revised Guidance, July 2010, p. 5.

[304] See FY 2010 Appropriations Act, Sec. 7029. The term “internationally recognized worker rights” includes “ a prohibition on the use of any form of forced or compulsory labor” and “and a prohibition on the worst forms of child labor” (which includes forced or compulsory labor of children). See 19 USC. 2467(4).

[305] Letter from Gregory Beck, acting assistant administrator, bureau of Asia, United States Agency for International Development, to Human Rights Watch, undated [received by Human Rights Watch July 1, 2011].

[306] Letter from Human Rights Watch to Dr. Rajiv Shah, July 8, 2011, administrator, USAID, requesting a response by July 29, 2011; Letter from Francis Donovan, mission director, USAID in Vietnam, to Human Rights Watch, August 4, 2011.

[307] Letter from Human Rights Watch to Albert Seimens, chairman and chief executive officer, Family Health International, from Human Rights Watch, May 17, 2011; Letter from Human Rights Watch to Gregory R. Niblett, president and chief executive officer, Academy for Educational Development, May 24, 2011; Letter from Human Rights Watch to Hua Ngoc Thuan, chairman, Ho Chi Minh City Provincial AIDS Committee, May 2, 2011.

[308]  Letter from Gregory Stanton, demand reduction program officer, Bureau for International Narcotics and law Enforcement Affairs, US Department of State, to Human Rights Watch, June 16, 2011. Recent State Department reports from bureaus other than INL do identify the existence of forced labor in detention centers. See the US State Department, Bureau of Democracy, Human Rights, and Labor, “Country Reports on Human Rights Practices – 2010: Vietnam,” April 8, 2011, www.state.gov/g/drl/rls/hrrpt/2010/eap/154408.htm (accessed June 6, 2011). The report states under the heading “Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment” that “[t]he government reported that more than 33,000 drug users were living in forced detoxification labor camps. The overwhelming majority of these individuals were administratively sentenced to two years without judicial review.” Under the heading “Arbitrary Arrest or Detention” the report notes that police “can propose that one of five "administrative measures" be imposed by people's committee chairpersons at district and provincial levels without a trial. …Terms of 24 months were standard for drug users and prostitutes. Individuals sentenced to detention facilities were forced to meet work quotas to pay for services and the cost of their detention.” See also US State Department, “Trafficking in Persons Report— 2011: Vietnam,” June 27, 2011, http://www.state.gov/g/tip/rls/tiprpt/2011/164233.htm (accessed July 11, 2011). The report states, “There continued to be evidence of forced labor in drug treatment centers in which drug offenders, sentenced administratively, are required to perform low-skilled labor, though this practice is reportedly declining.”

[309] Letter from Human Rights Watch to Aloysius Joseph, vice president, Daytop International, May 24, 2011.

[310] The Global Fund, “[HIV round 8] Grant Performance Report: Vietnam VTN-809-G07-H,” 2010, p. 12.

[311]  See, for example The Global Fund, “[HIV round 8] Grant Performance Report: Vietnam VTN-809-G07-H,” 2010, p. 12.

[312]  Letter from Michel Kazatchkine, executive director, the Global Fund to Fight AIDS, Tuberculosis and Malaria, to Human Rights Watch, June 11, 2011.

[313] The World Bank, “FAQs- Human Rights,” October 2009, http://web.worldbank.org/WBSITE/EXTERNAL/EXTSITETOOLS/0,,contentMDK:20749693~pagePK:98400~piPK:98424~theSitePK:95474,00.html (accessed May 1, 2011).

[314]  The World Bank, “Core Labor Standards and the World Bank,” June 2000, http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTSOCIALPROTECTION/EXTLM/0,,contentMDK:20310132~menuPK:390633~pagePK:148956~piPK:216618~theSitePK:390615~isCURL:Y,00.html (accessed May 1, 2011). A discussion of the World Bank’s relationship with human rights published in 1998 noted: “When the Bank has concerns with the level or kind of child labor in a borrowing country, it raises the issue, with an eye toward helping the government to address the problem. This may take the form of including a provision in lending agreements that the borrower would undertake to enforce its laws where there is good reason to believe that exploitative child labor with negative development effects may occur.” The World Bank, “Development and Human Rights: The Role of the World Bank,” 1998, p. 23.

[315] The World Bank, “Project Appraisal Document on a Proposed Grant in the Amount of SDR 23.1 million (US$ 35.0 million equivalent) to the Socialist Republic of Vietnam for the Vietnam HIV/AIDS Prevention Project,” Report No. 30319-VN, March 7, 2005, p. 9.

[316]  Ibid., p. 38.

[317]  Letter from Victoria Kwarka, Vietnam country coordinator, The World Bank, to Human Rights Watch, June 9, 2011.

[318] United Nations Charter, arts. 1(3), 55

[319]  The Global Compact is an initiative to encourage businesses to embrace and promote a series of 10 widely accepted principles.

[320] UN Global Compact, "About the UN Global Compact: The Ten Principles," at http://www.unglobalcompact.org/AboutTheGC/TheTenPrinciples/index.html (accessed May 1, 2011). These are also Fundamental Principles two and three of the ILO Declaration of 1998 which is binding on all ILO member states.

[321]  Letter from Sandeep Chawla, deputy executive director, UNODC, to Human Rights Watch, August 10, 2011.

[322] Letter from Sandeep Chawla, deputy executive director, UNODC, to Human Rights Watch, August 10, 2011.

[323] UNODC, “VIEH68: technical assistance to Treatment and Rehabilitation at Institutional and Community Level, 2006 Annual Project Progress Report,” 2006; UNODC, “VIEH68: technical assistance to Treatment and Rehabilitation at Institutional and Community Level, 2007 Annual Project Progress Report,” 2007; UNODC, “VIEH68: technical assistance to Treatment and Rehabilitation at Institutional and Community Level, 2008 Annual Project Progress Report,” 2008; UNODC, “VIEH68: technical assistance to Treatment and Rehabilitation at Institutional and Community Level, 2009 Annual Project Progress Report,” 2009; UNODC, “Mid-term Evaluation Report AD/VIE/H68: Technical Assistance to Treatment and Rehabilitation at Institutional and Community Level,” 2008, http://www.unodc.org/unodc/en/evaluation/project-evaluations-2007.html (accessed April 11, 2011).

[324]  UNODC, “Mid-term Evaluation Report AD/VIE/H68: Technical Assistance to Treatment and Rehabilitation at Institutional and Community Level,” 2008, http://www.unodc.org/unodc/en/evaluation/project-evaluations-2007.html (accessed April 11, 2011).

[325] Letter from Sandeep Chawla, deputy executive director, UNODC, to Human Rights Watch, August 10, 2011.

[326]  AusAID, “Human rights and Australia’s aid program,” December 2010, http://www.ausaid.gov.au/keyaid/humanrights.cfm (accessed May 1, 2011).

[327]  Letter from Peter Baxter, director general, AusAID, to Human Rights Watch, May 30, 2011.

[328]  Letter from Julia Newton-Howes, chief executive, CARE Australia, June 21, 2011.

[329] Ibid.

[330] Ibid. Human Rights Watch is surprised by this conclusion which is wholly inconsistent with the frequent reports of violence received from former detainees during the course of researching this report.”

[331] Letter from Sandeep Chawla, deputy executive director, UNODC, to Human Rights Watch, August 10, 2011.

[332] UNODC, “Advanced level Training Curriculum for Drug Counselor,” 2008, Handbook 1, p. 31.

[333] Family Health International, “Case Management for Recovering Drug Users in Vietnam: A training Curriculum Participants Manual” March 2009, p. 74.

[334] Letter from Sandeep Chawla, deputy executive director, UNODC, to Human Rights Watch, August 10, 2011.

[335] UNODC/WHO, “Principles of Drug Dependency Treatment,” p.9.

[336] Ibid., p. 14.

[337] UNAIDS, “Report on the global AIDS epidemic 2010,” p. 188, http://www.unaids.org/globalreport/Global_report.htm (accessed July 28, 2011).

[338] Ibid.

[339] “Does drug rehabilitation in closed settings work in Vietnam,” Duc T. Tran, presentation at Harm Reduction 2009, Bangkok, April 21, 2009, direct attendance by Human Rights Watch researcher. Vietnam’s CCM stated that in 2008 the rate of detainees who were HIV positive was an average of 40-50 percent, although in 2010 it claimed that the HIV prevalence rates of detainees was 15-20 percent. Vietnam Country Coordinating Mechanism, “Proposal Form- Round 8,” 2008, p. 30; Vietnam Country Coordinating Mechanism, “Proposal Form- Round 10,” 2010, p.21.

[340] Vietnam Country Coordinating Mechanism, “Proposal Form- Round 10,” 2010, p. 3.

[341] Decree 135 of 2004 establishes that people certified as having contracted a serious illness shall be exempt from the decision to detain them or have that decision delayed. The same decree provides, “In cases an individual serving the decision contracted a serious illness or fatal disease that exceeds the caring capacity of the Center for Social Treatment, Education and Labor, he/she shall be transferred to a state run hospital, or returned to the family for caring and treatment. The duration of caring and treatment shall be accounted for as part of the period of serving the decision.” The 2009 decree governing post-rehabilitation management has similar provisions. See Decree 135/2004/ND-CP, June 10, 2004, art. 18 and 34(1). Also see Decree 94/2009/ND-CP, October 26, 2009, art. 32(1). The principle that people suffering a serious illness should be released from drug detention has been present in Vietnam’s drug detention center regulations since the mid-1990s. See, for example,Decree 20/CP of 1996, art. 36.

[342]Letter from Victoria Kwarka, Vietnam country coordinator, The World Bank, to Human Rights Watch, June 9, 2011. Similarly, AusAID noted, that “During AusAID discussions with the Provincial Government in the three provinces (Hoa Binh, Tuyen Quang, Bac Kan) [i.e. northern provinces in which AusAID funds the project HIV/AIDS Asia Regional Program (HAARP) to work in the centers] we have raised the question of implementation with health and law enforcement officers. We were told by these officials that seriously ill drug users are transferred to provincial health centers or hospitals. We are considering the possibility of HAARP providing funding for Hepatitis B and Hepatitis C treatment in hospitals to which intravenous drug-users that became seriously ill would be transferred as an incentive to implement the decree.” Letter from Peter Baxter, director general, AusAID, to Human Rights Watch, May 30, 2011.

[343] World Medical Association: Guidelines for medical doctors concerning torture and other cruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment. Adopted by the 29th WMA Assembly, Tokyo, Japan, October 1975.

[344] International Council of Nurses, “Nurse’s role in the care of detainees and prisoners,” Geneva, 2006, http://www.icn.ch/publications/position-statements/ (accessed May 1, 2011). See also International Federation of Social Workers (IFSW), International Association of Schools of Social Work (IASSW), “Ethics in Social Work, Statement of Principles,” approved at the General Meetings of the International Federation of Social Workers and the International Association of Schools of Social Work in Adelaide, Australia, October 2004, http://www.ifsw.org/f38000032.html (accessed May 1, 2011).

[345] “Providing Impact, Promoting Rights. The Global Fund to Fight AIDS, Tuberculosis and Malaria,” Michel Kazatchkine, presentation at AIDS 2010 - XVIII International AIDS Conference, July 18-23, 2010. Available at: www.theglobalfund.org/documents/executive_director/ED_ProvingImpactPromotingRights_Speech_en/ (accessed August 23, 2011).

[346] Letter from Michel Sidibé, Executive Director of UNAIDS to Human Rights Watch, March 30, 2010, on file with Human Rights Watch; UN Commission on Narcotics Drugs, “Drug Control, Crime Prevention, and Criminal Justice: A Human Rights Perspective, Note by the Executive Director,” E/CN.7/2010/CRP.6*–E/CN.15/2010/CRP.1 , March 3, 2010, http://www.unodc.org/documents/commissions/CND-Uploads/CND-53-RelatedFiles/ECN152010_CRP1-6eV1051605.pdf (accessed May 12, 2011); Comments by Mandeep Dhaliwal, Cluster Leader: Human Rights, Gender & Sexual Diversities, United Nations Development Programme, “Harm Reduction 2010 The Next Generation: Addressing the Development Dimensions,” presentation at the International Harm Reduction Association Annual Conference, Liverpool, April 29, 2010; “Statement of the care and protection of children in institutions in Cambodia,” UNICEF East Asia & Pacific Regional Office, June 8, 2010, http://www.unicef.org/eapro/UNICEF_Statement_on_HRW.pdf (accessed May 12, 2011); Email from Gottfried Hirnschall, Director of HIV/AIDS Department of WHO to Human Rights Watch, May 6, 2010, on file with Human Rights Watch; “High Commissioner calls for focus on human rights and harm reduction in international drug policy,” United Nations Office of the High Commissioner on Human Rights press release, March 10, 2009, http://www.unhchr.ch/huricane/huricane.nsf/view01/3A5B668A4EE1BBC2C12575750055262E?opendocument (accessed May 12, 2011); UN Human Rights Council, Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Manfred Nowak, A/HRC/10/44, January 14, 2009, http://www2.ohchr.org/english/bodies/hrcouncil/docs/10session/A.HRC.10.44AEV.pdf (accessed May 12, 2011); UN General Assembly, Report of the Secial Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Anand Grover, A/65/255, August 5, 2010, http://daccess-dds-ny.un.org/doc/UNDOC/GEN/N10/477/91/PDF/N1047791.pdf?OpenElement (accessed May 12, 2010); Comments by Carel Edwards, Director of the Drug Policy Coordination Unit of the European Commission, in Hungarian Civil Liberties Union, “Abuse in the Name of Treatment- Drug Detention Centers in Asia,” video report, 2010, http://tasz.hu/en/hclu-film/abuse-name-treatment-drug-detention-centers-asia (accessed May 12, 2011).

[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.

[349] Decree 135/2004/ND-CP, June 10, 2004, art. 8; Decree 94/2009/ND-CP, October 26, of 2009, art. 4. A similar provision has been in place since the mid-1990s. See, for example, Decree No. 20/CP on April 13, 1996, art. 5.

[350] “Cost analysis as a tool for assessing options for addressing drug use and related HIV infection in Vietnam,” T. Xuan Sac, et al., Abstract no. WEPE0883, AIDS 2006 - XVI International AIDS Conference, August 13-18, 2006. Copy on file with Human Rights Watch.

[351] “Does drug rehabilitation in closed settings work in Vietnam,” Duc T. Tran, presentation at Harm Reduction 2009, Bangkok, April 21, 2009, attended by Human Rights Watch researcher.

[352] “UK finances Vietnam’s anti-AIDS prevention,” Nhan Dan online, June 9, 2009, http://www.hoilhpn.org.vn/NewsDetail.asp?Catid=122&NewsId=10920&lang=EN (accessed July 28, 2011).

[353] Letter from Andrew Mitchell, secretary of state for international development, Department for International Development, to Human Rights Watch, May 18, 2011.

[354] Letter from Joya Donelly, charge d’affaires a.i., Embassy of Canada in Vietnam, to Human Rights Watch, July 19, 2011.

[355] Letter from Ajay Chhibber, UN assistant secretary general, UNDP assistant administrator and regional director for Asia and the pacific, to Human Rights Watch, June 20, 2011.