Harm reduction and “Clean” community: can Viet Nam have both?

The history of drug use and the evolution of discourses on drug use in Viet Nam have created these conflicting pressures on police, and thus created contradictory expectations and led to different views and attitudes of police regarding various harm reduction measures. This might aid understanding why, despite the comprehensive and progressive policies on HIV/AIDS and harm reduction in Viet Nam, it is not easy for police to actively and effectively support and be involved in harm reduction at the ground level.To promote the wider acceptance of harm reduction the concept of community safety must be expanded to include community health; harm reduction must be integrated into the “new society” movement; and laws and policies need further revision to reduce contradiction between current drug laws and HIV laws.Harm reduction guidelines for police and other actors need to be disseminated and supported, embodying better ways of working between sectors, and all sectors in the partnership require support for building capacity to contribute to the overall goal.Viet Nam has had a major concentrated epidemic of HIV, from detection of the first case in 1990 to an estimated 280,000 infected in 2012, approximately 0.47% of the population. Around 65% of those infected have histories of injecting drug use (IDU), and among them HIV prevalence has reached 70% or more [1]. As detailed elsewhere in this volume, Viet Nam has responded with development of comprehensive and progressive policies on HIV and AIDS, including policy and legal support for harm reduction [2].How effectively do these policies translate to street level; and do they actually enable the work of implementers of harm reduction approaches? And more specifically, given that the major mechanism of implementation of laws is through law enforcement, especially by police: how effectively is law enforcement, especially community-level policing, involved in harm reduction in Viet Nam, and how can this involvement be improved?W