‘New bottle, but old wine’: From family planning to HIV/AIDS in post-Doi Moi Vietnam*

Abstract

This paper begins with an observation that during the past two decades HIV/AIDS has emerged as a new public health priority in Vietnam and has commanded increasing attention and resources from both the government and the donor community. By juxtaposing HIV/AIDS with family planning, another social and health priority that preceded, and overlapped with, HIV/AIDS for a large part of the 1990s, we show two major gaps that have undermined both programmes. One is the lack of a strong civil society, that could have served as advocates for change, especially outside the government and the donor community. The other is the desire for control of women's bodies and sexuality that has been driven by the ever shifting project of nation building. We argue that these two major gaps represent more continuity than discontinuity in the way sexual and reproductive health issues are approached in Vietnam despite the seeming shift in priority that the emergence of HIV/AIDS suggests.

Keywords:

• Vietnam
• HIV
• reproductive health
• family planning
• gender

Acknowledgements

We acknowledge the support of the Ford Foundation (Hanoi Office) for the preparation of this paper. We also thank our assistants, Ha Hai Doan and Lung Bich Ngoc, for their excellent work in library research. Last but not least, we want to express our gratitude to the invaluable comments and encouragement that we have received from the Secretariat of the Sexuality Policy Watch (SPW) and other researchers who have participated in this global study. All opinions expressed in this paper and their limitations are, of course, our own.

Notes

*This article is based on a longer study that was developed in collaboration with Sexuality Policy Watch, with funding provided by the Ford Foundation. For an extended discussion of the issues examined in this article, see “From family planning to HIV/AIDS in Vietnam: Shifting priorities, remaining gaps”, which is available as part of the e-book, SexPolitics: Reports from the Front Lines, edited by Richard Parker, Rosalind Petchesky, and Robert Sember, 2007. This e-book includes a series of case studies, as well as a crosscutting analysis, focused on the politics of sexual health and rights in eight countries and two institutional contexts. SexPolitics can be found online at <http://www.sxpolitics.org/frontlines/home/>.

1. Resolution of the Polite Bureau on continuing to strengthen the implementation of policy on population and family planning (Resolution 47/NQ-TW).

2. Decision of the Prime Minister on approval of the strategy for population and family planning to the year 2000 (Decision 270/TTg).

3. Various reasons have been attributed to this rapid decline in fertility rate. Some considered the leadership of the Party and timely policies and programmes initiated by the government as a crucial factor (Nhan & Phuong 2004); other critics called attention to harsh and even “forced” measures introduced in various localities, including heavy fines for couples who had more than two births (Goodkind 1995); Scornet (2001); and some have called attention to lesser known factors, such as the fact that Vietnamese people rapidly changed their attitudes and willingness to child bearing while under influences of economic and political pressures, as well as modernity aspirations Gammeltoft (1999). As Daniel Goodkind (1995) pointed out, the fact that the institution of “one-to-two-child” policy in 1988, however little political and financial backing that it received from the state at that time, overlapped with the introduction of economic reforms, made it difficult to separate “the independent roles of population policy, economic development, and other factors in fomenting fertility decline in Vietnam” (Goodkind 1995).

4. In his speech, delivered at the Cairo meeting, the Minister of NCPFP, Mai Ky, confirmed that “the government of Vietnam is deeply conscious of the close link between population and development”. However, the prevailing emphasis in most policy documents and programme implementation in Vietnam at that time, was on ways in which curbing population growth could contribute to development, especially economic growth, rather than the new emphasis on the contribution that development and equity could bring to various population and health issues.

5. Decision of the Prime Minister on ratifying the Vietnam population strategy for the period 2001–2010 (Decision 147/2000/QD-TTg).

6. Ordinance on Population, approved by the National Assembly Standing Committee (Ordinance 06/2003/PL-UBTVQH).

7. Directive on strengthening the leadership in the prevention and control of AIDS, issued by the Communist Party Central Committee's Secretariat (Directive 52/CT-TW).

8. Decree of the Government on strengthening management of cultural activities and services and abolishment of serious social evils (Decree 87/CP).

9. Decision of the Prime Minister on approval of the National Strategy on HIV/AIDS Prevention and Control in Vietnam until 2010 with a vision to 2020 (Decision 36/QD-TTg).