Report and Recommendation of the President to …

1 Report and Recommendation of the President to the Board of Directors Sri Lanka Project Number: 38581 June 2006 Proposed Asian Development Fund Grant Socialist Republic of Viet Nam: HIV/AIDS Prevention among Youth Project CURRENCY EQUIVALENTS (as of June 2006) Currency Unit dong (D) = $ $ = D15,967 ABBREVIATIONS ADB Asian Development Bank ADF Asian Development Fund BCC behavior change communication DFID Department for International Development DMC developing member country EA executing agency IDU injecting drug user IEC information, education.

2 Communication IPC interpersonal communication JFPR Japan Fund for Poverty Reduction M&E monitoring and evaluation MDG Millennium Development Goals MOH Ministry of Health NGO nongovernment organization PCPFC Provincial Committee for Population Family and Children PEPFAR President s Emergency Plan for AIDS Relief PLWHA people living with HIV/AIDS PMU project management unit PP procurement plan PPMU provincial project management unit SAVY Survey Assessment of Vietnamese Youth STI sexually transmitted infection TA technical assistance UNAIDS Joint United Nations Programme on HIV/AIDS VAAC Viet Nam Administration of HIV/AIDS Control VCPFC Viet Nam Commission for Population, Family and Children VCT voluntary counseling and testing VOV Voice of Viet Nam VTV Viet Nam Television WHO World Health Organization WU Women s Union NOTES (i) The fiscal year of the Government and its agencies ends on 31 December.

3 (ii) In this Report , "$" refers to US dollars. Vice President C. Lawrence Greenwood, Jr., Operations Group 2 Director General R. Nag, Southeast Asia Department (SERD) Director S. Lateef, Social Sectors Division, SERD Team leader L. Studdert, Health Specialist, SERD Team member R. O Sullivan, Senior Counsel, Office of General Counsel CONTENTS Page GRANT AND PROJECT SUMMARY i MAP v I. THE PROPOSAL 1 II. RATIONALE: SECTOR PERFORMANCE, PROBLEMS, AND OPPORTUNITIES 1 A. Performance Indicators and Analysis 1 B. Analysis of Key Problems and Opportunities 4 III. THE PROPOSED PROJECT 9 A. Impact and Outcome 9 B.

4 Outputs 9 C. ADF IX Grant Component 12 D. Special Features 12 E. Project Investment Plan 13 F. Financing Plan 13 G. Implementation Arrangements 14 IV. PROJECT BENEFITS, IMPACTS, ASSUMPTIONS, AND RISKS 17 V. ASSURANCES 19 A. Specific Assurances 19 B. Conditions for Grant Effectiveness 20 VI. Recommendation 20 APPENDIXES 1. Design and Monitoring Framework 21 2. HIV/AIDS in Asia and Viet Nam: Transmission, Risks, and Youth 25 3. Behavior Change Communication for Youth and HIV/AIDS Prevention 28 4.

5 External Assistance and Coordination in the HIV/AIDS Sector 31 5. Province Selection 33 6. Summary of Phu Tho Provincial Action Plan 35 7. Gender Strategy 38 8. Detailed Cost Estimates 43 9. Project Management and Implementation Structure 45 10. Implementation Schedule 47 11. Indicative Procurement Plan 49 12. Summary Poverty Reduction and Social Strategy 54 13. Summary Economic Analysis 56 14. Ethnic Minority Issues and Action Framework 58 SUPPLEMENTARY APPENDIXES (available on request) A. Detailed Description of Project Components B. Provincial Action Plan Ha Tay Province C.

6 Provincial Action Plan Phu Tho Province C. Detailed Economic Analysis D. A Report on Consultations for Project Development iGRANT AND PROJECT SUMMARY Grant Recipient Socialist Republic of Viet Nam Classification Targeting classification: Targeted intervention Sector: Health, nutrition, and social protection Subsectors: Health programs Themes: Inclusive social development, gender and development Subthemes: Human development, other vulnerable groups, gender equity in empowerment and rights Environment Assessment Environmental Category: C. Project Description The Project will support Government efforts to halt and begin to reduce the spread of HIV/AIDS by 2010.

7 The Project will assist the Government to implement a comprehensive behavior change communication (BCC) action plan, including mass media and community outreach to effect behavior change and reduce the risk of HIV infection among youth (15 24 years). The Project will be implemented nationally and in 15 provinces over 5 years.. Rationale In March 2006, the Government of Vietnam noted that there were about 104,000 reported HIV/AIDS cases in Viet Nam. It is estimated that the actual number of cases is three times this figure, with national prevalence in the 15 49-year old population.

8 These figures represent rapid, exponential growth that has shown no signs of abating. Viet Nam s epidemic is largely driven by injecting drug use but a growing number of infections occur among sex workers. The clients of sex workers then become the bridge to the general community (through their wives or girlfriends and, through mother-to child transmission). Young people between the ages of 15 and 24 years account for about 40% of cases and are a key target group for focused prevention efforts. Young men and their risk-taking behavior (drug use and unprotected sex with sex workers) are a driving force of the epidemic.

9 The Government of Viet Nam has a national HIV/AIDS strategy (endorsed by the Prime Minister in 2004) that identifies behavioral change information, education, and communication programs, as well as harm reduction, as priority activities for HIV/AIDS prevention and control. With awareness levels already high, international best practice dictates that role modeling and integrated media and community-based approaches that personalize knowledge are the appropriate next step in a learning and behavior change continuum. Grant financing is justified given that HIV/AIDS prevention is a public good and highly cost-effective.

10 Ii Impact and Outcome Consistent with the directions provided by the national HIV/AIDS strategy, the Project will reduce HIV infection risk behaviors among youth aged 15 24. It should result in more than 34,000 HIV infections being avoided over a 20-year period. This will provide positive social and economic benefits, including the avoidance of costs associated with reduced productivity and the prolonged periods of care and treatment needed by patients. Component 1 activities will target leaders, policy development, and program integration, from the national to the community level, with advocacy and support for youth programs.