The Vefa is not really a hotel, but a short-term apartment rental. The staff are all nice people, but they do lack sophistication. I stay there about five times per year, and have not experienced exactly what the other reviewer ("Omer ") has experienced, but it doesn't surprise me. Breakfast room service is included in the room rate, although half the time you can get random choices on the breakfast tray. Since the majority of the TV channels are Russian, perhaps the place is geared toward Russian travelers, and thus a different set of expecations and standards.
So why do I stay there?
1. Good location. A block from Rudaki Park, within quick walking distance of half a dozen great restaurants.
2. Apartment. When I come to Dushanbe, I stay for 2-4 weeks. Any hotel room would seem like a prison cell. Having a separate living room makes a difference.
3. Washing machine. See above. I can bring fewer clothes and do a wash, which makes packing much easier.
Of the few places in Dushanbe that a Westerner would stay, each has its good and bad points. On balance, I've found that the good outweighs the bad at the Vefa, and on balance is the best place I've found for my long and frequent trips.
If I were only staying a few days, and I was unfamiliar with the city, I would stay at the Hyatt.