HIV prevention services for key populations in Albania on the brink of collapse

Civil society organisations from Albania issued an open letter expressing their concerns regarding a difficult context of provision of HIV services to key populations groups in the country.

The implementation of the Global Fund grant came to an end on 31 December 2019 and the new transition grant is not still signed yet. By 1st of January, all NGOs providing services to key population run out of any kind of support. Access to the services of 1800 people who inject drugs and 380 methadone clients, 1200 MSM, 290 sex workers, 30 prisoners and up to 200 people living with HIV is being jeopardized.

NGOs are required to shut down services, cut human resources and return all assets to the principal recipient (Ministry of Health and Social Protection): computers, printers, minivans, tables, furniture and even remaining rapid tests. This is disturbing for those NGOs which are renting spaces.

There is a total lack of information from all institutions, including CCM, how the project will continue, what will be the role of each actor and how the sustainability of services will be ensured, if it will be.

Albanian NGOs appeal to the Global Fund Secretariat, CCM and Minister of Health and Social Protection of Republic of Albania requesting them not to neglect this situation but to act fast and appropriately to ensure the sustainability of HIV prevention services for key populations. The support of other donors and technical partners is also very welcomed.

DPNSEE has already, in partnership with Correlation and EHRA, raised issue of sustainability of harm reduction services in Albania, Bosnia Herzegovina, Bulgaria and Romania.

The open letter is available following this link>>>.

Growing like weeds?

The cultivation of cannabis in Albania goes back several decades, but experienced a peak around 2016, at which point the police undertook an eradication operation in an attempt to curtail the country’s widespread cannabis production industry. A more recent resurgence in cannabis cultivation, however, points to the fact that the underlying drivers of this illicit economy are still in place. Without a concerted effort to address collusion in the cannabis market and the country’s structural conditions, which entice many young people to seek a livelihood in cannabis production, the conditions that enable the market are unlikely to be disrupted.

Key points of the brief on this issue “Growing like weeds? Rethinking Albania’s culture of cannabis cultivation“, published by the Civil Society Observatory to Counter Organized Crime in South-Eastern Europe, include:

  • The conditions that enable cannabis cultivation in Albania have been in place for many years.
  • Despite police crackdowns on cultivation, the phenomenon continues to be pervasive.
  • Cultivating cannabis is seen as a source of income for many, particularly the young.
  • Colluding state officials are among the drivers of the Albanian cannabis economy.
  • A new approach is needed to break the cycle of reliance that the cannabis economy provides and attract young people into legitimate work.

The Global Initiative against Transnational Organized Crime is a network of prominent law enforcement, governance and development practitioners who are dedicated to seeking new and innovative strategies and responses to organized crime.

Policy briefs on current issues in the Western Balkans are published on a regular basis by the Civil Society Observatory to Counter Organized Crime in South-Eastern Europe which operates under The Global Initiative.  The Observatory is a platform that connects and empowers civil-society actors in Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia. The Observatory aims to enable civil society to identify, analyse and map criminal trends, and their impact on illicit flows, governance, development, interethnic relations, security and the rule of law, and supports them in their monitoring of national dynamics and wider regional and international organized-crime trends.

The briefs draw on the expertise of a local civil-society network who provide new data and contextualize trends related to organized criminal activities and state responses to them.

To read this brief, follow this link>>>

New case study on HIV prevention in Albania

Eurasian Harm Reduction Association (EHRA) just published the case study “The Challenges of Global Fund Transition in Albania: HIV Prevention Services for Key Populations on the Brink of Collapse” which looks at the challenges which could be faced by country in sustaining HIV prevention programmes among KAPs, implemented primarily by civil society organisations (CSO’s), as a result of the withdrawal of the Global Fund through the transition period.

The purpose of this report is to identify gaps and challenges faced by CSO’s in the transition from Global Fund assistance to government support of services for key populations (KP) under the 2017-2019 grant. Whilst the funding commitment by government institutions is to absorb all costs, the methodology to prepare for this transition, and also the strategy to transfer costs, is unclear.

We hope that the information and arguments presented in this case study as well as the recommendations could be used by the civil society and communities representatives to support their sustainability and transition related advocacy activities as well as to establish the communication with other potential donors to persuade them to establish a ‘safety net‘ through which bridging funds can be made available to address the sustainability related challenges faced by KPs services in country.

HIV Prevention Services for Key Populations on the Brink of Collapse

This case study is available at EHRA’s webpage following this link>>>

 

Our initiative presented at the Global Fund Board meeting

The Developing Country NGO Delegation at the Global Fund published a statement with the 42nd Board Meeting highlights, including 8 important matters they pushed for at the meeting, with ways that civil society can move them forward. The statement is available following this link>>>

The initiative of the three regional networks: Correlation – European Harm Reduction Network, Eurasian Harm reduction Network and Drug Policy Network South East Europe to respond to the critical situation concerning the sustainability of harm reduction services in Albania, Bosnia and Herzegovina, Bulgaria and Romania was among the issues that the Delegation raised at the Global Fund Board meeting. It is mentioned in the point 4 of the statement:

Addressing civil society concerns: The Developing Country NGO brought to the Board and bilateral meetings concerns raised by civil society organisations including those by nearly 100 NGOs about the ending of multi-country grants in West Africa; cases of the failed transitions and interruption of services for key populations, including the lack of funding for harm reduction programs in Albania, Bosnia and Herzegovina , Romania and Bulgaria; and exploring next steps to ensure access to health services, treatment and care in Venezuela.

We hope that the Global Fund will make some concrete steps in helping us find a quick response to the urgent needs and building a sustainable solution in these countries.

 

Emergency situation concerning the sustainability of harm reduction services in Albania, Bosnia and Herzegovina, Bulgaria and Romania

The three regional networks: Correlation – European Harm Reduction Network, Eurasian Harm reduction Network and Drug Policy Network South East Europe were informed by our members organisations about the situation with sustainability of  harm reduction services in Bosnia Herzegovina which is characterised by lack of strategy, policy and funding caused by the delay in establishing national Government for more than a year after the elections, withdrawal of international donors and misunderstandings and low level of cooperation between the governmental institutions and civil society, but also inside the civil society sector providing harm reduction services. The national Strategy for prevention and control of HIV and AIDS has ended (2016) and the Transition plan, developed by the Country Coordinating Mechanism during implementation of The Global Fund funded programme has not been implemented. As a result, the harm reduction services are closed in Sarajevo, Mostar, Bihać and Banja Luka and exist only in Zenica and Tuzla relaying on voluntary work of unpaid Staff and with all supplies already on minimum.

The three Networks expressed our deep concern about the situation and willingness to give contribution to finding solution and ensuring both quick response to the urgent needs and building a sustainable solution. We are ready to provide non-partisan support in identification and advocacy for the best possible approaches to urgently start provision of services to the populations of people who use drugs, sex workers and prisoners and other affected populations and to properly advocate for the sustainability of governmental funding.

The urgent action we are taking is to explore opportunities for emergency bridging funding to ensure survival of existing harm reduction services in the country. The situation is alarming and requires direct action and mobilisation of the international community. The three network have limited resources, so we are now contacting some of our partners and donors, explaining the situation and calling for immediate and urgent support. This could include short-term funding and technical support to ensure a minimum of harm reduction services. So far, we have a promise from the Open Society Foundations for a small grant which would cover basic need for the month of November.

We plan to develop and implement a comprehensive process to achieve sustainable long-term solutions. The activities for long-term solutions target local governments and policy-makers with the aim to ensure sustainable funding for harm reduction services. We already offered our expertise and support in this process, In addition, we would like to engage and involve other relevant stakeholders, such as donors and funders.

As the first concrete long term action we decide to send an appeal to the Global Fund to review their eligibility model of supporting middle income countries, besides Bosnia Herzegovina also Albania, Bulgaria and Romania.

In advance of the upcoming 42nd meeting of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) as well as the Global Fund Regional Meeting for Eastern Europe and Central Asia to take place in Istanbul on 26-27 November, 2019, we – civil society and community organisations and networks working in the Eastern Europe and Central Asia (EECA) region for the benefit of key affected populations, including people who use drugs – would like to express our profound concern as to the current lack of sustainable harm reduction services in the South East European countries of Albania, Bosnia and Herzegovina, Bulgaria and Romania, respectively. Taking into consideration the successful results of the recent Sixth Replenishment Conference, we would like to invite the Global Fund to safeguard a part of the catalytic investment funds available for the 2020-2022, including multi-country grants, matching funds and strategic initiatives, in order to sustain life-saving services for people who inject drugs and other vulnerable groups and to incentivise domestic investment in harm reduction in each of these post-transition countries.

41 civil society organisations from Eastern Europe and Central Asia supported the letter. We hope that the Global Fund shall understand the situation and support our proposal.

The letter to the Global Fund is available following this link>>>

 

Transition from Global Fund support to national funding: role, opportunities and priorities for civil society in Albania

Source:

The workshop “Transition from Global Fund support of HIV and TB programs to national funding: role, opportunities and priorities for civil society in Albania” took place in Tirana, the capital city of Albania, on 23 – 24 of October and gathered 29 participants including civil society representatives, CCM members, representatives of the Global Fund CRG Team and CCM Hub (online), experts from neighbouring countries and representatives of the governmental structures.

Albanian HIV and TB components became ineligible for regular funding after the 2014–2016 allocations were announced and therefore Albania became eligible to receive transition funding. It will receive a three-year transition grant within the 2017-2019 allocation period. This transition grant is expected to start in January 2020 and will be a significantly lower level of investment—about one third the value of current Global Fund grants. The implementation of the current Global Fund HIV and TB grant is ending in December 2019.

According to the estimated annual needs to sustain HIV and TB responses prior to submitting the transition grant request, Albania’s needs approximately US $3 million to address its two epidemics effectively. Hence US $9 million is required over 2020-2022, the three-year period of the transition grant. With an allocation of just under US $6 million within the current HIV and TB grants, roughly 60% of the funding need is currently being met. Without significant increases in domestic funding, the funding gap is expected to grow in the coming years. Moreover, the services for key affected populations (KAPs) are largely implemented by civil society. Their scale, quality and delivery models are to be improved under the new transition grant. So far, these services have not been funded from domestic resources, though there is an office for civil society and general funding for civil society groups in the country. The national strategies on HIV and TB are expiring in 2019. The Global Fund, under its pilot ‘CCM Evolution Project,’ supports Albania’s HIV and TB governance reforms although with no clear outcome so far.

Community and civil society advocacy is critical at this conjunction of processes to ensure sustainability of the response. But at the same time the transition Funding Request 2020- 2022 poses a direct challenge to the services provided by NGOs being sub-recipients of the Global Fund grant. It is expected that starting from 2020 the number of NGOs supported by Global Fund will become twice lower, decreasing from 12 to 5. It is not clear what happens with the activities implemented by those 7 NGOs left behind and which exactly NGOs this will be.

Taking this context into account, the Eurasian Harm Reduction Association (EHRA) in coordination with the Global Fund Secretariat, decided to organize a workshop for civil society and community representatives in Albania. The workshop aimed to help improve the understanding of local civil society representatives involved in the country’s HIV and TB responses, of the Global Fund transition-related processes currently taking place in country and also to stimulate ideas, plans and opportunities for their meaningful engagement into such processes to ensure the sustainability of HIV and TB response among key affected populations in Albania.

The participants first heard the information about the steps being taken by the government to prepare for transition of HIV/TB prevention interventions from the Global Fund’s support and also about the transition-related risks for HIV response and civil society services. Representatives of the Ministry of Finance and Ministry of Health updated the participants on the work being done to secure funding and social contracting from national and local authorities including on the public budget cycles, possibilities to advocate and influence the budget at central and local level. Guest activists from North Macedonia and Montenegro shared their lessons learnt from the transition experiences of their countries with regard to budget advocacy efforts being taken by civil society in these countries to sustain HIV response among KAPs. The representative of the Agency for Support of Civil Society informed the participants about the opportunities of funding available for NGOs, including those related to public health. On the second day of the event the participants also had the opportunity to discuss and plan the advocacy steps need to be taken by civil society in nearest future to ensure the sustainability of services for KAPs as well as to discuss their Global Fund related TA needs and plan the possible content of the potential requests for the support within the Global Fund CRG TA Program.

DPNSEE President Vlatko Dekov presenting lessons learnt from North Macedonia

Genci Muçollari, Executive Director at DPNSEE member organisation Aksion Plus who participated in the workshop, thinks that “It was an interesting workshop though we were expecting high level presentation from the GF and the Ministry of Health and Social Protection (MHSP). World Health Organisation representatives were attending, other NGOs as well. Above all discussions among partners, the role of the MHSP and the Albanian government is very important to ensure a gradual transition from Global Fund to state funds through social contracting and other ways of contribution both in money and in kind to programs and activities covered before by GF. The workshop organizers presented some of the funding opportunities from other regional donors and call for proposals in order to support activities after the GF.

The event was organized by the Regional Platform for Communication and Coordination for the EECA Region, hosted by Eurasian Harm Reduction Association (EHRA).

Promotional activities of the “Support. Don’t Punish“ campaign in Albania

The main activity was the awareness day in occasion of 26th of June, in Durrës. Since the major part of the population is in summer holidays, Aksion plus planned to organize a big event in Durres, in the beach, among vacationers. For this event they strongly collaborated with Caritas, informing at the beginning their 50 young volunteers and on 26th they went together and distributed information among people. Firstly, a big banderol “Support. Don’t Punish” with key message on drug policy was posted in the seaside, in order for the vacationers to see and to understand what this activity was about. The day continued with the distribution of the brochures, leaflets and posters of the campaign. All the volunteers and staff were wearing T-shirt with the message “Support. Don’t Punish”. It was an excited day for young volunteers, to say “no” to the discrimination toward these target groups.

On June 26, 2019, in one of the main streets in the city of Tirana, a drug information campaign was developed together with the SALUS clinic. This activity consisted in the distribution of brochures and leaflets for the purpose of informing the population in the framework of the “Support. Don’t Punish” campaign.

Have a look at the video from the activities below

Global Day of Action- Support. Don't Punish!

Support. Don’t Punish is a global grassroots-centred initiative in support of harm reduction and drug policies that prioritise public health and human rights. The campaign seeks to put harm reduction on the political agenda by strengthening the mobilisation capacity of affected communities and their allies, opening dialogue with policy makers, and raising awareness among the media and the public.The Support. Don’t Punish campaign aligns with the following key messages:-The drug control system is broken and in need of reform-People who use drugs should no longer be criminalised-People involved in the drug trade at low levels, especially those involved for reasons of subsistence or coercion, should not face harsh or disproportionate punishments-The death penalty should never be imposed for drug offences-Drug policy should focus on health, well-being and harm reduction-Drug policy budgets need rebalancing to ensure health and harm reduction-based responses are adequately financed.#Supportdontpunish #aksionplus #globaldayofaction #26ofJune

Gepostet von Aksion Plus am Donnerstag, 27. Juni 2019

You can find more about the campaign activities recently held in Albania at the news following this link>>>

A month of Support. Don’t Punish activities in Albania

Our Albanian colleagues from the organisation Aksion Plus organised a sensitization campaign in the cities of Durres and Tirana in May and June 2019 as their contribution to the Support. Don’t Punish campaign.

On 9 May, a workshop was organized with the students of “5 October” High School. This workshop consisted in informing young people about drug use based on Aksion Plus’s many years of experience in providing services, awareness campaigns focusing on drug use as well as publishing of informative materials. Young students were also organized into work in groups in order to have everyone’s involvement and engagement. Additionally, a presentation by some of the school youth about their knowledge of the phenomenon of drug use was presented.

The focus of the meeting held on 16 May in the University of New York was the discussion with prospective professionals on issues that affect the reality of drug users, HIV / AIDS, giving special importance to prevention and damage reduction policies. These realities are already noticeably tangible in every part of society. Also discussed about the “Support, Don’t Punish” campaign.

This workshop in the High school “Charles Telford Erickson” held on 23 May consisted in informing students about drug use based on Aksion Plus’s many years of experience in providing services: Methadone Maintenance Therapy, Psychological Counselling, HIV Testing, Chlamydia, Gonorrhoea, Syphilis, Hep B, Hep C and awareness campaigns. It was presented a video. Young students were also organized into work in groups in order to have everyone’s involvement and engagement.

This workshop in the High school “Gramoz Palushi”, including 4 representatives of Caritas Albania, was held on 14 June. A video was presented. Young students were also organized into work in groups in order to have everyone’s involvement and engagement. The goal was to involve all students in an interactive way. At the end of the workshop, some space was left for their questions, comments about what was discussed, and what suggestions they had about future workshops.

Hotspots of organized crime in the Western Balkans

A new report by Global Initiative Against Transnational Organized Crime has identified locations in these countries that are hotspots for organised crime.

Rather than focusing on illicit markets, flows of commodities or particular criminal groups, this report looks at places of interest: hotspots of organized crime in the Western Balkans. It looks at the characteristics of these hotspots, then provides a granular analysis of particular border crossings, intersections or regions of vulnerability. What makes these places particularly vulnerable? Why are they attractive to criminals? After discussing these questions, the report connects the dots between these locations to identify possible links and patterns that tell us more about the geography of crime in the region.

Regional illicit flows

To contextualize these organized-crime hotspots, the report provides an overview of the current situation in the Western Balkans, as well as some general information on the main illicit flows. It then looks at hotspots close to border or (internal) boundary crossings.

The other main section of the report focuses on major intersections of organized crime in the Western Balkans – mostly bigger cities (particularly capitals), coastal towns and places where major highways intersect. Maps are provided to show the hotspots as well as key traffic arteries. Amid these assessments, the report takes a deeper dive into vulnerable locations, such as Sarajevo, three ports along the Montenegrin coast, northern Kosovo as well as the triangular region where North Macedonia meets south Serbia and Kosovo.

One key observation of this report, which is important to highlight upfront, is that illicit flows through ports, cities and border crossings in the Western Balkans are enabled by a political economy of crime that is deeply entrenched in most countries of the region. The report therefore takes a look at the ecosystem of crime that creates an environment in which illicit activity can flourish. It concludes with a prognosis of potential future hotspots of crime.

The report is available in EnglishAlbanianBosnian and Macedonian

Youth Studies South East Europe

The Friedrich Ebert Stiftung (FES) published reports on the experiences and aspirations of youth in Southeast Europe. The FES carried out a representative region-wide survey on a sample of more than 10.000 young people aged 14 – 29 from ten countries in Southeast Europe in early 2018.

“FES Youth Studies Southeast Europe 2018/2019” is an international youth research project carried out simultaneously in ten countries in Southeast Europe: Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Kosovo*, North Macedonia, Montenegro, Romania, Serbia and Slovenia. The main objective of the surveys has been to identify, describe and analyse attitudes of young people and patterns of behaviour in contemporary society.

A broad range of issues were addressed, including young peoples’ experiences and aspirations in different realms of life, such as education, employment, political participation, family relationships, leisure and use of information and communications technology, but also their values, attitudes and beliefs.

Findings are presented in ten national and one regional study and its accompanying policy papers, which have been published in both English and the respective national languages.

The most important results are grouped under headlines:

  • A wish to belong to Europe
  • Migration and mobility do not have to be zero-sum
  • Fighting corruption as a crime, not as a concept
  • Employment discourse shifting towards the quality of work
  • A different kind of ‘political’…
  • …which has to do with ‘the social’
  • Give youth a say in Europeanisation

To download the regional study and its accompanying policy papers following this link>>>

You can read the national studies at this webpage.