Black days for harm reduction in Bulgaria

June 2020 saw alarming situation in Bulgaria: all harm reduction services with public funding stopped for the second time in three years. The oldest, biggest, and most experienced harm reduction organisation, Initiative for Health Foundation, DPNSEE member organisation, shut down too after a few years of struggling to ensure sustainability. As a consequence, no needle and syringe programs remained open in the country. The only working harm reduction facility for people who use drugs is in Sofia – the Pink House, the drop-in centre run by the Centre for Humane Policy, also DPNSEE member organisation, which covers its costs mainly by individual donations.

More about these black days for harm reduction in Bulgaria is available in the article prepared by Yuliya Georgieva and published by the Drug Reporter you can access following this link>>>.

 

DPNSEE have already warned about the alarming situation last autumn. We have launched an advocacy campaign with our colleagues from Correlation – European Harm Reduction Network and Eurasian Harm reduction Network about the situation with sustainability of harm reduction services in Albania, Bosnia and Herzegovina, Bulgaria and Romania. 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 sent an appeal to the Global Fund to review their eligibility model of supporting middle income countries and a project proposal to the Radian call of the Elton John AIDS Fund. Unfortunately, our efforts were not successful. And the result is here.

Even more, it is expected that the only harm reduction service in Bosnia Herzegovina provided by the organisation Margina will also close as from September.

 

Global Fund 2020 Eligibility List

The Global Fund have just published their 2020 Eligibility List and the updated Projected Transitions List. Some of the changes are related to South East European countries.

Since Bulgaria and Romania are not on the OECD DAC list of ODA recipients, they may be eligible for an allocation for HIV for non-governmental or civil society organizations under Paragraph 9b of the Eligibility Policy only if they have demonstrated barriers to providing funding for interventions for key populations, as supported by the country’s epidemiology. As 2020 is an allocation year, the Secretariat has conducted an assessment and has determined that Bulgaria and Romania don’t meet the requirements under Paragraph 9b of the Eligibility Policy. Therefore, they have been determined not to be eligible for an HIV allocation for the 2020-2022 allocation period.

Kosovo* was classified as an Upper-Middle Income country in the 2019 Eligibility List based on the latest three-year average of GNI per capita data (Atlas method). As a result, the HIV and TB components may be eligible for an allocation of Transition Funding in the 2020-2022 allocation period.

North Macedonia‘s HIV component is now classified as eligible in the 2020 Eligibility List after meeting eligibility criteria for two consecutive eligibility determinations, noting that eligibility does not guarantee an allocation.

Montenegro and Serbia remain eligible for HIV and Romania for Tuberculosis.

 

The 2020 Eligibility List is now available on the Global Fund’s website>>>

The projected transitions list is available 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>>>

 

6-0 Tournament for People Against Addictions

The featured image of this news presents teams of Kethea (Greece) and HOPS (North Macedonia) which, besides sport competition and cooperation in the area of addiction, promote friendship and multi-cultural understanding.

The sixth edition of the 6:0 International People’s Tournament for People Against Addictions was held during the weekend at the Boyana National Football Base of the Bulgarian Football Union (BFU), with participating teams Heart Team, School of Life, Live, HOPS, SVOI, Bilani, Kethea ithaki, Open Eyes, New Beginnings, Remar, Renaissance, Freedom, Solidarity, ON LIFE and KA Sport Jump coming from Bulgaria, Greece, Northern Macedonia, Slovakia, Russia and Ukraine.

The official opening ceremony, held on 13 September, was preceded by a round table with the participation of the Minister of Youth and Sports Krasen Kralev, Deputy Minister of Health Svetlana Yordanova, Deputy BFU Executive Director Anton Popov and representatives of the Sofia Municipality. The round table discussed the problems with dependent behaviour in Bulgaria.

“The fight against youth addiction is a priority topic in the activities of the Ministry of Youth and Sports. One of the main programs of the Ministry with a budget of BGN 2 million a year is the National Program for the implementation of youth activities. In its essence it represents a real counteraction to aggression and all kinds of addictions through the implementation of various preventive activities and the inclusion of sport as a main tool for prevention”, Minister Kralev told the roundtable participants.

Special guests of the tournament are the popular TV presenter, singer and cook Leo Bianchi and former Bulgarian football national Stanislav Angelov. The two will also participate in the event as part of Team Heart.

The project is organized by the Revenche Association and the School for Life Foundation, co-financed by the Municipal Strategy for the Development of Physical Education and Sport of Sofia Municipality and supported by the Sofia – European Capital of Sport initiative.

This event is a citizens’ initiative. The project is organized by specialists with experience in the treatment of addiction who know the problem internally. Since 2015, with the assistance of the Bulgarian Football Union, five tournaments have been held under the common slogan “Not all people are addicts, but all addicts are people!

 

HIV prevention services for key populations started in Sofia after two years of interruption

Two years after the end of the HIV prevention programs for key populations funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the services started again with governmental funding. This long awaited moment will re-establish the contacts between the non-governmental organizations and the most vulnerable communities among which the epidemic was kept at low levels for many years thanks to the daily hard work.

The new activity is possible thanks to the implementation of a public procurement tender of the Ministry of Health announced at the end of 2018. In Sofia the tender winner is Consortium I.Z.I.  – a union of three non-governmental organization with extensive experience in working with key populations – Association “Health without Borders”, Initiative for Health Foundation and I Foundation.

It is envisaged that for a period of 12 months 800 people who inject drugs will receive safer injecting services (clean injecting equipment); 2100 MSM and 400 women and men sex workers will be reached with condoms and safer sex consultations. It is planned that 3.300 free and anonymous HIV tests will be provided in the three groups through outreach mobile services and in the Center for Sexual Health CheckPoint Sofia. The program includes also testing for syphilis and hepatitis C as well as specialized counselling and support for 100 people living with HIV. The contract amount is 166,310 BGN without VAT.

The renewal of the HIV prevention programs for key populations in Sofia is a very positive fact for several reasons. On one hand, without specialized services these populations stay outside of the health system and for some of them the outreach teams are the only connection with the health and social services helping them to receive counselling, referrals and support for many other health and social problems. In the last two years thanks to private funding it was possible to maintain the testing and indoor prevention services for men who have sex with men in CheckPoint Sofia, as well as support for people living with HIV. But due to the lacking outreach work for people who inject drugs and sex workers the spread of HIV in these groups is unknown at the moment. On the other hand, after the long years of solely international funding which made these programs possible, the starting of prevention services with governmental finances is an essential precedent bringing hope for the sustainability of the results achieved with the GFATM support.

The representatives of Consortium I.Z.I. evaluate positively the state support for HIV prevention in key populations, although they believe that the way to sustainability hasn’t been found yet. The period for which the services will be covered is short and the funding for Sofia is approximately ¼ of what was provided before by the GFATM. The deepest concern is related to the lack of a real sustainable mechanism for social contracting. The public procurement tender as a form of funding is a temporary decision which cannot ensure continuity of the services and turns the social work into a business service which brings substantial risks for its quality.

During the first day of operation, 35 people obtained a safe injection equipment from the service.

***

Association “Health without Borders” was established in 2004. It is specialized in counseling and testing services for HIV, hepatitis and sexually transmitted infections in key populations. It maintains a low-threshold medical center CheckPoint Sofia – Center for Sexual Health.

Initiative for Health Foundation was established in 1997. It is specialized in the provision of services for reduction of the harms of injecting drug use.

I Foundation was established in 2004. It is specialized in the provision of counseling and support services for people living with HIV.

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.

Global Fund eligibility list 2019

The Global Fund to Fight AIDS, Tuberculosis and Malaria has recently published its updated country eligibility list for 2019. The list reflects the eligibility determinations for the year 2019 (a non-allocation year) and is for information purposes only. Allocations are made once every three years following the outcomes of the Global Fund’s replenishment The 2020 Eligibility List will determine which country components are eligible for an allocation for the 2020-2022 allocation period.

SEE countries affected by changes are Bulgaria, Kosovo*, North Macedonia and Romania. Montenegro and Serbia remain eligible for HIV disease component due to high disease burden.

Bulgaria and Romania may be eligible for an allocation for HIV/AIDS for non-governmental or civil society organizations if there are demonstrated barriers to providing funding for interventions for key populations, as supported by the country’s epidemiology for the 2020-2022 allocation period.

Kosovo is newly classified as an Upper-Middle Income country based on the latest three-year average of GNI per capita data. As Kosovo’s HIV/AIDS and TB burden are ‘Not High’, both the HIV/AIDS and TB components are now eligible for Transition Funding for the 20202022 allocation period.

North Macedonia‘s HIV/AIDS disease burden classification changed to ‘Low’ in 2018 to ‘High’ in the 2019 Eligibility List, resulting in one determination of eligibility. Country components must be eligible for two consecutive eligibility determinations to be classified as eligible on the Eligibility List.

According to the GF Eligibility Policy “Upper-middle income countries meeting the disease burden criteria, but some may be eligible for an allocation for HIV/AIDS to directly finance non-governmental and civil society organizations, if there are demonstrated barriers to providing funding for interventions for key populations, as supported by the country’s epidemiology. Eligibility for funding under this provision will be assessed by the Secretariat as part of the decision-making process for allocations. As part of its assessment, the Secretariat, in consultation with UN and other partners as appropriate, will look at the overall human rights environment of the context with respect to key populations and specifically whether there are laws or policies which influence practices and seriously limit and/or restrict the provision of evidence-informed interventions for such populations”.

To read full document with the eligibility list follow this link>>>>

Two member organisations joined DPNSEE

At the DPNSEE General Assembly, held on 10th December 2018, in The Palace of Serbia, in Belgrade, Serbia, two new member organizations were accepted into the DPNSEE Network: Timok Youth Center (TOC) from Serbia and Center of Human Policy, from Bulgaria.

Both organizations were accepted by a unanimous decision of all present member organisations representatives.

Timok Youth Center (TOC) is a non-profit organization registered in Zaječar 2004. and operating on the territory of Zaječar, Timok region and the South -East Serbia. TOC agrees with the mission and vision of the DPNSEE and wants to actively promote the objective and open debate on the effectiveness, direction and maintenance of national, regional and international political drugs, and to promote constructive policy recommendations that lead to the adoption of human and effective drug policies in SEE.

Timočki Omladinski Centar

TOC is ready to actively engage with the creators of political and decision-making bodies in Serbia and in the region of Southeast Europe.

Timok Youth Center is an organization that is recognized at the local as well as at the national level when it comes to the fight against addiction, and above all the fight against drug abuse. Preventive programs that are implemented, and which concern addiction diseases, are mostly oriented towards young people, especially with youth at risk. TOC think that the young people from 15 to 30, as a sensitive category of the population, are especially affected by the problem of drug abuse. The research that we have conducted on the territory of Zaječar district, in the last few years has shown that young people in most of these years most often try one of the drugs. Also, in the period from 2007 to 2014, TOC is an organization that worked within the Global Fund for Reducing HIV/AIDS in South East Serbia and developed a volunteer program dealing with this issue. They believe that intersectoral and partner cooperation in prevention programs and harm reduction programs are very important and we have good cooperation with local municipalities and ministries. TOC’s work has been recognized by the The Office against drugs of Republic Serbia, with which we have signed a Memorandum of Cooperation.

Center for Humane Policy was created in 2016 by leading experts in drug addictions and drug policy field in Bulgaria. The main goals of the organization are to promote, facilitate and support development of effective, evidence based methods and policies in the field of public health, social care and education.

The organization is a member of the Eurasian Harm Reduction Association (EHRA) and the chair of the Center is also co-chair of the Steering committee of the network. Center for Human Policy is very good in understanding the importance of working together with organizations from different countries to improve the drug policy situation in the region.

During the last year the organization focused their efforts on the implementation of “Preventure” in the country. It is a school-based intervention aimed at reducing adolescent drug and alcohol use in high-risk teenagers.

Nowadays Center for Humane policy relies on two experts, trained in Canada by the inventor of the Preventure methodology – Patricia J Conrod from the University of Montreal. Also the organization has personal support of professor Conrod to implement the intervention system in the country.

Center for Humane policy also builds networks with the authorities to ensure the sustainability for fereb=nt implementation of good practices, and they have the support of the Secretary of National Council on Narcotic Substances and the Vice-Minister of Ministry of Health.

Together with these activities, the organization prepares statements, reports and analyses regarding the efficiency of Harm reduction, Opioid Substitution therapy, HIV and drug treatment policies.

Bulgaria back to the map of the Support. Don’t Punish campaign

After a year without the campaign, the Initiative for Health Foundation added Sofia to the list of participating cities in 2018.

The Foundation engaged a professional reporter to explain the content of the campaign, its story around the world and in Bulgaria. The article was published in the web-site and FB of Initiative for Health Foundation (where the article reached primarily 531 persons), in the web-portal of the Bulgarian non-governmental organizations NGOBG and in 4 online media.

A photo-frame for profile pictures was developed and distributed in Facebook for people who would support the campaign.

In addition, 80 t-shirts were produced with the campaign logo and were distributed during 4 events of Initiative for Health Foundation in the period 31 May – 26 June 2018: one public discussion, one networking seminar and two trainings.