New model of work in Zenica and Tuzla

Denis Dedajić, President of the Association Margina from Bosnia and Herzegovina sent us a short summary of the situation from March 1 to April 10.

Drawing on our life experiences we have had the opportunity to experience (the 4-year war, the floods of 2014), we can point out that we have very quickly adapted to the situation caused by the COVID 19 pandemic.

Our operations are compounded by the funding problems of our services that you are already aware of. Our organization is the only one that has survived the provision of harm reduction services in all of Bosnia and Herzegovina.

In accordance with the orders and recommendations of the Crisis Staff managing this health and social crisis, we had to close both Drop in centres (Zenica and Tuzla) and transferred all forces to the field.

A rapid mapping of the terrain was carried out and interviews with a large number of clients enabled a new methodology of work, all in line with the recommendations on the method of contacts between people. We currently cover all our clients in two regions, covering about 1 million people and about 1.800 of our clients, and with the great help of our clients we have identified in both regions 20 key points – persons to whom we deliver all the materials available to us.

The material is delivered on the basis of the stated needs of our clients. In the period from March 1st to April 10th we distributed in both regions 51.800 needles and syringes, 25.000 pieces of distilled water, alcohol wipes, containers for preparation of the mixture and 1.200 containers for disposal of infectious waste. It should be noted that during this period about 45.000 needles and syringes and other infectious material were collected and deposited in our drop in centres until this crisis passed.

We have established 4 sex workers supply lines and have distributed a lot of materials (over 500 hygiene packages) and unfortunately this is the only one they have received over the last three months.

The biggest win at the moment is the involvement and commitment of our clients throughout this work process.

In interviews with the inmates of the largest prison, we confirmed that they lack basic equipment such as mask gloves and disinfectants and the needs are quite high. The good situation is that all visits are suspended and there is very little opportunity for COVID to break into these facilities, although they need urgent help with these safeguards to improve the prevention system and reduce the possibility of infection.

 All of this work is done by 6 of our employees and we all do all the work and have very few resources at our disposal. The 6 of us have been volunteering for a long time and will work as long as we have materials to share with our clients.

If this model of work continues, our supplies are sufficient by the end of June. After that we will be forced to close after 18 years of conducting harm reduction services in Bosnia and Herzegovina because we will no longer be able to do so.

 

SOS project coordination meeting

On October 2 – 3, the coordination meeting of the multi-country #sos_project, managed implemented by the consortium led by the Alliance for Public Health was held in Skopje, North Macedonia. The project team met with colleagues from the Balkan region to discuss budget advocacy issues, further interaction and strengthening of cooperation between EECA and the Balkans.

The priority areas of the cooperation are:

  • Implementation of WHO protocols with the inclusion of assisted and self-tested HIV testing.
  • ART price optimization.
  • Development of regulatory changes to improve the quality of HIV services.
  • Popularization of PrEP in the region of Southeast Europe.

DPNSEE President Vlatko Dekov and Board member Denis Dedajić presented our work on budget advocacy and monitoring in countries of South East Europe, supported by the European Harm Reduction Association and Open Society Foundations.

Alarming situation in Bosnia Herzegovina

With delay in establishing political structures in the country and reduced international donor support, the situation with harm reduction services in Bosnia Herzegovina became alarming. Here is what we heard from Denis Dedajić, Chairman of the Association Margina and DPNSEE Board member:

The current situation is as follows: the Margin Association is the only survivor with the services and we provide them now and on a larger scale because no other service provided by other NGOs is active, so all clients have turned to us. We are taking over users and equipment from Sarajevo and we shall organise distribution with support of few gatekeepers who used to work for us recently.

I estimate that we will endure until the end of October and after that we shall have no more materials for distribution. The salaries of our staff need not be talked about, as of May we are all volunteers and the funds we had are already spent on transportation and rents of the space we use.

The situation is further complicated by a few things. What concerns us most are the indolence of the authorities and the large waves of migrants coming to Bosnia and Herzegovina. Yesterday, I was in contact with asylum officers and they informed me that about 1.000 immigrants a day enter northern Bosnia and in different ways move west to the border with Croatia and the EU respectively. They aim at Western Europe, but their psycho-physical condition is very poor. There is an increasing number of fatalities, both as a result of illness (quite a large number of TB and Hepatitis C), which is due to conflicts between groups from different countries (Afghanistan Pakistan, Algeria Morocco, Syria, Bangladesh). These conflicts generally end with very serious injuries by knives or other cold weapons. We have had about 100 contacts so far and have been using sterile injection supplies. According to asylum officers, many drug users have been around for several years.

NO one is doing anything on this issue, and we are simply waiting for when a major incident will occur so that everything will surface.

We sincerely hope that a solution will be found soon to revitalize the harm reduction services and ensure health support needed.

New DPNSEE Board elected at the General Assembly

The new DPNSEE Board was elected at the General Assembly, held on 10th December 2018, in The Palace of Serbia, in Belgrade, Serbia.

The Chairman reminded the representatives of the member organisations that there is no clear procedure for this election in the Statute and proposed the following procedure:

  • Select three persons for the commission (persons who are neither nominated nor a member of organisations whose members are nominated)
  • Nominate candidates for the Board
  • Vote anonymously for seven Board members
  • Commission to count votes and declare the results

The proposed procedure was adopted by a unanimous decision.

Commission members that fulfill the criteria were selected:

  1. Olga Pateraki from Diogenis, Greece,
  2. Nataša Boškova from Coalition ‘Sexual and Health Rights of Marginalized Communities’, Macedonia and
  3. Marjana Krsmanović from Juventas Montenegro.

There were 9 candidates proposed for for the Board. Elected members of the DPNSEE Board are:

  1. Anna Lyubenova from Initiative for Health Foundation
  2. Denis Dedajić from Margina
  3. Marios Atzemis from Positive Voice
  4. Nebojša Đurasović from Prevent
  5. Safet Blakaj from Labyrinth
  6. Sanja Šišović from Cazas
  7. Vlatko Dekov from HOPS

The proposal to choose Vlatko Dekov as the President and Nebojša Đurasović as the Vice-President of the Board was adopted by a unanimous decision of all 16 member organisations representatives.

During the discussion about the elections, the proposals were made to change the Statute so that all functions other than president and vice-president become just „member“ and to extend the duration of the mandate of the Board members from two years to three. The Assembly at this meeting had 2/3 majority needed for the change of Statute. The proposed changes of the Statute were adopted by a unanimous decision.

Nebojša Đurasović proposed the new co-opting procedure – if somebody resigns from the Board during their mandate to be replaced with the first person below the line from the list of nominated but not elected persons if that person agrees. This proposal brought about a short discussion of possible issues in proposed case. On this proposed change of the Statute 14 member organisations representatives voted for and 2 against which was not sufficient majority for the Statute change, so it was not adopted.

Drug Policy Network South East Europe General Assembly 2018

With the support from the Central European Initiative (CEI) and funded through the European Union project, The Drug Policy Network South East Europe organised regular annual General Assembly on 10 December 2018 in The Palace of Serbia, in Belgrade, Serbia.

The participants at the Assembly were welcomed by Milan Pekić, Director of the Office for Combating Drugs of the Government of the Republic of Serbia. In their short opening speeches, Mr Pekić and the President of the Board of the Network Vlatko Dekov emphasized the importance of partnership in achieving the aim of effective drug policies.

The participants held voting rights from 16 out of 22 ordinary member organisations. That provided the Assembly with the right to make qualified decisions, even those related to the amendments to the Statute.

The Assembly was chaired by Anna Lyubenova, representative of the member organisation Initiative for Health Foundation from Bulgaria.

During the agenda point on membership issues, candidatures for membership from two organisations were discussed. The Assembly unanimously recognised as ordinary members Timok Youth Center from Zaječar, Serbia and Center for Human Policy from Sofia, Bulgaria. The Network now has 24 ordinary and 2 associate member organisations.

The General Assembly discussed the Operational and financial report for 2018 and elements for the Action plan and the Financial plan for 2019. The General Assembly welcomed the reports. They will be completed with the activities in December and then be adopted. The Assembly analysed the donor and funding trends and issues and concluded that, based on donor research, negotiation and exchange, no funding from EU for the Network can be expected for 2019 and some amounts can be obtained for year 2020, more project based. Funding plans and activities and possible issues that might be funded in 2019 include budget advocacy, the Network being the leader on the issue of quality of services in the region, redefining harm reduction and human rights element of the approach in work. The need for greater participation in relevant international events and DPNSEE taking role in organizing regional events were emphasized.

Nine candidates applied for elections to the DPNSEE Board. The new Board includes Anna Lyubenova from Initiative for Health Foundation, Denis Dedajić from Margina, Marios Atzemis from Positive Voice, Nebojša Đurasović from Prevent, Safet Blakaj from Labyrinth, Sanja Šišović from Cazas and Vlatko Dekov from HOPS.

The Assembly decided to keep at the current positions Vlatko Dekov as the President, and Nebojša Đurasović as Vice-President.

More information about the elections are available following this link >>>

An external consultant Jarmila Bujak Stanko facilitated the strategic workshop through which participants analysed achievement of aims and objectives of the strategic plan adopted in 2016 and indicated in which way and by which activities the priorities will be followed in the next two years.

The General Assembly ended in a positive and friendly atmosphere with an improved sense of belonging to the Network.

Situation in Romania full of challenges

Delegation of the Drug Policy Network South East Europe with Nebojša Đurasović, Vice-President, Denis Dedajić, Secretary of the Board, and Milutin Milošević, Executive Director, visited Romania on 19 November 2018. It was one of the two remaining in the serial of visits aimed to present DPNSEE to the society, build strong relationships with the authorities, institutions and services and explore opportunities for partnerships.

The situation in the country is far from good with no harm reduction services available outside Bucharest, no support for MSM services and no HIV strategy and strategic plan (a proposed document is in the Ministry of Health for one year but not approved). Opioid Substitution Therapy funding is a nightmare (procedurally), therefore hospitals do not want to engage in that, and Harm Reduction is in a survival mode. State institutions and civil society organisations have different data on key populations, with number of drug users ranging from 9.000 to 19.000.

At the meeting with Sorin Oprea, Director of the Agency for Combating Drugs, in a friendly atmosphere created through recent contacts, we discussed about the potential to raise drug policy higher on political agenda during the Romanian presidency over EU starting in January. We were informed about forthcoming purchase of 900.000 syringes for harm reduction services, the data collecting system that operates well in Romania and will be offered to Turkey, a 3 Million Euro programme that is planned for civil society organisations and plans to develop a system of alternative sanctions. Our interest in protection of personal data of drug users was replied with assurance that the problem was solved and that anonymity is guaranteed. The optimistic situation presented by the Agency was questioned by our civil society colleagues during the next meetings.

Discussion with our colleague Dragoş Roşca, director of the Romanian Harm Reduction Network, presented a bit different and challenging situation in the country. Among others, Dragoş gave us a good insight in functioning of country coordinating mechanism after departure of Global Fund. RHRN mainly functions as a watchdog for state institutions. He informed us that out of 15.500 people living with HIV, 14.000 are on treatment.

Dan Popescu from our member organisation ARAS took us to two methadone centres where they serve almost 500 people. The most vulnerable 100 of them get the service for free, while other can choose to pay 3 Euro for a daily service or 120 Euro for monthly package. We instantly commented that the country should provide the services for free – otherwise people’s basic right for health is not respected! In the centre situated in a large hospital, 11 committed activists work from 7:00 AM to 6:00 PM, supported by a doctor, nurse and social worker. This service operates for 12 years already.

We also had an opportunity to see one of two their outreach team and their van which cruises the streets of Bucharest and provides service on the spot.

The visit was really good opportunity to learn about a variety of issues related to drug policy in this complex and segmented country.

SEE HIV Ministerial Meeting

The Prime Minister and Minister of Health of the Former Yugoslav Republic of Macedonia hosted a South-Eastern European Ministerial Meeting on Sustainable Responses to HIV and TB in Skopje on 7 May 2018. The aim of the Ministerial Meeting was to discuss the progress, challenges and opportunities towards reaching sustainable responses to HIV and TB in South-Eastern Europe. Civil society representatives had an opportunity to join the high level representatives from all SEE countries, donors and global development partners and exchange about progress made and what remains to be done to meet the goal of ending the AIDS and tuberculosis epidemics in the region as part of the 2030 Agenda for Sustainable Development.

The ministers recognized increasing ownership of the national responses to the diseases, as external financial support including from the Global Fund is transitioning to support countries with the highest global burdens of disease and least economic capacity. The ministers expressed commitment to allocating domestic funding for and ensuring access to HIV and tuberculosis treatment for all, guided by governance structures that involve civil society and affected communities along with health professionals and technical partners. Still, a few comments from the civil organisations warned that the situation is far from satisfying and that “behind numbers are people about whom we need to care” – as underlined by the DPNSEE Board member Denis Dedajić.

DPNSEE representatives Vlatko Dekov, Chairman of the Board, Denis Dedajić, Secretary of the Board and Milutin Milošević, Executive Director, met with several Global Fund Board members, country representatives, donors and civil society colleagues. An important meeting was the one with Ekaterina Lukicheva from the Open Society Foundations International Harm Reduction Development Program and Raminta Štuikyte, consultant about the budget advocacy and implementation project and other ideas for future cooperation.

Photo with Peter Sands, the Executive Director of the Global Fund

The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria, at its 39th Board meeting, highlighted the importance of strengthening sustainability and supporting successful transition to domestic financing to build long-term solutions and achieve greater health security.

The Global Fund is committed to being a good partner in working toward sustainability, acting as a catalyst to additional investment, filling short-term gaps, and addressing bottlenecks to successful transition to more domestic funding. While shifting financing often includes challenges, including how to effectively fund civil society, transition increases country ownership and is necessary to end epidemics.

An important news for the region is that the Board approved an approach to ineligible upper-middle income countries in crisis where economic and epidemiological metrics are collapsing and where spill overs threaten regional progress against HIV, TB and malaria.

More about the Board meeting is available at the Global Fund website following this link >>>

Meetings with the Open Society Foundations representatives

On the margins of the dialogue between civil society and donors, representatives of the Open Society Foundations visited DPNSEE office on 18 January 2018: Daniel Wolfe, director of International Harm Reduction Development, Julia Greenberg, director of Governance and Financing, and Ekaterina Lukicheva, program officer for the International Harm Reduction Development Program (all three from the OSF Public Health Programme) along with Raminta Štuikyte, consultant. Vice-President Nebojša Đurasović, Secretary of the Board Denis Dedajić and Executive Director Milutin Milošević welcomed the distinguished guests.

DPNSEE hosts presented work and potentials of the Network and answered many questions. Guests were especially interested by the fact that DPNSEE gathers member organisations from all SEE countries and that it has a wide approach to the issue, including various elements of drug policy. They underlined that their full withdrawal from the region of Eastern Europe and Central Asia is not good so they decided to assign funds to it. In 2017, they already supported two CSO projects in Montenegro with and they still have funds for support to Bosnia Herzegovina, Romania and Serbia which were not distributed, while for 2018 they have planned additional support to the region. Agreement was reached, in principle, that DPNSEE will implement a project on budget advocacy and implementation in Serbia, on local and national level. DPNSEE also proposed such an initiative on the regional level. Discussions about potential cooperation extended throughout the next two days of meetings.

Before the meetings in Belgrade, OSF and GF representatives visited Montenegro to discuss implementation of the two project they finance since 2017 and preparations for the national project application to the Global Fund. Our member organisations Cazas and Juventas were involved in the meetings.

Representatives of Margina and Viktorija had working meetings with both OSF and GF representatives. Result of the meetings is that the same support as the one for Montenegro is proposed for Bosnia Herzegovina, for a similar project adjusted to the structure of the country. Two projects are foreseen: one on accreditation of the harm reduction services in the Republic of Srpska and other on social contracting in the Federation of BH. The trigger for this decision was presentation which Denis had as panellist.

The OSF visit ended with visit to the Drop-in for drug users and Shelter for sex workers in Novi Sad managed by Prevent. The visit was very effective, with excellent presentation of Prevent’s work and very emotional discussion with three sex workers in the Shelter. At the end the guests (including representatives of SWAN and Mama Cash foundation) haven’t made any concrete promise for support but they expressed their willingness to help finding donors. The visit should be used as a model for welcoming donors and convincing them to finance services.

At the Drop-in for drug users

DPNSEE General Assembly

The Drug Policy Network South East Europe held its 2nd regular annual General Assembly in Belgrade, Serbia from 3rd to 5th December 2017. It was the opportunity to meet, analyse the work looking back on the year that almost ended and decide about the future work.

Thanks to the generous support from the Office for combating drugs of the Republic of Serbia, the Assembly was held in the Palace Serbia, the governmental representative building. Representatives of 15 out of 22 member organisations participated, including 2 newly recognised members.

Our distinguished guests at the Assembly were His Excellency Ambassador of Portugal Augusto Saraiva Peixoto and Director of the Office for Combating Drugs of the Government of Serbia Milan Pekić.

The Assembly adopted the report about the work in 2017 and financial report presenting the Network’s main activities. The plans for 2018 were also adopted, based on the strategic priorities proposed by the Board and ideas for possible projects and partnership building.

Changes in the Board were introduced to ensure that this governing body is active in implementing the action plan. Vlatko Dekov (HOPS, FYRO Macedonia) is elected new Chairperson and Nebojša Đurasović (Prevent, Serbia) new Vice-Chair. While Denis Dedajić (Margina, Bosnia Herzegovina), Marios Atzemis (Positive Voice, Greece) and Saša Mijović (4 Life, Montenegro) remain members of the Board as Secretary, Treasurer and Member, newly elected Board member Anna Lyubenova (Initiative for Health Foundation,IHF, Bulgaria) will serve as Deputy Secretary, and Erlind Plaku (Aksion Plus, Albania) as Deputy Treasurer.

In order to establish common positions, small group work was organised on key issues for which DPNSEE will issue statements in the future. Cannabis and Drug checking were specific topics for sharing and generating ideas.

Treatment Systems in Prisons in Eastern and Southeastern Europe

Pompidou Group – Council of Europe Co-operation Group to Combat Drug Abuse and Illicit Trafficking in Drugs, published a new publication “Drug Treatment Systems in Prisons in Eastern and Southeastern Europe”. The publication sheds light into the situation of drug users among criminal justice populations and corresponding health care responses in ten countries in Eastern and Southeastern Europe: Albania, Bosnia-Herzegovina, Georgia, Kosovo*, Macedonia, Moldova, Montenegro, Russia, Serbia, and Ukraine.

Prisons differ across different countries, as do prisoner populations. In some of the countries in the study there is an almost complete unavailability of effective drug dependence treatment (e.g. Opiate Agonist Treatment), or the potential of these treatment has not been exploited yet to its full. But also models of good practice exist in a few of the researched countries.

The publication is a product of the Pompidou Group of the Council of Europe project “Improving Drug Treatment Systems in prisons” which was financed by Luxembourg.

DPNSEE Chairperson Tijana Žegura and Secretary of the Board Denis Dedajić contributed to the publication.

Those interested in downloading the publication should follow this LINK>>>