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.

Awareness video on human rights and harm reduction approach

Our member organisation Labyrinth invite to check out awareness video-animation they produced on Human rights and Harm reduction approach for people who use drugs in Kosovo.

The video was a part of the project that Labyrinth implemented “Enhancing drug user’s rights and entitlements” and was supported by the EU Office in Kosovo. The purpose of the “ENDURE” project was to create a more appropriate environment for people from marginalized communities to realize health, social and legal rights and to be involved in all processes of social life.

The project aimed to address the needs of discriminated and stigmatized groups by strengthening their capacities to invoke anti-discrimination law. The “ENDURE” project also aimed to raise awareness against discrimination providing legal and psychological support to drug users and improve access to drug users.

In scope of the ENDURE project, Labyrinth prepared two publications (both in Albanian):

Have a look at this excellent video. Subtitles are available both in English and Serbian language.

UNAIDS calls for greater urgency as global gains slow and countries show mixed results towards 2020 HIV targets

Taken from a UNAIDS press release

The pace of progress in reducing new HIV infections, increasing access to treatment and ending AIDS-related deaths is slowing down according to a new report released on 16 July 2018 by UNAIDS. UNAIDS’ Global AIDS Update, Communities at the centre, shows a mixed picture, with some countries making impressive gains while others are experiencing rises in new HIV infections and AIDS-related deaths

We urgently need increased political leadership to end AIDS,” said Gunilla Carlsson, UNAIDS Executive Director, a.i., “This starts with investing adequately and smartly and by looking at what’s making some countries so successful. Ending AIDS is possible if we focus on people, not diseases, create road maps for the people and locations being left behind, and take a human rights-based approach to reach people most affected by HIV.”

The report shows that key populations and their sexual partners now account for more than half (54%) of new HIV infections globally. In 2018, key populations – including people who inject drugs, gay men and other men who have sex with men, transgender people, sex workers and prisoners – accounted for around 95% of new HIV infections in eastern Europe and central Asia and in the Middle East and North Africa.

However, the report also shows that less than 50% of key populations were reached with combination HIV prevention services in more than half of the countries that reported. This highlights that key populations are still being marginalized and being left behind in the response to HIV.

Globally, around 1.7 million people became newly infected with HIV in 2018, a 16% decline since 2010, driven mostly by steady progress across most of eastern and southern Africa. South Africa, for example, has made huge advances and has successfully reduced new HIV infections by more than 40% and AIDS-related deaths by around 40% since 2010.

However, there is still a long way to go in eastern and southern Africa, the region most affected by HIV, and there have been worrying increases in new HIV infections in Eastern Europe and Central Asia (29%), in the Middle East and North Africa (10%) and in Latin America (7%).

Disconcertingly, the report shows that the gap between resource needs and resource availability is widening. For the first time, the global resources available for the AIDS response declined significantly, by nearly US$ 1 billion, as donors disbursed less and domestic investments did not grow fast enough to compensate for inflation. In 2018, US$ 19 billion (in constant 2016 dollars) was available for the AIDS response, US$ 7.2 billion short of the estimated US$ 26.2 billion needed by 2020.

To continue progress towards ending AIDS, UNAIDS urges all partners to step up action and invest in the response, including by fully funding the Global Fund to Fight AIDS, Tuberculosis and Malaria with at least US$ 14 billion at its replenishment in October and through increasing bilateral and domestic funding for HIV.

Progress is continuing towards the 90–90–90 targets. Some 79% of people living with HIV knew their HIV status in 2018, 78% who knew their HIV status were accessing treatment and 86% of people living with HIV who were accessing treatment were virally suppressed, keeping them alive and well and preventing transmission of the virus.

Communities at the centre shows however that progress towards the 90–90–90 targets varies greatly by region and by country. In Eastern Europe and Central Asia for example, 72% of people living with HIV knew their HIV status in 2018, but just 53% of the people who knew their HIV status had access to treatment.

AIDS-related deaths continue to decline as access to treatment continues to expand and more progress is made in improving the delivery of HIV/tuberculosis services. Since 2010, AIDS-related deaths have fallen by 33%, to 770 000 in 2018.

Progress varies across regions. Global declines in AIDS-related deaths have largely been driven by progress in eastern and southern Africa. In Eastern Europe and Central Asia however, AIDS-related deaths have risen by 5% and in the Middle East and North Africa by 9% since 2010.

Communities at the centre shows that the full range of options available to prevent new HIV infections are not being used for optimal impact. For example, pre-exposure prophylaxis (PrEP), medicine to prevent HIV, was only being used by an estimated 300 000 people in 2018, 130 000 of whom were in the United States of America. In Kenya, one of the first countries in sub-Saharan Africa to roll out PrEP as a national programme in the public sector, around 30 000 people accessed the preventative medicines in 2018.

The report shows that although harm reduction is a clear solution for people who inject drugs, change has been slow. People who inject drugs accounted for 41% of new HIV infections in Eastern Europe and Central Asia and 27% of new HIV infections in the Middle East and North Africa, both regions that are lacking adequate harm reduction programmes.

Gains have been made against HIV-related stigma and discrimination in many countries but discriminatory attitudes towards people living with HIV remain extremely high. There is an urgency to tackle the underlying structural drivers of inequalities and barriers to HIV prevention and treatment, especially with regard to harmful social norms and laws, stigma and discrimination and gender-based violence.

Criminal laws, aggressive law enforcement, harassment and violence continue to push key populations to the margins of society and deny them access to basic health and social services. Discriminatory attitudes towards people living with HIV remain extremely high in far too many countries. Across 26 countries, more than half of respondents expressed discriminatory attitudes towards people living with HIV.

The report highlights how communities are central to ending AIDS. Across all sectors of the AIDS response, community empowerment and ownership has resulted in a greater uptake of HIV prevention and treatment services, a reduction in stigma and discrimination and the protection of human rights. However, insufficient funding for community-led responses and negative policy environments impede these successes reaching full scale and generating maximum impact.

UNAIDS urges countries to live up to the commitment made in the 2016 United Nations Political Declaration on Ending AIDS for community-led service delivery to be expanded to cover at least 30% of all service delivery by 2030. Adequate investments must be made in building the capacity of civil society organizations to deliver non-discriminatory, human rights-based, people-centred HIV prevention and treatment services in the communities most affected by HIV.

To read full report follow this link>>>

DPNSEE have made an excerpt with the country data for 10 countries of the region, which you can download following this link>>>

Nova stranka first to sign “Declaration on Sustainable National Response to HIV”

Nova stranka  is the first political party in Serbia which signed the Declaration for sustainable national response to HIV, proposed by the Group for Analysis of Public Policies (GAJP) as part of their project Political support to the harm reduction programmes. Aim of this project is to invite all political parties in Serbia to sign the Declaration that will oblige them to support harm reduction programmes and their financing from budgetary sources in their future work and participation in legislative and executive bodies.

The President of the Council of the Nova stranka, Aris Movsesian said that it is normal for the Nova stranka, as well as all other political parties, to sign this declaration.  Nova stranka is committed to joining the European Union, and the last year’s European Commission report calls for regulating the treatment of HIV patients, specifically in Chapter 28 where such measures are proposed. Nova stranka also emphasises in point 8 of their Action Plan the problem of relations with vulnerable groups of citizens.

Movsesian invited other political parties to follow our example and make such a civilization step.”

The declaration is developed in scope of the Budget Advocacy and Monitoring in South East Europe project. The project is managed by DPNSEE, and coordinated in Serbia by the Association Prevent.

To read the news from the signing of the declaration in Serbian follow this link>>>.

New publication from Eurasian Harm Reduction Association

EHRAThe Eurasian Harm Reduction Association (EHRA) presented its new publication “Getting to know the Civil Society and Eastern Europe and Central Asia Delegations to the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. An Information note for Eastern Europe and Central Asia”. The publication is developed within the project of the EECA Regional Platform for Communication and Coordination.

This Information Note is an easy-to-use document which allows for greater understanding of the work and role of the Communities, Developed Country NGO, Developing Country NGOs and the Eastern Europe and Central Asia (EECA) Delegations to the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. The EECA Delegation is dedicated to the causes and concerns of the region, both from a public sector and civil society perspective. The other three Delegations have specific mandates to bring to the Board the issues of civil society and all the communities of persons living with, and affected by, the three diseases in those countries eligible for Global Fund support.

Getting to know the Civil Society and Eastern Europe and Central Asia Delegations to the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria

Whilst there are four distinct Delegations, these Global Fund Board representatives have similar practices for their internal functioning and in consulting with civil society and communities as well as established opportunities to engage with them. This document provides information concerning these key practices and opportunities. The communities and civil society organizations (CSO’s) in the EECA region will be able to use this document to better plan and coordinate their advocacy efforts and engage with their representatives to the Fund at the most opportune times and in strategic ways.

The Global Fund is the world’s largest financing organization for HIV and AIDS, TB and malaria prevention, treatment, care and support programs. The Fund’s purpose is to attract, leverage and invest additional resources to end the epidemics of HIV, tuberculosis and malaria to support attainment of the Sustainable Development Goals (SDG’s) established by the United Nations. Since its founding in 2002, the Global Fund’s investments in the EECA region have contributed to considerable progress in combating three diseases as well as in developing enabling environments and the strengthening of health and community systems, making the Global Fund the major donor to support the HIV and TB response in the EECA region.

To read or download this publication follow this link>>>>

62nd CND Session – Day 2

The second day of the 62th CND was full of side events and sharing with participants.

An overviews of the side events we participated in today includes:

Psychoactive substances and the Sustainable Development Goals – Towards a comprehensive approach in the era of the 2030 Agenda

Organized by the Government of Slovenia, Utrip Institute for Research and Development, the Pompidou Group of the Council of Europe and IOGT International. Jože Hren started his presentation reminding that for 20 years already the approach in Slovenia is that drug use is primarily a health problem and that possession of small quantities is a misdemeanour also since 1999. Those who are caught in possession of drugs get a fine of 40 Euro, but there is a process to change it to an oral warning or referral to treatment in more complex situations. Representative of the Pompidou Group spoke about the bi-annual prize the Group awards to innovative prevention programmes created by young people for young people. Another Slovenian representative presented their work emphasizing the need to invest in mental health programmes for adolescents. Cost of mental health disorders in Europe take 3 to 5 percent of GDP. There is a need for a reallocation of resources for more sustainable and impactful outcomes in tackling harmful substances and behaviours. Medical help is not enough – it has to be combined with comprehensive and long lasting prevention. They have a programme called “This is me”, which is in line with the Goal 3 of the SDGs. Kristina Sperkova, president of the IOGT International (international network of Templar organisations) works on prevention of alcohol and other drugs harm world-wide. Sanela from Utrip Institute advocated for a community approach to prevention. Notes from the side event are available at the CND Blog following this address>>>.

Leaving no one behind: People at the centre of a harm reduction, human rights and public health approach to drug use

Organized by the Netherlands and Norway, UNODC, UNDP, UNAIDS, WHO, IDPC, AFEW International, Harm Reduction International, INPUD, Open Society Foundations, Aidsfonds and Frontline AIDS. Ann Fordham from IDPC highlighted that the new UNADIS report indicates that 99% of people who use drugs doesn’t have a proper access to health services. WHO representative reminded that half a million people worldwide die of drug related deaths, mainly overdose and blood borne diseases HIV/AIDS and Hepatitis C. People also suffer because they can’t access the medicines they need. The Netherlands has “put people first” in their approach to harm reduction. The right to health is fundamental to all people irrespective of whether they are using drugs. Drug policies should seek to reduce violence, promote the rule of law, support the most marginalized and vulnerable, lift up human rights. Prohibition and criminalization means a continuation of armed conflict supported by disproportionate spending. Naomi Burke-Shyne from HRI reminded that funding for harm reduction has flat lined from 2007 to 2016, which stands in shocking contrast to the estimated funding need by UNAIDS: existing funding represents only 13% of this estimated need. Judy Chang from INPUD stated that “Existing drug policies threaten security, democracy and the well-being of all, especially those most marginalized and vulnerable. The war on drugs and drug-free agenda undermines the SDG agenda.” Zaved Mahmood from ‎UN Office of the High Commissioner for Human Rights estimates that People who use drugs are not just left behind, they are kept out. The right to life includes the obligation to take measures where peoples’ lives might be threatened, including in relation to the use of drugs and HIV and hepatitis.

Drug prevention approaches that make a difference

Organized by the Governments of Iceland and Serbia, and the Pompidou Group of the Council of Europe. Serbian representative to the OSC made an introduction speech. The same like the Minister of Health on Thursday 14 at the Ministerial Segment, he said that the Drug Strategy has 5 chapters instead of 7, avoiding to say that Harm Reduction is one of them. Jelena Janković from the Ministry of Health presented the latest developments, including information about overdose deaths in 2018 and creation of the Ministerial Commission (for fighting narcomania in schools). She also presented the project the Ministry did with experiences and support from Israel. Iceland presented their project with are seen as the flagship project on prevention. Almost 2% of the alcohol and tobacco taxes go to prevention programmes! They see as the main risks and protective factors family factors, peer group effect, general well-being and extra-curricular activities and sports. Their learning is that the multidisciplinary collaboration is the key to success. The change thy achieved is different attitude of parents and society – don’t buy alcohol for children. It is not OK for adolescents to be drunk in public. It is not the amount of time that parents spend with their children – it is the quality of time. There are no unsupervised parties. Pompidou Group emphasised the role of police in prevention. Interventions from the floor were on offering more than just sports and having campaigns that cover illicit but also legal substances.

Other side events held today that may be of interest are:

Other events

The Vienna NGO Committee on Drugs (VNGOC) held regular Annual General Assembly. The Committee welcomed new members, reviewed and approved the VNGOC annual report and reflected on activities for 2018/19 including those of the Civil Society Task Force (CSTF), got information about the annual accounts for 2018, the latest financial status and audited accounts for 2018, Strategic Plan 2019-21 and Budget for 2019 and Voluntary Code of Conduct for NGOs at the CND and received an update on developments within UNODC. The Committee discussed the future organisation of the VNGOC, based on the background paper presented by the Board.

Following a governance review process undertaken in 2017, VNGOC agreed to stagger the elections for the VNGOC Board to ensure greater stability and continuity. In order to do this, three of the positions elected last year were given one-year terms, the other three positions were given the standard two-year terms. This year, the following three positions were up for re-election: Chairperson, Deputy Treasurer, Deputy Secretary. Our friend fro International Drug Policy Consortium Jamie Bridge was re-elected for the Chairperson. Congratulations!

The South East Europe pre-Conference Meeting held in Bucharest

With the support from the Open Society Foundations, the Drug Policy Network South East Europe organised the South East Europe Meeting on 20 November in Bucharest, Romania, prior to the 4th European Harm Reduction Conference. The event aimed to get together activists working on harm reduction services, exchange experiences and promising ideas for the future, meet with international partners and discuss future opportunities for collaboration. 36 representatives of harm reduction organisations and institutions from countries of the region and from various international organisations attended this meeting: Albania, Bosnia and Herzegovina, Bulgaria, Greece, Kosovo*, Macedonia, Montenegro, Romania, Serbia and Slovenia.

Nebojša Đurasović, Vice-President of the DPNSEE Board opened the Meeting with welcome note and agenda review and announced first session Where is South East Europe now? Sofia Galinaki from Diogenis, the member of the IDPC Members’ Advisory Council, moderated this session. She presented the results of the Harm Reduction Survey. Dragoş Roşca, Romanian Harm Reduction Network, continued this session and spoke about current situation in Romania, Denis Dadajić, from Margina, explained situation in Bosnia and Herzegovina and Silvana Naumova from HOPS, presented current situation in Macedonia.

Facilitating the second session What do we actually do?, DPNSEE Executive Director Milutin Milošević, reminded on some dilemmas, including those of quality in the times of transition and integrated services for all vs. those specific for key sub-populations. Ivica Cekovski from HOPS spoke about the concept of quality in Macedonia. The session continued with Dr Vera Kerleta-Tuzović, Agency for Healthcare Quality and Accreditation in FBiH who presented accreditation of drop-in centres Bosnia and Herzegovina and session was closed with Tomaž Koren, from Alliance of NGOs for Drugs and Addictions, from Slovenia, who talked about quality of services in Slovenia, with special view on harm reduction in nightlife and festival settings.

The pre-conference meeting continued with third session that was moderated by Jelena Čolaković, from the DPNSEE member organisation Juventas, Montenegro. The speakers crossed over specific topic Where do we go from here? and was centred around opportunities for collaboration, including a regional program on sustainability supported by the Global Fund. Vladan Golubovic, from Chairman sent a presentation about the Regional Coordinating Mechanism. Tetyana Deshko, from Alliance for Public Health presented upcoming Global Fund supported regional project “Sustainability of services for key populations in Eastern Europe and Central Asia region”. Then, Mišo Pejković from Cazas spoke about experiences in cooperation in the region. The session was closed by Amarildo Fecanji, from ERA, who talked about potential cooperation between the networks and organisations.

At the last session What else we need to talk about? Ganna Dovbakh from Eurasian Harm Reduction Association emphasized potentials for advocacy in the process of EU Enlargement on national level.

Closing the Meeting, Nebojša Đurasović thanked all for contributing to the Meeting which he found successful. He noted a very friendly and open atmosphere and hoped that the experiences and ideas presented will be a good basis for future cooperation and partnerships.

Photos: Snežana Šundić – Vardić and Sanja Đurasović

A tool presenting the situation in South East Europe

The Drug Policy Network South East Europe published the document  Addressing the acute funding crisis facing harm reduction services in South-East Europe with the aim to emphasize the acute funding crisis facing harm reduction services in Balkan states and South-East Europe, to influence the policies and actions of the Global Fund to Fight AIDS, Tuberculosis and Malaria  and other donors. It is a complementary part of a larger body of work being done by a wide range of partners – including the Open Society Foundation and the International Drug Policy Consortium – to document the consequences of changes in donor eligibility policies, and to urgently try and influence donor policy away from a withdrawal from middle-income countries in South East Europe.

DPNSEE worked with their partners and members across the region to gather case studies of Opioid Substitution Therapy stock-outs or shortages, service closures or reductions in coverage, and other critical issues experienced by civil society partners in South East Europe related to transitions away from Global Fund support. Through interviews with key stakeholders and desk-based research, DPNSEE gathered information, experiences, feedback and recommendations from Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Kosovo*, Macedonia, Montenegro, Romania and Serbia.

The material was collected in November – December 2017. Since then, it was used only internally. The document was published and shared with the participants of the South East Europe pre-Conference meeting, held in November 2018 in Bucharest, Romania.

Click here to download the document >>>

The 4th European Harm Reduction Conference in Bucharest

The 4th European Harm Reduction Conference, called for 21 to 23 November 2018 in Bucharest, Romania is organised by the Correlation Network in cooperation with Romanian partners and different European Networks and partners, such as Infodrug Switzerland, the European Network of People Who Use Drugs, the Eurasian Harm Reduction Association and the European Joint Action HA-REACT.

The conference will present the latest harm reduction research results, innovative and next best-thing practices, discuss drug policy including the need to scale up harm reduction services and provide an appropriate platform to create a link between national and European developments in drug policies and harm reduction.

The European Harm Reduction Conference is aimed at professionals that work in the areas of harm reduction, treatment, prevention, medicine, research, law enforcement and politics and, finally but importantly, drug user and community organisations.

With the support from the Open Society Foundations, the Drug Policy Network South East Europe will coordinate participation of South East Europe in the 4th European Harm Reduction Conference. Specific objectives of this project include:

 

  • Improve and extend partnerships in South East Europe
  • Provide organizational and logistic support to SEE representatives at the Conference
  • Organize a SEE side-event before EuroHRC
  • Support linking of the SEE participants with various networks, EU agencies etc.
  • Envisage and agree on models of long term co-operation in the region

The pre-conference South East Europe meeting will be held on 20 November. Aim of the event is to get together, exchange experiences and promising ideas for the future, meet with international partners and discuss future opportunities for collaboration. So far, 36 representatives of harm reduction organisations and institutions from all countries of the region and from various international organisations applied for the event.

More about the Conference is available at the website following this link>>>

Implementing Different Harm Reduction Policies in Macedonia

Janaki Mitrovski, lawyer and co-founder of the Cannabis and Green Policies Association “BILKA” from Skopje, author of articles in the legal magazines “Pravnik” and “Pravomatika”, wrote about different harm reduction policies in Republic of Macedonia for the Drugs – Politics and Practices magazine published by HOPS – Healthy options project Skopje.

Mitrovski spoke about differences in European countries, and he underline the most important thing – urgent implementing program for safe drug use facilities in Republic of Macedonia.

In order to apply some of the existing models practiced or to establish a hybrid and an entirely different model of addressing this issue in the Republic of Macedonia, there are legal obstacles to be considered. Making possible drug use facilities, safe or not, is prohibited and is penalized with Article 216 from the Criminal Code of the Republic of Macedonia, according to which a person who shall provide spaces for the enjoyment of narcotic drugs and psychotropic substances shall be punished with imprisonment from 1 to 5 years. A qualified (more severe) form of this act is considered extant if the same is done with respect to a minor person or with respect to a larger group of people or if the deed has caused serious consequences, in which case the doer will be punished with 1 to 10 years of imprisonment. If, however, the act is perpetrated by a legal person, the same will be punished with a fine, and the narcotic drugs, as well as all moveable properties or any real estate used for their transport or distribution, or if they are especially intended for or meant for use, will be confiscated.

He drew attention for legal circumstances in criminal legal system and the result of international legal obligations Republic of Macedonia agreed to with the 1961 Single Convention on Narcotic Drugs, as well as the 1988 Convention against the Illicit Traffic in Narcotic Drugs and Psychotropic Substances, decreed by the United Nations, which go as far as providing legal framework for the signatory countries to even confiscate such spaces.

Unfortunately, the Republic of Macedonia does not allocate even approximately enough funding and has no political will to introduce such programs towards helping drug addicts with harm reduction, as well as protect the very users, but also society, from spread of unwanted diseases”, said Mitrovski.

He concluded that the Republic of Macedonia has to implement one program providing safe drug use spaces in the future, which will provide health benefit for users and also for the citizens.

The entire article “Implementing Different Harm Reduction Policies in the Republic of Macedonia – Safe Drug Use Facilities” is available following this link>>>