Drug-related infectious diseases in Europe

Excerpts from the EMCDDA press release

Testing for drug-related infectious diseases among people who inject drugs (PWID) is crucial if international health targets are to be met. This is among the conclusions of a new EMCDDA report Drug-related infectious diseases in Europe. The update, from the agency’s drug-related infectious disease network, stresses that early diagnosis through testing, and improving links to treatment and care, are crucial steps towards reaching global health goals.

Launched during European Testing Week (15–22 May), the report offers an overview of drug-related infectious diseases among PWID in Europe, including the prevalence and incidence of HIV and viral hepatitis. It also tracks progress on health targets and showcases successfully implemented evidence-based interventions. It underlines the need to ramp up prevention and testing and signals that European countries are lagging behind when it comes to treating hepatitis C virus (HCV) and HIV among PWID.

HIV and chronic viral hepatitis are highly prevalent among people who inject drugs, being transmitted through the sharing of injecting equipment, such as needles and syringes. Addressing the needs of this group is critical to achieve the UN Sustainable Development Goal of Good Health and Well-being (SDG 3), which calls for ending the AIDS epidemic and combatting viral hepatitis as a public health threat by 2030 (SDG 3.3).

Besides data which include SEE countries which are EU members, there is a small update from neighbouring countries within the Instrument for Pre-accession Assistance 7 and EU4Monitoring Drugs project:

The Instrument for Pre-accession Assistance (IPA) 7 technical cooperation project comprises six beneficiary countries: Albania, Bosnia and Herzegovina, Kosovo (1), Montenegro, North Macedonia and Serbia. Data on PWID and other key populations in the region are available from RDS seroprevalence studies: Albania, Kosovo and North Macedonia have conducted such surveys in the past 3 years; Bosnia and Herzegovina, Montenegro and Serbia are planning to collect data in 2020. There were no HIV-positive cases among PWID in recent surveys conducted in Kosovo or North Macedonia (Mikikj, 2017); older HIV prevalence estimates among PWID ranged between 0 % in Bosnia and Herzegovina in 2015 (Skocibusic et al., 2016) to 2 % in Serbia in 2013 (IPH Serbia, 2013). Most recent HCV infection prevalence estimates ranged from 23.8 % in Kosovo to 72 % in North Macedonia. All six beneficiaries are signatories of the Dublin Declaration.

To read full report, follow this link>>>

 

European Testing Week 2020

European Testing Week is a European campaign that encourages partner organisations – in community, health care and policy institutions – throughout Europe to unite for one week twice a year to increase testing efforts and promote awareness on the benefits of earlier hepatitis and HIV testing. This initiative has progressed since its start in 2013 and has grown to be a widely recognised European event with hundreds of organisations participating every year.

European Testing Week offers partners across Europe the unique opportunity to unite to increase awareness of the benefits of early HIV and hepatitis testing among those who are at risk and promote increased access to testing. In 2019, more than 750 organisations from across 49 countries took part in ETW and thousands more people are now aware of their HIV and hepatitis status.

What once started as an annual event has now become a biannual event with two ETWs occurring each year in Spring (May) and Autumn (November). Each organisation volunteers their own time to organise their Testing Week activities and create incredible displays of a united effort to increase testing awareness at all organisational levels.

Now in its eighth year, the European Testing Week initiative will hold its third Spring European Testing Week from 15 – 22 May 2020.

The aim of the Spring and Autumn ETWs remain the same: to unite partner organisations throughout Europe for one week to increase access to testing and promote awareness on the benefits of earlier hepatitis and HIV testing.

There are many activities that an organisation can do for ETW. They can include activities such as:

  • Outreach testing activities for HBV/HCV/HIV
  • Awareness raising and/or advocacy initiatives
  • Engaging with HBV/HCV/HIV ambassadors or celebrities
  • Training/capacity building
  • Media campaigns and so much more!

For more information, ideas and tools to participate in the campaign, follow this link>>>

Hep C robust prevalence estimates

The European Centre for Disease Prevention and Control published their new Toolkit to support the generation of robust estimates of hepatitis C prevalence. This toolkit supports EU Member States in generating robust prevalence estimates for hepatitis C.

The overarching aim of this toolkit is to gain a better understanding of the HCV epidemiology in the EU/EEA.

European surveillance data show on-going transmission of viral hepatitis across the European Union and European Economic Area (EU/EEA). The available notification data however, do not provide a clear epidemiological picture of hepatitis C in Europe. Prevalence data from population surveys are a key source of information to complement the surveillance data for hepatitis C due to the limitations of surveillance for hepatitis: the infection is often asymptomatic and notifications are strongly influenced by local testing practices.

This toolkit offers:

  • An algorithm to assist EU/EEA Member States in their decision-making around selecting the type of HCV prevalence survey that should be undertaken
  • The technical protocol for conducting hepatitis C prevalence surveys in the general population
  • Modelled estimates of the national burden of viral hepatitis C in EU/EEA countries

To read and download the Protocol, follow this link>>>

HepC Conference scholarship available!

The International Network on Hepatitis in Substance Users (INHSU) is an international, not-for-profit, member-based organization dedicated to scientific knowledge exchange, education, and advocacy focused on improving health for people who use drugs, including focusing on hepatitis C prevention and care for people who use drugs.

INHSU annual conferences are a unique opportunity to connect with the global community working to improve health outcomes for people who use drugs including the prevention, treatment and care of hepatitis C. Their 9th International Conference on Hepatitis Care in Substance Users will be held 8 – 10 October 2020 in Glasgow, Scotland, UK.

Focused on supporting scientific exchange and knowledge dissemination, the conference provides delegates with access to the latest research and evidence regarding effective treatment and care to improve health outcomes for people who use drugs, with a specific focus on hepatitis C prevention, treatment and care. It provides an opportunity for those working in this area to share their research and professional expertise with leaders working in this field. It profiles cutting edge practice that links people who use drugs to prevention, treatment and care in a range of clinical, custodial and community settings.

This conference also brings together leaders engaged in the global effort to eliminate viral hepatitis by 2030.

Have a look at the conference promotional video

A number of scholarship opportunities are available for the full or partial scholarships for the Conference.

A full scholarship will include: conference registration, return economy class flights and accommodation. A partial scholarship will include conference registration.

To apply you must be currently enrolled in a BSc, PhD or Masters Degree and submit an abstract before the deadline: Sunday 15 March 2019.

For more information and to apply, follow this link>>>

European Hepatitis C Community Summit

The 3rd European Hepatitis C Community Summit was held in Marseille, on 25 and 26 November 2019. The aim of the Summit was to bring together researcher, health and community workers, medical staff and HCV patients and advocates to discuss elimination of the disease and role of harm reduction and community services. The event was organised by Correlation – European Harm Reduction Network, in cooperation with the European Union funded Eurosider project.

The programme contained plenary and parallel sessions and focused on priorities for community involvement and advocacy targets for after the event.

A variety of examples of good practice was presented during parallel sessions on: Models of good practice, HCV in prison, Peer Involvement works – we just need to implement it, Capacity building, Access to services, ODBuster – Digitally Networking the Response to Opioid Overdose Emergencies, HCV prevention for (un) documented migrants and Building Capacity to support People who use drugs. Probably the most interesting one was on HCV in prison.

Several representatives of DPNSEE member organisations participated, including Aksion Plus, Margina, Proi, Prometheus, Juventas, HOPS, Positive Voice, ARAS and Alliance of Non Governmental Organisations for Drugs and Addictions in Slovenia. The DPNSEE Board member Marios Atzemis was member of the planning team of the Summit.

The French Embassy in Belgrade provided support for two representatives from Serbia. One was from the Institute for Public Health while the second was DPNSEE Executive Director Milutin Milošević.

At the Summit, a statement about the negative effects of criminalisation on health and well being of people who use drugs entitled The decriminalisation of drug use and ensuring national funding of key services will reduce death, disease and marginalisation of people who use drugs was launched – without any opportunity to discuss it.

Ninth European drugs summer school

The University Institute of Lisbon (ISCTE-IUL) and the EU drugs agency (EMCDDA) will be joining forces once again next summer to hold the ninth European drugs summer school (EDSS) on ‘Illicit drugs in Europe: demand, supply and public policies’. Registration is now open for the two-week course, which will take place in the Portuguese capital from 29 June to 10 July.

Through a multidisciplinary and interactive approach to the drugs problem, EMCDDA scientific experts, leading academics, guest speakers, policymakers and professionals having participated in previous rounds of the EDSS, will prepare participants to meet the complex policy challenges in this field – both in Europe and beyond. The focus of the 2020 course will be hepatitis C.

Week 1 of the summer school, focusing on the ‘Drugs problem: substance use and problems, substance characteristics, and market’, will feature lectures on: the global burden of drug-related problems; drug markets in Europe; detecting new drugs; and prevention approaches in demand-reduction interventions. This session will also focus on the EMCDDA’s epidemiological indicators and their use in informing drug policy.

Week 2, dedicated to ‘Policymaking for drug-related issues’, will include lectures on: drug policies and new challenges (concepts, issues and analysis); the use of evidence to inform decision making; drug laws; and monitoring supply reduction and drug enforcement activity. It will also include group discussion exercises on how to use the knowledge acquired during the course, to sustain drug-related debates. Finally, students will be guided through an analysis of the link between evidence and decision-making, including examples of implementation.

Study visits to outreach facilities and to one of the Portuguese commissions for dissuasion will be organised over the two weeks. During the course, students will also participate in interactive workshops to discuss their own projects and views. The course will conclude with an open debate with guest speakers.

The target audiences for the EDSS are: university students, researchers, professionals and administrators interested in working on drug issues. The previous rounds of the summer school brought together students from the EU Member States as well as from Africa, Asia, Australia and the Americas.

In 2020, students will again be able to apply for scholarships and ‘early-bird’ reductions are also available.

Information and registration is available following this link>>>

Have a look at the promotional video of the European drugs summer school below

Medicines Shortage Survey

The EU Civil Society Forum on HIV, TB and Hep working group on access to medicines is inviting you to contribute to a short survey on medicines shortages for the treatment of hepatitis B&C, HIV, TB and OST in 2019. The deadline for contribution is 27 June 23:59 CET.

The data collected and summarized will be used in a meeting with the European Commission with other civil society partners on 1 July 2019 to back a request for an investigation into the causes of shortages in order to improve understanding of the situations and possible solutions.

The survey is not limited to EU countries.

Please, fill in the survey here>>>

Good results of the „Support. Don’t Punish” campaign in Montenegro

NGO Juventas, together with NGOs 4 Life and Montenegrin High School Students Union, implemented “Support don’t punish” campaign for the third time in Montenegro. This year campaign was dedicated to the burning issues in the country:

  • Lack of sustainable support to Harm Reduction services,
  • Lack of treatment for underage people who use drugs,
  • Youth and drug use.

NGO Juventas and NGO 4 Life made a public statement on the 26 June, in which they requested urgent enabling on:

  1. Provision of free of charge residence in the Public institution for accommodation, rehabilitation and re-socialization of drug users for all persons in need of this treatment.
  2. Provision of payment of treatment costs to the Public Institution for accommodation, rehabilitation and re-socialization of Persons who use drugs who are members of families already been entitled to social protection benefits.
  3. Introduction of Non-Interferon Therapy for the Treatment of Hepatitis C Viral Infection and Issuance of Non-Interferon Therapy Generic Medication Purchase Permission.

 

At the other hand, NGO Juventas in partnership with Montenegrin Union of High school Students implemented online survey among young people in Montenegro from 16th to 26th June. 590 persons from most of municipalities of Montenegro, younger than 30 participated in survey, which gave an overview on the state of Youth and drugs in our country. 1/3 of respondents were underage.

After public presentation of survey results, Public Debate on the topic of “Legalisation of marihuana in Montenegro – Pros and Contras” was organised in Youth Centre of Podgorica and team of “Slobodan Škerovic” High school Pro and team of Political Science Faculty Contra.

At the end, a short video form was created in order to rise questions on the state of people who use drugs and available health and social care support in Montenegro, which was seen by 7800 people.

At the other hand, Juventas supported activities of NGO Link, first association of persons who use drugs in Montenegro during “Self-Support, don’t punish Us” campaign, during which a public statement on stigma and discrimination as one of main problems of people who use/inject drugs was made.

In order to improve the quality of life of drug addicts, but also to influence positive changes in our community, participating organisations proposed a series of measures:

  1. Establishment of the Clinic for the treatment of drug addiction and strengthening the role of the psychiatrists and the personal doctor in the treatment of this disease in all health centres in Montenegro.
  2. Increase the capacity of substitution programs in health canters, in particular in Podgorica, to reduce existing waiting lists for starting treatment in the capitol.
  3. Introduce free distribution of Naloxone
  4. Enabling conditions for adequate treatment of persons who use drugs within the Institution for Execution of Criminal Sanctions
  5. Opening the safe injection room

 

Juventas supported implementation of drug-addicted persons activity related to painting „Support. Don’t Punish” logo in the center of Podgorica.

The main result of this year „Support don’t punish” campaign in Montenegro is decision of Ministry of Health to support development of substitution treatment in Podgorica and ensure opening another centre of this kind in 2018. The latest. NGO Juventas succeeded to make this agreement, just at the end of July, after whole month of very demanding negotiations.

Without Shift: Harm Reduction After Global Fund in Serbia

For three years, Serbia was not eligible for funding from the Global Fund, which resulted in the closure of harm reduction programs around the country. The movie, prepared by NGO Re Generation, gives a glimpse of the desperate situation faced by injecting drug users in Serbia, and also explores the consequences of the closure of needle exchange programs in Belgrade, whilst trying to assess the current situation in the country!

Serbia is at the crossroads of a number of heroin trafficking routes. It has a significant population of injecting drug users – 20,000 according to the official estimates. Thanks to grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria, several harm reduction services were introduced during the first decade of this century. Approximately two thousand people enrolled in opiate substitution programs, and four needle exchange programs provided sterile equipment to injecting drug users. The prevalence of HIV among drug users was low, though access to harm reduction services was far from adequate – the best indicator of risk being the high prevalence of Hepatitis C infections.

The last grant from the Global Fund ended in June 2014. The Government made no commitment to continue funding the programs, and there are no other international donors available to step in and cover the harm reduction funding gap. This resulted in closing of all needle and syringe projects except one, which is operated by Association Prevent in Novi Sad. Three years later, the Government has changed but the programs are still out of focus when it comes to national funding!

 

What it means for Serbia at this point, and what it will mean for the future of the needle and syringe programs in the country is yet unknown. To find out more, watch the movie “Without Shift” produced by NGO Re Generation with support of Drug Reporter, exploring the opinions of different stakeholders on the topic.

Greek organisations united around the “Support. Don’t Punish” campaign

For one more year, the global campaign “Support.Don’t Punish” has been successfully implemented in Greece. In 2017, 6 different civil society organizations – that constitute the Greek NGO Platform for Psychoactive Substances, an unofficial initiative for joint action among organizations working in the area of drug policy and psychoactive substances – joined forces and cooperated in order to effectively spread the message of the campaign, sensitize the public, raise awareness regarding the harms being caused by the criminalization of people who use drugs and promote the need for human rights and public health oriented drug policy and drug law reform.

The organizations that supported the implementation of the campaign were:

  • CENTRE FOR LIFE” for the support of people living with HIV/AIDS [DPNSEE member]
  • DIOGENIS”- Drug Policy Dialogue [IDPC partner member & DPNSEE partner member]
  • PeNUPS”- Peer Network of Users of Psychoactive Substances
  • POSITIVE VOICE”- Association of People living with HIV/AIDS [DPNSEE member]
  • PROMETHEUS” – Hellenic Liver Patient Association [DPNSEE member]
  • PRAKSIS” [IDPC network member]

For the achievement of the aforementioned goals, two main activities were implemented:

  1. A press interview (June 27th, 12.00-14.00h, at Romantso, 3-5 Anaksagora Street, Omonia, Athens)
  2. A street event (June 27th, 19.00h at SIN Athina, Athens)

Furthermore, before the 27th of June, representatives of these organizations took the initiative to spread the message of the campaign during several official events, that were organized by state authorities by asking officials, journalists, scientists, decision-makers and other high-ranking representatives of governmental organizations to take a photograph with the logo of “Support.Don’t Punish” (e.g. Mrs. Teta Papoutsopoulou-Diamantopoulou, the National Drug Coordinator; Mr. Evaggelos Kavetzopoulos, President of the Hellenic Organization against Drugs- OKANA; Mr. Nikolaos Manios, Chairman of the Parliament’s Committee on Social Affairs; Μr. Nikolaos Paraskevopoulos, MP and former Minister of Justice).

The press interview given by representatives of PeNUPS

The press interview was given by representatives of PeNUPS (Peer Network of Users of Psychoactive Substances), Mr. Christos Anastasiou and Mr. John Kissas, promoting in that way peer involvement which is one of the basic principles of Harm Reduction.

The remaining organizations actively supported the needs for the preparation and successful implementation of this activity. It was the first time that people coming from the community of PWUD had the floor in a press interview, which attracted 30 participants and was coordinated by the journalist Mrs. Ioanna Sotirchou.

During the afternoon of the 27th of June, a street event also took place in the center of Athens. The goals of this activity were to make the campaign more visible, celebrate the message of “Support.Don’tPunish”, provide informational material and offer some services both to the general population and vulnerable groups (including PWUD) in the area.

 

The street event in the center of Athens

Volunteers from the coordinating organizations actively contributed in the implementation. T-shirts, bags, stickers with the logo of “Support. Don’t Punish” and flyers with the basic principles of Harm Reduction were distributed. In addition, NGO Praksis offered free, anonymous and voluntary rapid testing for HIV, HBV and HCV with its mobile unit. Moreover, of outmost importance was the contribution of the initiative “STEPS” that helped in the preparation of food and beverages and offered music. This event gathered and united around a hundred people.

For the needs of campaign’s promotion a facebook page was created under the title: Support.Don’t Punish -Greece- where you can have access to more detailed information, videos and photographs. Facebook advert was used attract more people to the page, resulted in 300 likes within a week.

2 facebook events were also created for the promotion of the two activities:

https://www.facebook.com/events/203865003471040

https://www.facebook.com/events/321069778316468

Group photo from the street event