Assessment of gender sensitivity of the drug harm reduction program for youth in Serbia

This gender analysis of harm reduction services for young people who use drugs (PWUD) “Assessment of gender sensitivity of the drug harm reduction program for youth in Serbia“, published by our member organisation Prevent from Novi Sad, was conducted within the Erasmus+ regional project “Creating Gender-Based Programs for Young People Who Use Drugs,” with the aim of identifying gender-related barriers, gaps, and opportunities in existing programs. The study places a strong focus on the needs and lived experiences of young PWUD, including those of diverse gender identities and sexual orientations, while assessing the level of gender sensitivity and inclusiveness of current services. In 2025, the harm reduction landscape in Serbia is marked by the absence of an updated national strategy, weakening multisectoral cooperation, and the exclusion of civil society organizations (CSOs) from policymaking processes. Existing policies only partially recognize harm reduction and lack gender-specific or transformative approaches, while the legal framework remains repressive and discourages service access. Additionally, there is a significant lack of gender-disaggregated data and gender analysis in public systems, alongside documented discrimination against women, trans, and LGBTQAI+ individuals. Despite these challenges, CSOs continue to play a crucial role as primary service providers, offering essential support such as sterile equipment, testing, counselling, and safe spaces, though they face limited funding, administrative barriers, and declining international support, putting especially gender-sensitive and youth-focused services at risk of closure.

The findings highlight that women – particularly sex workers, Roma women, and trans and non-binary individuals – face multiple and intersecting forms of marginalization, compounded by the lack of gender-responsive services and systemic exclusion from public institutions. There is a clear need for more inclusive, gender-sensitive, and accessible approaches, including mobile and night outreach, integrated legal and healthcare support, and safe shelters. While CSOs are actively developing anti-stigma protocols, gender-neutral spaces, staff training, and protection mechanisms, their efforts remain constrained by unstable funding. Accordingly, the recommendations emphasize the urgent need to integrate a gender perspective into public policies, ensure sustainable institutional funding for CSOs, reform punitive legal frameworks, and enable meaningful participation of both CSOs and young PWUD in decision-making. At the organizational and programmatic levels, priorities include diversifying funding sources, strengthening partnerships, preserving core services, expanding peer-led and gender-sensitive programs, improving outreach and communication, addressing violence, and investing in continuous monitoring and staff capacity building. Overall, a coordinated and gender-responsive systemic shift is essential to ensure equitable, sustainable, and effective harm reduction services in Serbia.

The report, in Serbian, is available following this link>>>.

Prevent also published a comparative report which is the result of collaboration between civil society organizations from three countries: Prevent from Novi Sad, HOPS from Skopje, and Sananim from Prague. It provides a comprehensive overview and comparison of three national gender analyses of harm reduction programs conducted in Serbia, North Macedonia, and the Czech Republic during 2025, using a shared methodology. The main objective was to identify gender-related barriers, gaps, and opportunities within existing harm reduction services, with a particular focus on the needs and experiences of young people who use drugs, including individuals of diverse gender identities and sexual orientations. The report examines the extent to which services are gender-sensitive, inclusive, and responsive to the specific needs of users, taking into account the influence of gender norms, identities, and structural inequalities on both access to and quality of services.

The analysis combines two key components: a desk review of existing strategies and policy frameworks, and qualitative insights gathered through semi-structured interviews with organizations working directly with marginalized communities, including people who use drugs, sex workers, LGBTI+ individuals, and youth. To ensure a standardized and evidence-based assessment, the evaluation of programs and policies was conducted using the World Health Organization’s Gender Responsive Assessment Scale (GRAS), which enabled the identification of levels of gender responsiveness as well as critical gaps across the three national contexts. This comparative approach not only highlights shared challenges but also provides a foundation for developing more inclusive, gender-responsive harm reduction policies and practices across the region.

The report is available in Serbian following this link>>>.

Youth and gambling

The Regional Conference “Youth and Gambling – National and regional perspectives” was held on 20 November 2024 in Skopje. The conference is organized by HOPS – Healthy Options Project Skopje, in partnership with Labyrinth from Kosovo and Prevent from Serbia within the framework of the regional project “Youth and Gambling” with the support of the Western Balkans Fund. The main goal of the project is to advance national policies and practices aimed at preventing gambling among youth under the age of 25.

The conference was attended by representatives of the ministries, institutions and civil society organizations responsible for this issue from North Macedonia, Serbia and Kosovo.

The results of the research “Youth and their Betting Habits in North Macedonia, Serbia and Kosovo” were presented at the conference. This research, which included 214 young people under the age of 25 in Macedonia, showed that 17.8% of respondents declared themselves addicted to gambling. Eighty-four percent of respondents said that they know someone younger than 25 who is addicted to playing games of chance. Of these, as many as 39.3% said they knew more than 10 people under the age of 25 who were addicted to gambling, and only 11.2% said they did not know a person under the age of 25 who was addicted to gambling.

Regarding the information provided to gambling players by the organizers of these games about the danger of becoming addicted, only 19.2% of respondents said that in the facilities where they play gambling there is information that one can become addicted to these games. Also, only 7.5% of respondents said that in the facilities where they play gambling there is information where one can seek help in case of addiction to these games.

Similar data are noted in Serbia and Kosovo.

The conference adopted regional and recommendations for each of the participating countries/territories.

Reports from the project are abailable in Macedonian, Serbian and Albanian.

Evaluation of the National Strategy for Drugs

Our member organisation HOPS – Options for a healthy life Skopje published the “Evaluation of the National Strategy for Drugs 2021-2025 and the Action Plan for Drugs 2021-2023 of the Republic of North Macedonia“.

The purpose of this evaluation was:

  • To measure the relevance of the goals of the Strategy for Drugs 2021-2025 and the Action Plan for Drugs 2021-2023 in relation to the situation with the drug problem in North Macedonia;
  • To measure the impact of the Drug Strategy 2021 – 2025 and the Drug Action Plan 2021 – 2023 in relation to the national response to the drug problem;
  • To determine the degree of implementation of the measures from the Action Plan for Drugs 2021-2023,
  • To detect the obstacles and barriers that appeared in the implementation of the action plans, but also to determine the support systems or resources in the implementation of the measures from the action plans;
  • To define directions and priorities that should be observed in creating the new Action Plan for drugs 2024-2025.

This evaluation was carried out and published within the framework of the project “Improvement of the National Drug Policy in the Republic of North Macedonia” coordinated by HOPS and supported by the regional project SMART Balkans – Civil Society for a Connected Western Balkans implemented by the Center for the Promotion of Civil society (Centar za promeno členni društva – CPCD), by the Center for Research and Policy Making (CIKP) and by the Institute for Democracy and Mediation (IDM), financially supported by the Ministry of Foreign Affairs of the Kingdom of Norway.

The Evaluation is available (in Macedonian) following this link>>>.

 

We demand the criminalization of online sexual harassment

The Network for Protection against Discrimination held a promotion of the policy document with a focus on rape and sexual harassment “How to effective protection in cases of sexual violence?”. The event was organized within the framework of marking the international campaign 16 days of activism against gender-based violence. Its purpose was to promote proposed solutions for the effective protection of victims of sexual violence in accordance with the already accepted obligations from the Istanbul Convention and to request the immediate adoption of amendments to the.

In the period of waiting for the amendments to the Criminal Code, which passed the first reading in the Assembly of the Republic of North Macedonia, after more than a year, one can witness inadequate implementation of the procedures for criminal prosecution of the perpetrators of sexual violence, prolonging of the procedures, inappropriate qualification of the acts and unjustified termination of prosecutions that punish victims instead of perpetrators.

Dragana Drndarevska from the Network for Protection against Discrimination and legal adviser in the Coalition Margini (DPNSEE member organisation) opened the event by pointing out that “the delay in adopting the amendments to the Criminal Code means that we still do not have a consensus between the political parties on the issue of protecting victims from gender-based and sexual violence “.

This event, as well as the prepared document for public policies, are activities within the project “Network for Protection against Discrimination: Promotion of Policies and Practices for Protection against Discrimination and Promotion of Equality”, which is financially supported by the Open Society Foundation – Macedonia.

The document is available following this link>>>.

 

Updated national drug situation overviews for North Macedonia and Serbia

From the EMCDDA webpage

The EU drugs agency (EMCDDA) published updated national drug situation overviews for North Macedonia and Serbia. These reports are the result of an 8-month online capacity-building exercise, organised with the support of the Austrian Reitox national focal point Gesundheit Österreich (Austrian National Public Health Institute).

The report on the Republic of North Macedonia provides a top-level overview of the drug situation in the country, covering drug supply, use and public health problems as well as drug policy and responses. It brings together the most recent data available by the end of May 2022.

The report on Serbia provides a top-level overview of the drug phenomenon in this country, covering drug supply, use and public health problems as well as drug policy and health and social responses. The report contributes to a better understanding of the drug situation in Europe and is targeted at national and international audiences, including government, civil society, researchers and funders.

The reports are available following these links – North MacedoniaSerbia.

 

The EU Western Balkans and Turkey Civil Society Forum 2022

The EU TACSO 3 project organised the EU Western Balkans and Turkey Civil Society Forum on 8 – 9 June 2022, in Skopje, North Macedonia. Senior officials from the European Commission, EU Delegations, governments and diverse representatives from civil society organisations attended the Forum, a total of 120 participants in person, and an additional 100 online. In light of recent dramatic developments in Europe, namely the COVID-19 pandemic and Russia’s war of aggression against Ukraine, the Forum provided an opportunity to better understand challenges and opportunities in the region, and the role of civil society in helping to respond.

The main objective of the Forum was to launch the revised EU Guidelines for Support to Civil Society in the Enlargement region (2021-2027). These Guidelines set out objectives for EU assistance to civil society, provide a tool for governments to improve cooperation with civil society, and help to measure progress towards meeting conditions for EU integration. Over the period 2014 to 2020, through the Civil Society Facility and Media Programme, the EU has provided around EUR 330 million in support for civil society, whereas the amount planned for the period 2021-2023 is EUR 218 million. The Guidelines will assist the EU to assess the impact of this support.

Commenting on the discussion which followed, DPNSEE Executive Director Milutin Milošević emphasized two important point: that the most of the support goes to a selected number of large civil society organisations and that support whould also be shared to small and medium-size organisations, and that besides indicator proposed for implementation of the Guidelines, the impact achieved should be the main source of measuring their success.

The forum also discussed the current state of affairs for CSOs in the region, as well as joint actions on the part of the EU, public authorities and civil society that would address the identified challenges. The four priority areas: the Green Agenda; Rule of law, good governance and anti-corruption; Human rights, anti-discrimination and poverty reduction; and CSO cooperation with the media were discussed in separate breakout sessions.

 

Supporting women who use drugs victims of gender-based violence

Our member organisation HOPS – Options for Healthy Life Skopje, in the period from the 13th to the 15th April 2022, realized three one-day trainings in three different cities: Strumica, Bitola and Skopje on the topic: “Treatment of women victims of gender-based violence who use drugs“, intended for professionals working with victims of gender-based violence.

On April 13, the training was held in the Therapeutic Community “Pokrov” – Strumica, which was attended by a total of 13 representatives: 8 representatives from the Centers for Social Work in Sveti Nikole, Strumica, Kočani and Štip and 5 representatives from other non-governmental organizations: Educational – humanitarian organization “EHO” – Štip, Youth Club of the Red Cross Strumica, Women’s Action Radoviš, Sky Plus Strumica and the therapeutic community Pokrov Strumica.

On April 14, the training was held at the hotel “Millennium Palace” Bitola, which was attended by a total of 12 representatives, of which: 3 representatives from the Centers for Social Work in Prilep and Resen, 2 representatives from PHI Health Center Bitola and PHI General Hospital Prilep, 1 representative from PHI Psychomedica Bitola and 6 representatives from non-governmental organizations: Center for Human Rights AMOS – Bitola, Via Vita – Bitola, Station 5 – Prilep and Association for Social Action, Prevention Education EASP Prilep.

On April 15, the training was held in the hotel “City Park” Skopje, which was attended by a total of 13 representatives, as follows: 4 representatives from the Centers for Social Work in Skopje, Veles and Tetovo, 2 representatives from PHI General Hospital Kumanovo and 7 representatives by non-governmental organizations: Macedonian Young Lawyers Association, Association for Health Education and Research HERA Skopje, Civic Initiative for Women Sveti Nikole, National Network against Violence against Women and Domestic Violence and the Red Cross of the Republic of Northern Macedonia.

The trainings were led by prof. Dr. Liljana Ignjatova from the Medical Faculty Skopje, Department of Psychiatry and Hajdi Sterjova Simonovic – Executive Director of the Association HOPS. The purpose of these trainings is to sensitize the professionals who work with women who use drugs in cases when they are victims of gender-based violence.

The participants evaluated all three trainings extremely positively, both from the aspect of high quality and level of theoretical and practical knowledge of the trainers, as well as from the aspect of interaction established between the participants and the trainers and the possibility for exchange of information and experiences.

The experience from the held trainings showed us that there is a huge interest in this topic and the need to conduct such trainings in the future.

The trainings are organized by the Association HOPS, supported by the Eurasian Harm Reduction Association (EHRA), as part of the project “Access to comprehensive care for women who use drugs in cases of violence” funded by COVID-19 Response Mechanism (C19RM) of the Global Fund to Fight AIDS, Tuberculosis and Malaria as part of the regional project “Sustainability of services for key populations in Eastern Europe and Central Asia region” (#SoS_project) implemented by the Alliance for Public Health.

HOPS closed their harm reduction center

From the HOPS webpage and the Radio MOF news

The Association HOPS – Options for Healthy Life Skopje announced that yesterday, on World Health Day, and in just a day before today’s International Roma Day, after 15 years of existence, they had to close the daily harm reduction center Šuto Orizari – a Skopje suburban municipality with a Muslim Romani people majority.

They point out that the reason for closing the day center is the reduction of funds for HIV prevention programs from the national budget.

“This center opened in 2007, with funds from the Global Fund, and from then until yesterday was the only place where Roma who use drugs and their families had easy access to all services that provide HIV prevention, but also harm reduction from drug use. In this center our customers received basic (and often unique) medical care, received information and support for their social and legal problems, could wash their clothes, warm themselves in winter, eat when they are hungry, drink coffee or tea in a friendly, non-stigmatizing and non-discriminatory atmosphere,” said HOPS.

During the coronavirus pandemic, HOPS managed harm reduction centre was one only contact with the system drug users and their families in Šuto Orizari had.

“When they were isolated and had no therapy, when they had health problems, when they survived all forms of violence, including gender-based violence, when they were given criminal warrants for violating curfew because they went out to find food, goods or therapy – they only received help from our team,” states HOPS. In addition, they say that access to health services, which has already been difficult for these people, has multiplied during the pandemic.

The association says that although in 2017 with the transition of funding from the Global Fund of the Government they merged two other centers, just to keep the center in Šuto Orizari. Now, as they say, they have been put in a position to close the busiest and most visited center in Kisela Voda or to close the “much needed” center in Šuto Orizari.

“From today, the lives of people who use drugs in Šuto Orizari and the surrounding area will not be the same, but HOPS will do its best within its financial means to continue its activities for prevention of HIV and other infectious diseases.” said HOPS.

At the same time, they announced that three times a week, their field team consisting of a social worker and a field worker will visit the users in their homes, dwellings or temporary residences, and that twice a week a medical person will visit them with their vehicle.

 

Drug users guide on contacting by the police

Our member organisation Coalition “Margini” from North Macedonia published a very useful guide for guide for drug users in situations when they are contacted by police.

What if I get caught with drugs? Can the police call me for an interview and do I have to show up? How can I exercise my right to a lawyer? – These are just some of the questions that can be answered in this handbook, primarily intended for drug users when contacting the police.

The guide, in Macedonian, is available following this link>>>.

 

Protest for drastic budget cut for HIV prevention program

Three civil society organisations from North Macedonia, our member HOPS (Healthy Options Project Skopje), Stronger together (Association for Support of People Living with HIV) and HERA (Health Education and Research Association) protested today because of the budget cuts for HIV prevention program.

Here are some extracts from their statement:

By cutting the budget for HIV prevention by 40%, the Ministry of Health puts the health of at least 10,000 affected citizens at stack. In a scandalous and flat way, without any expert discussion, the Ministry of Health cut as much as 40% of the funds provided for HIV prevention in the Program for protection of the population from HIV-infection for 2022, which the Government adopted only a month ago. Thus, the state puts at risk the closure of the established capacities for control of HIV infection in the country and endangers the health of at least 10,000 citizens from the marginalized communities.

Instead of the envisaged 46.5 million denars in the Program for protection of the population from HIV infection intended for HIV prevention services implemented by about 14 associations in 12 cities in the country, the Ministry of Health yesterday announced a public call for associations with an amount reduced by even 19 million denars. The decision was not consulted by the National Commission on HIV.

 Thanks to these programs, the Republic of Northern Macedonia in the past 15 years has maintained full control of the HIV epidemic in populations of people injecting drugs and sex workers and one of the lowest infection rates in the region. In the past 3 months, the entire national response to this epidemic is literally at the expense of 14 civil society organizations, which continue to work without any compensation for their work.

 Discontinuation of services for vulnerable groups will mean an increase in new infections and an increase in deaths due to HIV, and on the other hand increased pressure on key health institutions, such as the Infectious Diseases Clinic and addiction treatment centers. Even a small increase in the HIV epidemic will lead to a multiplier increase in the cost of treatment and health care. Hence, the decision to arbitrarily cut is simply a bad public health policy.

 In Macedonia, young people are still dying from HIV, and according to the methodology of the European Center for Disease Control, it is estimated that even one third (34%) of the total number of people living with HIV in the country are not aware that they have the virus. With this, Macedonia lags significantly behind the world average, which for 2020 was only 16%. The global goal by 2025 is to reduce the percentage of people who are not aware that they have HIV to less than 5%, which will lead to a drastic decline in the transmission of infection and will allow to put an end to the HIV epidemic by 2030.

 Given the alarming situation and citing the country’s commitments under the United Nations Policy Declaration on HIV and AIDS of June 2021, including the obligation to end the HIV epidemic, as well as the commitments made by the Government to ensure the continuity of HIV programs, we require:

  • Urgently correct the announced public call for associations that will implement the activities for HIV prevention in accordance with the amounts provided in the Program for protection of the population from HIV-infection for 2022, adopted by the Government in February this year;
  • The Government and the Parliament should finally guarantee the continuity of the already established system for protection against HIV. This means: The Assembly to adopt without delay and in full the amendments to the Law on Health Care which are in parliamentary procedure, and refer to the mechanism of involvement of associations in the implementation of health programs, and the Ministry of Health to develop bylaws that will fulfilled the obligations from the conclusions adopted by the Government in September 2017 and the obligations from the previous and current Government Strategy for cooperation and development of the civil society sector;
  • Due to the long delay in announcing the public call, the Government and the Ministry of Health through intervention support to reimburse the costs of the associations for the first quarter of 2022 incurred due to their dedicated maintenance of the national response to HIV.