Category: General News

Community Manifesto for HIV Long-Acting Injectable PrEP in Europe

Posted on by Milutin

More than 40 global and regional civil society organisations endorsed a community manifesto calling for the introduction of long-acting injectable PrEP in Europe.

Oral PrEP has had a significant impact on population HIV incidence, especially in gay and bisexual men and other men who have sex with men (GBMSM), in high-income settings.

Oral HIV PrEP is highly efficacious when taken as prescribed, and is largely acceptable as an HIV prevention technology in those who use it. Oral PrEP has been a significant new addition to combination HIV prevention approaches, along with condoms, PEP, and treatment-as-prevention.

However, significant barriers to accessing oral PrEP remain and these barriers result in significant health inequalities. Further, taking a (daily) oral medication is not an acceptable or feasible method of HIV prevention for many who could benefit from PrEP. The development of multi-methods of PrEP will increase adherence as well as PrEP acceptability and choice, and thereby improve uptake of PrEP regionally and globally.

New formulations of PrEP have been studied, with a number of highly effective methods becoming approved for use. These include vaginal-ring formulations, and long-acting injectable PrEP. ViiV’s long-acting formulation of cabotegravir PrEP (LA-CAB) has been approved in, Australia, Botswana, Malawi, South Africa, US, and Zimbabwe and has been submitted for regulatory approval to the EMA and in over 10 countries thus far. Recent voluntary licensing agreements have been agreed, enabling generic LA-CAB to be manufactured and prescribed in over 90 countries, subject to pending regulatory approvals. However, due to a dearth of manufacturing facilities, drug stock is currently limited until new plants become fully functional in 2025.

This document results from a consensus meeting held in Paris in March 2023 between regional and international HIV prevention organisations and activists including: AIDES; AIDS Action Europe; AVAC; Coalition PLUS; EATG; Fundacja Edukacji Spolecznej; GSSG – Germany’s Charitable Foundation Sexuality and Health; and PrEPster at The Love Tank CIC.

To find out more, access the Manifesto, follow this link>>>.

 

Mental Health and Substance Use

Posted on by Milutin

On the 10th of October, on World Mental Health Day, the Civil Society Forum on Drugs (CSFD) sent its position paper People Who Use Drugs and Mental Health to the EU Spanish Presidency, the Horizontal Working Party on Drugs, and the European Commission.

The paper addresses the complexity of the relationship between mental health conditions and substance use. Mental health conditions are influenced by social determinants such as inequality, discrimination, violence, and homelessness, factors which disproportionately affect people who use drugs. Furthermore, specific subpopulations, including women, young people, ethnic minorities, and indigenous groups, face unique challenges in accessing appropriate services for their mental health and substance use needs. These disparities highlight the pressing need for a comprehensive and inclusive approach to addressing these issues from a person-centred, holistic perspective. The paper also calls for specific terminology reform, promoting the use of the term ‘comorbidity’ to describe the existence of both mental health conditions and substance use.

The paper concludes with a number of recommendations related to this issue, urging for a comprehensive review of current shortcomings in accessibility, inclusivity and sustainability of care. The CSFD welcomes the introduction of this topic within the political agenda, as these issues have historically been disregarded and warrant urgent consideration. The CSFD’s position paper serves as a call to action, urging policymakers, healthcare providers, and society at large to recognize and address the critical issues surrounding mental health and substance use. By adopting these recommendations and working together, we can strive for a more inclusive and compassionate approach to mental health care for all, particularly those who use drugs and face complex challenges.

Read CSFD’s position paper here>>>.

Marija Mijović, member of the DPNSEE Board, who contributed to the document, translated it into Montenegrin (also easy to read by those speaking Bosnian, Croatian and Serbian). You can access the document Osobe koje koriste droge i mentalno zdravlje following this link>>>.

Human rights challenges in addressing and countering the world drug problem

Posted on by Milutin

Source: International Drug Policy Consortium (IDPC)

In a landmark report Human rights challenges in addressing and countering all aspects of the world drug problem released this month, the Office of the United Nations High Commissioner for Human Rights (OHCHR) denounced the failure of punitive drug policies and the global ‘WarOnDrugs’, and called for a new approach based on health and human rights, including through the responsible regulation of drugs.

The report outlines human rights challenges in addressing and countering key aspects of the world drug problem. It also offers an overview of recent positive developments to shift towards more human rights-centred drug policies, and provides recommendations on the way forward in view of the upcoming midterm review of the 2019 Ministerial Declaration and to contribute to the implementation of the 2030 Agenda for Sustainable Development.

To implement the recommendations laid down by the High Commissioner, the civil society, on the IDPC initiative, calls on the international community to reform and rebalance the global drug control regime, and national drug laws and policies. A collective statement, signed by over 100 civil society organisations, including DPNSEE, calls on the international community to act on the UN human rights chief’s groundbreaking call for systemic drug policy reform.

Ann Fordham, Executive Director at International Drug Policy Consortium, analyses in this article key takeaways and significance of the report, noting how its call for transformative change includes an unprecedented recommendation on the responsible regulation of currently-illegal drug markets.

IDPC’s advocacy note highlights the major gains from the 2023 OHCHR report and provides recommendations to Member States and UN entities for its effective implementation.

 

A webinar on the World Drug Report 2023 for civil society

Posted on by Milutin

From the UNODC website

UNDOC’s World Drug Report is a crucial annual publication that provides member states and civil society with up-to-date and comprehensive information on global drug trends, patterns of drug use, and emerging substances. The knowledge equips civil society organizations worldwide with a solid understanding of the current landscape, empowering them to effectively educate their communities, advocate for evidence-based policies, and implement effective interventions, working towards a healthier and safer society.

The UNODC Civil Society Unit (CSU) and the Vienna NGO Committee on Drugs (VNGOC) jointly organized a webinar for civil society on 20 July 2023, presenting the key findings of this year’s World Drug Report. The webinar provided a spotlight on the latest global and regional trends. Simultaneous interpretation in English, Russian, Spanish and French allowed participants to discuss the latest data with the authors of the 2023 World Drug Report.

Ms. Chloe Carpentier, Chief of UNODC Drugs Research Section, and Mr. Thomas Pietschmann, Research Officer, provided an overview of the latest developments in the World Drug Report 2023, published on 26 June. They also introduced the new interactive online segment which enables easy access to the available data and allows users to extract graphs and maps as required.

This year’s report emphasizes, among other, that a growing number of people worldwide suffer from drug use disorders, 296 million in 2021. This is often exacerbated by the increasing proliferation of cheap synthetic drugs and illicit drug economies that flourish in situation of conflicts. Partnerships are key to reduce the adverse health and social consequences of drug abuse and civil society has an open role to play, often having better access to key populations on the ground.

During the Webinar, two civil society experts also shared their insights and experiences on some of the issues highlighted in the World Drug Report. Professor John Toumbourou from the Dalgarno Institute in Australia discussed prevention and treatment of drug use disorders. He highlighted the success of abstinence-based programs and policies in reducing school-age alcohol, tobacco, and other drug use. Australia’s approach focused on prevention may serve as a positive example in addressing drug-related issues among youth. Focusing on the Amazon region in South America, Rebeca Marques Rocha, representing Youth RISE, stressed the importance of investing in health and education, and offering employment opportunities for young people and indigenous groups in order to more effectively tackle organized crime, including drug trafficking, in the region.

With more than 350 attendees from over 80 countries engaging in a lively questions and answers section, the webinar reflected the enormous interest in up-to-date, reliable data on drug related matters among civil society organizations.

 

Further Information:

World Drug Report 2023

NGO Marketplace

Recording of the Webinar

 

Harm reduction services for people who use drugs recreationally

Posted on by Milutin

The Alliance for Public Health organises webinar “Introducing harm reduction services for people who use drugs recreationally in EECA and the Balkans”, with the support from ReGeneration and DPNSEE.

Recreational drug use is on the rise, but at the same time young people who engage in it are not properly targeted by harm reduction services and don’t receive the necessary support, information and commodities they need to prevent them from turning to problematic use and all the relevant consequences.

On this webinar international experience on planning and implementing harm reduction programs specifically for this target population will be shared. Also, the draft guide that on this topic will be presented.

The Agenda includes topics:

  • Introducing the key principles and the justification behind the need to advocate for, develop and offer HR services for people who use recreationally.
  • Promoting Safety, Health, and Well-being: The need for Systematic implementation of Harm Reduction Strategies in Southeastern European Festivals.
  • Ukrainian experience on harm reduction services for people who use drugs recreationally.
  • #SafeParty – good practice example of multi-sectoral approach in nightlife harm reduction and recreation settings.
  • Q&A and Discussion.

This webinar will be useful for program managers, advocates, policy makers and communities from across the region to help them inform their decisions and actions.

The webinar will be held via Zoom platform on Tuesday 25 July, from 11:00 to 12:30 CET. Translations will be available in English, Russian, BHCS and Albanian.

Please register to participate following this link>>>.

 

The path that ends AIDS

Posted on by Milutin

From the UNAIDS press release

A new report released today by UNAIDS shows that there is a clear path that ends AIDS. This path will also help prepare for and tackle future pandemics and advance progress towards achieving the Sustainable Development Goals. The report, ‘The Path that Ends AIDS’, contains data and case studies which highlight that ending AIDS is a political and financial choice, and that the countries and leaders who are already following the path are achieving extraordinary results.

The report highlights that HIV responses succeed when they are anchored in strong political leadership. This means following the data, science, and evidence; tackling the inequalities holding back progress; enabling communities and civil society organizations in their vital role in the response; and ensuring sufficient and sustainable funding.

Progress has been strongest in the countries and regions that have the most financial investments, such as in eastern and southern Africa where new HIV infections have been reduced by 57% since 2010.

Thanks to support for and investment in ending AIDS among children, 82% of pregnant and breastfeeding women living with HIV globally were accessing antiretroviral treatment in 2022, up from 46% in 2010. This has led to a 58% reduction in new HIV infections among children from 2010 to 2022, the lowest number since the 1980’s.

Progress in the HIV response has been strengthened by ensuring that legal and policy frameworks do not undermine human rights, but enable and protect them. Several countries removed harmful laws in 2022 and 2023, including five (Antigua and Barbuda, the Cook Islands, Barbados, Saint Kitts and Nevis, and Singapore) that have decriminalized same-sex sexual relations.

The number of people on antiretroviral treatment worldwide rose almost fourfold, from 7.7 million in 2010 to 29.8 million in 2022.

However, the report also sets out that ending AIDS will not come automatically. AIDS claimed a life every minute in 2022. Around 9.2 million people still miss out on treatment, including 660 000 children living with HIV.

Women and girls are still disproportionately affected, particularly in sub-Saharan Africa. Globally, 4,000 young women and girls became infected with HIV every week in 2022. Only 42% of districts with HIV incidence over 0.3% in sub-Saharan Africa are currently covered with dedicated HIV prevention programmes for adolescent girls and young women.

Almost one quarter (23%) of new HIV infections were in Asia and the Pacific where new infections are rising alarmingly in some countries. Steep increases in new infections are continuing in eastern Europe and central Asia (a rise of 49% since 2010) and in the Middle East and North Africa (a rise of 61% since 2010). These trends are due primarily to a lack of HIV prevention services for marginalized and key populations and the barriers posed by punitive laws and social discrimination.

Funding for HIV also declined in 2022 from both international and domestic sources, falling back to the same level as in 2013. Funding amounted to US$ 20.8 billion in 2022, far short of the US$ 29.3 billion needed by 2025.

There is an opportunity now to end AIDS by increasing political will by investing in a sustainable response to HIV through financing what matters most: evidence-based HIV prevention and treatment, health systems integration, non- discriminatory laws, gender equality, and empowered community networks.

In 2022, an estimated:

  • 39,0 million people globally were living with HIV
  • 29,8 million people were accessing antiretroviral therapy
  • 1,3 million people became newly infected with HIV
  • 630.000 people died from AIDS-related illnesses

To access the report, follow this link>>>.

 

Global day FOR action

Posted on by Milutin

Statement from our Board member Marios Atzemis

This text is not an “anniversary” piece, nor is it a kind of report. Anniversary approaches do not suit us, nor does the cynicism that accompanies them in some cases, and an account would be too long for this occasion.

Every such day, officially called “against drugs” but those of us who are active in peer-led harm reduction call it “Global Day for Action” and for us it is a daily routine, we are given the opportunity to talk about what is of concern to us and to acknowledge the positive developments and future challenges in the field – not as self-appointed saviors, but as people who have experienced our country’s drug policies and therapeutic (or in some cases anti-therapeutic) approaches under our own skin. We also now have the appropriate peer led education, field experience and an ongoing communication, collaboration and osmosis with major civil society organizations abroad on HIV, harm reduction and drug policies.

Yet, in many cases, we are considered the most unqualified to express an opinion on the thorny field of “addictions”, and there are many times when we are tried to be displaced by people without clinical experience and lived experience or any kind of theoretical background, who think they can speak and decide for us without us. All of the above are manifestations of the multiple and multidimensional stigma that we harbour, and which at the first opportunity are indirectly emphasized by the ‘professional saviours’ to remind us that they know better than we do, and that the field of advocacy and politics is not our domain.

As far as the situation in Greece is concerned, significant breakthroughs have been made in recent years with the development of a multitude of services that have solved problems that we used to face, such as housing and having a safe place to use. We have also reached a high level of cooperation with the people who staff these serorganisation sanisations, which is to the benefit of the affected community.

However, we must point out that when we talk about the field, we are talking about something that is constantly changing, as the disparate communities of people who make up the field are always one or more steps ahead of policies and agencies. Thus, we recognize as phenomena that we are called upon to address: The proliferation of shisha (crystal methamphetamine of poor quality) and the consequent changes it has brought about in the psyche of its problematic users; synthetic opioids (which are being decimating in North America); the chemsex phenomenon; the complete absence of LGBTQ+ inclusion in services aimed at users; and the gap between medicalised harm reduction and that on a peer basis. It also shows in some cases how strong the legacy of punitive degrading ‘tough love’ practices is in some cases, and the lack of up-to-date and evidence-based practices that are not based on outdated and ineffective approaches. We should also note the presence of so many private self-proclaimed rehabilitation centres of dubious efficacy and scientific training that are not audited and that trade on the human suffering and desperation of users and their closest support context.

In conclusion, we recognize the need for our country’s alignment with the European Drug Strategy and the corresponding Action Plan, which propose the active and meaningful participation of civil society and the affected community in the design and implementation of services and policies that directly affect their lives. We will continue our work, as it were, meeting people where they are but without leaving them there…

Marios Atzemis, Harm Reduction Officer of Positive Voice – Greek Association of PLHIV

 

Quality Assurance for Drug Use Disorder Treatment Systems

Posted on by Milutin

The Prevention, Treatment and Rehabilitation Section (PRTS) of the United Nations Office on Drugs and Crime (UNODC), with the support fom the Ministry of Health of Serbia, organised a three-day Training on Quality Assurance for Drug Use Disorder Treatment Systems. The aim of this training was to help stakeholders to review national drug use disorder treatment systems, identify gaps and develop plans that will enable the improvement and further development of the national treatment system.

25 participants came from specialised hospitals for treating addictions of pcychiatric hospitals from around the country, institute for public health, institute for mental health, centres for social work and ministry of health. DPNSEE Executive Director Milutin Milošević and representative from Izlazak represented the civil society organisations.

The program of the training was developed following the International standards for the treatment of drug use disorders, prepared by UNODC and the World Health Organisation. A translated version of the Standards was presented and shared during the training.

Trainers Victor Anthony Capoccia (USA) and Thomas Clausen (Norway) were supported by UNODC staff Christina Gamboa-Riano and Žana Glavendekić, Project Officer, UNODC South-Eastern Europe.

Regulating cannabis in EU: current policies and laws

Posted on by Milutin

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published document Cannabis laws in Europe: questions and answers for policymaking which provides an overview of current policies and laws at the EU level and in individual Member States. The speed and scale of cannabis policy change and the potential impact of these policies on public health and safety, has prompted the EMCDDA to publish this report

This publication answers some of the more frequently asked questions raised in discussions about cannabis legislation. While the primary focus is on the use of cannabis for recreational purposes, relevant legislation for other uses, including medical and commercial cannabis-derived products such as cosmetics, wellness products and foods, is included in order to provide the necessary context for various policy initiatives.

While the primary focus of this report is on the use of cannabis for recreational purposes, relevant legislation for other uses is included in order to provide the necessary context for various policy initiatives. Written for a broad audience, the report aims to give brief answers to some of the more frequently asked questions raised in discussions about cannabis legislation. These have been grouped into five parts:

  • Why is defining cannabis important?
  • What are countries’ international obligations to control cannabis?
  • How do EU countries respond to illegal use and supply of cannabis?
  • Is there a trend towards cannabis regulation — and if so why?
  • What laws cover medical and commercial cannabis-derived products?

This document is available at our Resource Centre following this link>>>, or at the EMCDDA website>>>.

 

HIV epidemic among injecting drug users in Greece

Posted on by Milutin

After the early HIV epidemics during the 1980s through the 1990s in Western Europe and North America, combined prevention and care interventions – such as needle and syringe (NSP) and opioid agonist treatment (OAT) programs, HIV testing and linkage to antiretroviral treatment (ART) – were introduced and scaled-up. This approach allowed to control the epidemics among PWID. Disruptions in service delivery due to economic crisis, complacency towards maintaining low HIV incidence in this population or other health threats, such as pandemics, may have a detrimental effect on what has been achieved so far in many countries. The largest of these recent epidemics occurred in Athens, Greece, where HIV prevalence in this population increased from less than 1% in 2010 to 16.5% in 2013.

During 2019–2021, and in the midst of the COVID-19 pandemic, a community-based intervention offering testing and linkage to care for HCV and HIV infections to PWID was implemented in Thessaloniki, the second largest city in Greece (ALEXANDROS program). During the intervention implemented in 2019–2021 in Thessaloniki, an increasing number of HIV cases was documented.

The article on the HIV epidemic among injecting drug users in Thessaloniki (second largest city of Greece) has just been published in the International Journal of Drug Policy. The aim of this analysis is to describe this new HIV outbreak among PWID (prevalence, incidence, risk factors for HIV seroconversion) that was documented through this intervention during the COVID-19 pandemic.

The research paper “A new outbreak of HIV infection among people who inject drugs during the COVID-19 pandemic in Greece” was published by the International Journal of Drug Policy, Volume 117. It is available following this link>>>.