Budget Advocacy Guide

From the HRI webpage

How money is collected and distributed through public budgets influences the lives of millions of people in every country in the world. Those decisions might ensure food and shelter for many, or deprive others from essential healthcare services. Budget advocacy, which is a tool to influence those decisions, can make an impact on millions of lives.

Essential healthcare includes harm reduction services for people who use drugs. These services – such as needle and syringe programmes (NSP), opioid agonist therapy (OAT), drug consumption rooms (DCRs), overdose prevention with naloxone, and drug checking – protect against HIV, TB and hepatitis C (HCV) and save lives. Not only are they effective, they are cost-effective and cost-saving, and they have a positive impact on individual and community health.

Yet, the provision of these services is critically low. Only 1% of people who inject drugs live in countries with high coverage of both NSP and OAT. The harm reduction response to stimulant use remains underdeveloped, drug checking services are scarce and DCRs only formally operate in 12 countries, all of them located in the Global North. In 2020, only 15 countries permitted peers of people who use drugs to distribute naloxone.

Meanwhile, HIV infections among people who inject drugs continue to rise, accounting for almost half of new infections in Eastern Europe and Central Asia, and the Middle East and North Africa in 2019. Prevalence of HCV among people who inject drugs is 50-times higher than among the general population, overdose deaths have skyrocketed in many countries around the world and stimulants use in Asia and sub Saharan Africa is increasing.  Despite the fact that many low- and middle-income countries (LMICs) include harm reduction in their national policy documents, few of them actually invest domestic resources in these life-saving services, even where the need is great. This is often due to the criminalisation of people who use drugs, stigma and discrimination. At the last count, only US$188 million was invested in harm reduction in LMICs – just over one tenth of the US$1.5 billion UNAIDS estimates is required for an effective HIV response among people who inject drugs. The majority of this funding comes from international donors.

The Harm Reduction International published a new resource for harm reduction advocates. This guide provides civil society and communities representatives with an introduction to budget advocacy and some tools and strategies to support advocacy for sustainable harm reduction funding.

To read the Guide, follow this link>>>.

 

A publication about our project

In the last decade, an increasing number of donors are withdrawing their support for healthcare. This has been especially true for middle-income countries, where the growth of domestic resources was one of the triggers for donor funding reduction. The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) has termed this process as “transition”.

In 2018 the Open Society Foundations, through the Eurasian Harm Reduction Association (EHRA), initiated the project Budget Advocacy and Monitoring in countries of South East Europe. It provided funding to three transitioning countries in the Balkan region – Bosnia and Herzegovina, Montenegro, and Serbia – through the sub-regional network organization, Drug Policy Network South East Europe (DPNSEE), to support budget advocacy for harm reduction services. The local coordinating organisations are Margina, Juventas and Prevent.

The case study looks at the implementation of this project as one of the demonstrations of the SBF mechanism, with the objectives to:

  • Document the pilot in 3 Balkan countries and to analyse the strengths and weaknesses of this approach and to develop suggestions for improvement; and,
  • Document the results, successes, and challenges of the budget advocacy projects supported through this approach.

Our project serves as a pilot for the Sustainability Bridge Funding (SBF), an idea that has been discussed among donors and civil society organizations as a way of mitigating the negative effects of transition and in providing support for key essential services for communities and key populations. As a safety net mechanism, it should respond to gaps in funding and mitigate adverse effects of donor funding withdrawal.

Please find the document following this link>>>

An interesting new publication

The Association for Emancipation, Solidarity and Equality of Women – ESE published a very useful publication “Budget monitoring and advocacy manual for harm reduction”. The manual provides detailed information for each of the stages in the process of budget monitoring and advocacy. Those who want to analyse and monitor budgets and advocate for more funds for harm reduction, can learn a lot from it.

ESE worked in partnerships with DPNSEE member organisation HOPS for several years to achieve an excellent success with ensuring that harm reduction services are supported from the national budget. The two organisations organised the training for organisations in Bosnia Herzegovina, Montenegro and Serbia in December 2017. DPNSEE is currently planning a project in the three countries on budget advocacy and monitoring.

The manual is available from the ESE webpage following this link>>>

Regional training on budget advocacy and monitoring

Why is it necessary to advocate for adequate funding of drug use harm reduction programs?
Which changes do we expect to achieve by advocating for adequate funding?

The regional training on budget advocacy and monitoring, held from 21 to 23 December 2017 in the hotel Romantik in Veles, Macedonia, tried to provide answers to these and many other questions. The training was organized by HOPS – Healthy Options, Skopje, with the support of the Foundation Open Society – Macedonia and conducted by experts from The Association for Emancipation, Solidarity and Equality of Women – ESE from Skopje.

The participants of the training gained knowledge that will help in their efforts to obtain financial resources from the state authorities, and covered topics that point out the problems that the organizations are experiencing due to insufficient funds, as well as the activities that the organizations can take to solve them. In addition, the process of budget analysis as a basis for advocating for creation of an effective budget as well as the procedures that are important in the process of monitoring and analysis of budgets were analysed.

11 participants come from six harm reduction civil society organisations from the region who are faced with a lack of funding for their programs after the departure of the Global Fund: Prevent and DPNEE from Serbia, Margina and PROI from Bosnia and Herzegovina, and Juventas and Cazas from Montenegro (all members of DPNSEE), and two came from local organisation Becej Youth Association from Bečej, Serbia and Group for Public Policies from Belgrade.