Tag: Bulgaria

An interesting discussion about the harm reduction crisis in SEE

Posted on by Milutin

On the 20th of April 2022, the three Networks organized a Webinar on Harm reduction crisis in South East Europe. During this event, national decision-makers from the region, researchers, harm reduction service providers, community and civil society representatives came together to present and discuss the key findings of the research activities.

Correlation – European Harm Reduction Network, the Eurasian Harm Reduction Association and the Drug Policy Network of South-Eastern Europe have been working together to advocate for addressing the harm reduction crisis in South East Europe since 2019.

Countries of South-Eastern Europe and the Balkans, including Albania, Bosnia and Herzegovina, Bulgaria, Kosovo, Montenegro, Romania and Serbia, are experiencing relatively high levels of HIV and HVC infection among people who inject drugs. However, due to limited domestic resources and the gradual withdrawal of the Global Fund from the region, the governments of these countries are facing a lack of resources to continue the long-term funding of comprehensive harm reduction programmes.

During this webinar, C-EHRN, EHRA and DPNSE present the research Crisis in harm reduction funding: The impact of transition from Global Fund to Government support and opportunities to achieve sustainable harm reduction services for people who inject drugs in Albania, Bosnia and Herzegovina, Bulgaria, Kosovo*, Montenegro, Romania and Serbia they have conducted in the area and discuss its key findings, which include among others:

  • Common challenges of scaling-up harm reduction programmes in the countries of South-Eastern Europe.
  • Consequences of the limited funding of the harm reduction services for public health and national healthcare systems.
  • Opportunities available for the governments of the region to act and invest funds and efforts in effective and proven models of harm reduction in their respective countries.

Building upon this research, this publication, and also policy briefing and factsheet, highlight opportunities available for the governments of the region to act and invest funds and efforts in effective and proven models of harm reduction in their respective countries.

Recording of the Webinar is available below.

Harm reduction crisis in South East Europe

Posted on by Milutin

Correlation – European Harm Reduction Network, the Eurasian Harm Reduction Association and the Drug Policy Network of South-Eastern Europe have been working together to advocate for addressing the harm reduction crisis in South East Europe since 2019.

The three networks are hosting an online discussion about the funding challenges and opportunities for governments to the crisis of harm reduction services in SEE countries and the Balkans.

The webinar will take place on the 20th of April from 13:00h to 14:30h CET.

Countries of South-Eastern Europe and the Balkans, including Albania, Bosnia and Herzegovina, Bulgaria, Kosovo, Montenegro, Romania and Serbia, are experiencing relatively high levels of HIV and HVC infection among people who inject drugs. However, due to limited domestic resources and the gradual withdrawal of the Global Fund from the region, the governments of these countries are facing a lack of resources to continue the long-term funding of comprehensive harm reduction programmes.

During this webinar, C-EHRN, EHRA and DPNSE will present the research they have conducted in the area as well as opportunities available for the governments of the region to act and invest funds and efforts in effective and proven models of harm reduction in their respective countries.

The webinar is open to national decision-makers from the SEE region, the Balkans and other European countries, researchers, harm reduction activists, civil society representatives, harm reduction service providers and the media.

The event will be held in English. To register and to receive the complete webinar agenda, please fill in the form https://us02web.zoom.us/webinar/register/WN_-4Dh14MmQumJc3mPJxZgOw

Please contact for more details: Roberto Perez Gayo rpgayo@correlation-net.org

 

Crisis in harm reduction funding

Posted on by Milutin

Correlation – European Harm Reduction Network, the Eurasian Harm Reduction Association and the Drug Policy Network of South-Eastern Europe have been working together to advocate for addressing the harm reduction crisis in South East Europe since 2019.

Countries of South-Eastern Europe and the Balkans, including Albania, Bosnia and Herzegovina, Bulgaria, Kosovo, Montenegro, Romania and Serbia, are experiencing relatively high levels of HIV and HVC infection among people who inject drugs, including those who inject psychoactive substances. However, due to limited domestic resources and the gradual withdrawal of the Global Fund from the region, the governments of these countries are facing a lack of resources to continue the long-term funding of comprehensive harm reduction programmes. In addition to these and other barriers, in some countries, there is no legal basis for NGOs to provide services to marginalized populations, including people who use drugs.

Graham Shaw produced the research he have conducted with our and support of our colleagues from the region.

The following report, policy briefing and factsheet present and analyze current common challenges of scaling-up harm reduction programmes in the countries of South-Eastern Europe and the consequences of the limited funding of the harm reduction services for public health and national healthcare systems. Building upon this research, these publications highlight opportunities available for the governments of the region to act and invest funds and efforts in effective and proven models of harm reduction in their respective countries.

Report

 

 

 

 

 

 

Policy brief

 

 

 

 

 

 

Factsheet

Taking stock of budget advocacy efforts in EECA

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The Eurasian Harm Reduction Association (EHRA) presented the mapping report „Taking stock of budget advocacy efforts in Eastern Europe, South-Eastern Europe and Central Asiа“ summarising budget advocacy efforts, funding and impact during the period 2018-2021 in CEECA countries. The focus of the assessment is on the role of civil society in budget advocacy, while acknowledging that government leaders, UN and technical partners play important roles as well. The assessment describes key budget advocacy initiatives and HIV donor support for them.

The report zooms in the four result areas of advocacy: civil society capacity to advocate; influencing HIV funding levels from national and local public sources; increasing efficiencies in spending; and contracting and funding for NGOs to deliver services. Without offering a comprehensive review, one of the final sections of the report shines light on efforts to influence budgets beyond HIV including in the fields of TB and health systems.

Regional overview is based on eight country case studies (including three fro Sout East Europe) exploring national experiences with budget advocacy, emerging challenges, and best practices. Kyrgyzstan, Moldova and Ukraine (lower middle-income countries), Georgia, Kazakhstan and Montenegro (upper middle income countries receiving donor support), and Bulgaria and North Macedonia (post-Global Fund countries) were selected for analysis.

To keep the mapping manageable and focused, this assessment has not attempted to assess neither the impact of the ongoing COVID-19 pandemic on HIV budget advocacy and fiscal space for health financing nor potential savings from reducing criminalization of population behaviours.

Analytical report «Taking stock of budget advocacy efforts in Eastern Europe, South-Eastern Europe and Central Asiа» has been prepared by EHRA in partnership with Open Society Foundations, The Global Fund to Fight AIDS, Tuberculosis and Malaria Sustainability, Transition and Efficiency Strategic Initiative and EECA regional team in cooperation with ECOM – Eurasian Coalition on Health, Rights, Gender and Sexual Diversity and Eurasian Women’s Network on AIDS (EWNA) as partners in the Eurasian Regional Consortium withing project “Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services” supported by the Robert Carr Fund for civil society networks. Information was provided by country, regional and international partners. We are grateful to all our partners, members of Regional Advisory Group on Sustainability, interviewees and reviewers for their time and effort in work on this report.

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

 

Expert update on drug-related infectious diseases

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The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) gathered the Drug-related infectious diseases (DRID) expert network to share the latest developments on drug-related infectious diseases in Europe and to identify steps needed to improve the production, availability and use of public health-oriented information at the European level.

The DRID network brings together national experts nominated by national focal points of the EU Member States, Norway and Turkey, as well as institutional partners (ECDC, WHO, Correlation). The meeting also welcomed experts from the Western Balkans (IPA7 project), the European Neighbourhood Policy countries (EU4MD project), Georgia, the United Kingdom, Australia and the United States. Participating experts come from ministries of health, public health institutes, drugs agencies, health services, universities, research institutes and civil society.

The group held an online meeting on 26-27 October 2021, focusing on:

  • The direct impact of COVID-19 on people who use drugs and the COVID‑19 vaccination campaign among this group;
  • A review of recent HIV trends and outbreaks, as well as infectious endocarditis linked to injecting drug use with a focus on risk factors and control measures in place;
  • Country experiences in the elimination of viral hepatitis as a public health threat among people who inject drugs (PWID) and related EMCDDA projects, with a focus on harm reduction and the continuum of care.

The report section on Outbreaks includes some interesting information from South East Europe.

In 2011, an HIV outbreak among PWID was detected in Athens, Greece (Paraskevis et al., 2011). After a combination of prevention and ‘seek-test-treat’ interventions were implemented (including scaled-up NSP, testing, linkage to AOT and antiretroviral treatment (ART), HIV incidence declined (Sypsa et al., 2017) from 7.8/100 person-years in 2012 to 1.7/100 person-years in 2013. However, preliminary data from the latest round of the ARISTOTLE study, conducted in 2018-20 (Roussos et al., 2021) among 681 PWID who were included in previous rounds, suggest that HIV prevalence increased from 14.2 % (2012-13) to 22 % (2018-20). While incidence estimates never returned to their 2011-12 levels, they ranged from 1.52 to 2.04/100 person-years, indicating ongoing transmission. The prevalence of homelessness (25.6 %) and cocaine injecting (28.1 %) had increased over the period. Predictors of seroconversion included lower education, larger network size and daily drug use. The authors concluded that the current level of prevention and treatment services was below levels that would be required to bring transmission down to pre-outbreak levels. They also noted that the COVID‑19 pandemic has severely impacted HIV prevention services for PWID, which could increase the risk of HIV transmission in this population. The study team conducted a similar study in Thessaloniki, the second-largest city in the country, where 1 101 PWID were recruited during 2019-20. They found high HIV incidence among the study population, suggesting that an outbreak was occurring at a time when COVID‑19 controls measures were in place. The authors highlighted that immediate interventions were required to control transmission.

Following the DRID meeting, national experts from three additional EU countries have reported signals of increased HIV transmission among people who use drugs. In Sofia, Bulgaria, reports indicate that the pandemic seems to have worsened a situation that was already deteriorating with respect to harm reduction funding. According to data from the laboratory at the State Psychiatric Hospital for Treatment of Drug Addiction and Alcoholism in Sofia, reported by the national expert, the positivity rate for HIV infection among PWID in the capital of Bulgaria was significantly higher in 2019-20 (12.8-14.5 %) than in the previous years (when positivity rates were between 3-6 %). A parallel increase in HBV positivity (HBsAg) was also noted from 2019 (5.9 %) to 2020 (7.6 %). This comes after the Global Fund ended its financial support to harm reduction services in 2017. It consequently led to a disruption in needle and syringe programmes, and a reduction by more than half in the number of PWID being tested annually. The National Centre of Public Health and Analysis is organising a meeting with stakeholders and decision-makers to initiate legal changes in order to ensure sustainable financial support for harm reduction services.

The national expert from Slovenia reported that, by November 2021, four new HIV diagnoses among PWID were reported to the National Institute of Public Health among a total number of 28 reported new HIV diagnoses during 2021. This raised concerns that HIV infections might have started to spread more during the COVID‑19 pandemic among PWID in the country. Since 1986, when HIV reporting became mandatory in Slovenia, a total of 29 HIV infections among PWID have been reported, and such a high number of cases (four) were reported only once before, in 1996. The importance of reaching a good coverage of harm reduction services for PWID was re-emphasised.

To read full report from this meeting and get the information from expert update, follow this link>>>.

 

Let’s talk about drugs

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Taken from the IDPC webpage

In June-July 2020 Rights Reporter Foundation, YODA, Re Generation, Young Wave and Center for Humane Policy conducted an assessment of drug education in Bulgaria, Hungary, Lithuania, Poland, and Serbia based on the methodology developed by EHRA within the LEt’s Talk about drugs – new MEthods of communication with youth – LET ME project funded by the European Commission (ERASMUS+ program). The goal of the study was to assess existing drug education and its effectiveness, look at what information on drugs is available and how it is perceived by young people, examine the methods and tools used by different actors to talk about drugs with youth, and gather best practices.

The stakeholders interviewed—young people and representatives of harm reduction, prevention, and youth organizations—all agree that existing drug education is ineffective and fails to address the needs and patterns of drug use among young people.

The report will be used to design and create the manual, but also for the advocacy activities related to the promotion of prevention and harm reduction services in the youth work.

The reports are available in English and all national languages following this link>>>.

 

Black days for harm reduction in Bulgaria

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June 2020 saw alarming situation in Bulgaria: all harm reduction services with public funding stopped for the second time in three years. The oldest, biggest, and most experienced harm reduction organisation, Initiative for Health Foundation, DPNSEE member organisation, shut down too after a few years of struggling to ensure sustainability. As a consequence, no needle and syringe programs remained open in the country. The only working harm reduction facility for people who use drugs is in Sofia – the Pink House, the drop-in centre run by the Centre for Humane Policy, also DPNSEE member organisation, which covers its costs mainly by individual donations.

More about these black days for harm reduction in Bulgaria is available in the article prepared by Yuliya Georgieva and published by the Drug Reporter you can access following this link>>>.

 

DPNSEE have already warned about the alarming situation last autumn. We have launched an advocacy campaign with our colleagues from Correlation – European Harm Reduction Network and Eurasian Harm reduction Network about the situation with sustainability of harm reduction services in Albania, Bosnia and Herzegovina, Bulgaria and Romania. The three Networks expressed our deep concern about the situation and willingness to give contribution to finding solution and ensuring both quick response to the urgent needs and building a sustainable solution. We sent an appeal to the Global Fund to review their eligibility model of supporting middle income countries and a project proposal to the Radian call of the Elton John AIDS Fund. Unfortunately, our efforts were not successful. And the result is here.

Even more, it is expected that the only harm reduction service in Bosnia Herzegovina provided by the organisation Margina will also close as from September.

 

Global Fund 2020 Eligibility List

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The Global Fund have just published their 2020 Eligibility List and the updated Projected Transitions List. Some of the changes are related to South East European countries.

Since Bulgaria and Romania are not on the OECD DAC list of ODA recipients, they may be eligible for an allocation for HIV for non-governmental or civil society organizations under Paragraph 9b of the Eligibility Policy only if they have demonstrated barriers to providing funding for interventions for key populations, as supported by the country’s epidemiology. As 2020 is an allocation year, the Secretariat has conducted an assessment and has determined that Bulgaria and Romania don’t meet the requirements under Paragraph 9b of the Eligibility Policy. Therefore, they have been determined not to be eligible for an HIV allocation for the 2020-2022 allocation period.

Kosovo* was classified as an Upper-Middle Income country in the 2019 Eligibility List based on the latest three-year average of GNI per capita data (Atlas method). As a result, the HIV and TB components may be eligible for an allocation of Transition Funding in the 2020-2022 allocation period.

North Macedonia‘s HIV component is now classified as eligible in the 2020 Eligibility List after meeting eligibility criteria for two consecutive eligibility determinations, noting that eligibility does not guarantee an allocation.

Montenegro and Serbia remain eligible for HIV and Romania for Tuberculosis.

 

The 2020 Eligibility List is now available on the Global Fund’s website>>>

The projected transitions list is available following this link>>>

 

Our initiative presented at the Global Fund Board meeting

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The Developing Country NGO Delegation at the Global Fund published a statement with the 42nd Board Meeting highlights, including 8 important matters they pushed for at the meeting, with ways that civil society can move them forward. The statement is available following this link>>>

The initiative of the three regional networks: Correlation – European Harm Reduction Network, Eurasian Harm reduction Network and Drug Policy Network South East Europe to respond to the critical situation concerning the sustainability of harm reduction services in Albania, Bosnia and Herzegovina, Bulgaria and Romania was among the issues that the Delegation raised at the Global Fund Board meeting. It is mentioned in the point 4 of the statement:

Addressing civil society concerns: The Developing Country NGO brought to the Board and bilateral meetings concerns raised by civil society organisations including those by nearly 100 NGOs about the ending of multi-country grants in West Africa; cases of the failed transitions and interruption of services for key populations, including the lack of funding for harm reduction programs in Albania, Bosnia and Herzegovina , Romania and Bulgaria; and exploring next steps to ensure access to health services, treatment and care in Venezuela.

We hope that the Global Fund will make some concrete steps in helping us find a quick response to the urgent needs and building a sustainable solution in these countries.

 

Emergency situation concerning the sustainability of harm reduction services in Albania, Bosnia and Herzegovina, Bulgaria and Romania

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The three regional networks: Correlation – European Harm Reduction Network, Eurasian Harm reduction Network and Drug Policy Network South East Europe were informed by our members organisations about the situation with sustainability of  harm reduction services in Bosnia Herzegovina which is characterised by lack of strategy, policy and funding caused by the delay in establishing national Government for more than a year after the elections, withdrawal of international donors and misunderstandings and low level of cooperation between the governmental institutions and civil society, but also inside the civil society sector providing harm reduction services. The national Strategy for prevention and control of HIV and AIDS has ended (2016) and the Transition plan, developed by the Country Coordinating Mechanism during implementation of The Global Fund funded programme has not been implemented. As a result, the harm reduction services are closed in Sarajevo, Mostar, Bihać and Banja Luka and exist only in Zenica and Tuzla relaying on voluntary work of unpaid Staff and with all supplies already on minimum.

The three Networks expressed our deep concern about the situation and willingness to give contribution to finding solution and ensuring both quick response to the urgent needs and building a sustainable solution. We are ready to provide non-partisan support in identification and advocacy for the best possible approaches to urgently start provision of services to the populations of people who use drugs, sex workers and prisoners and other affected populations and to properly advocate for the sustainability of governmental funding.

The urgent action we are taking is to explore opportunities for emergency bridging funding to ensure survival of existing harm reduction services in the country. The situation is alarming and requires direct action and mobilisation of the international community. The three network have limited resources, so we are now contacting some of our partners and donors, explaining the situation and calling for immediate and urgent support. This could include short-term funding and technical support to ensure a minimum of harm reduction services. So far, we have a promise from the Open Society Foundations for a small grant which would cover basic need for the month of November.

We plan to develop and implement a comprehensive process to achieve sustainable long-term solutions. The activities for long-term solutions target local governments and policy-makers with the aim to ensure sustainable funding for harm reduction services. We already offered our expertise and support in this process, In addition, we would like to engage and involve other relevant stakeholders, such as donors and funders.

As the first concrete long term action we decide to send an appeal to the Global Fund to review their eligibility model of supporting middle income countries, besides Bosnia Herzegovina also Albania, Bulgaria and Romania.

In advance of the upcoming 42nd meeting of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) as well as the Global Fund Regional Meeting for Eastern Europe and Central Asia to take place in Istanbul on 26-27 November, 2019, we – civil society and community organisations and networks working in the Eastern Europe and Central Asia (EECA) region for the benefit of key affected populations, including people who use drugs – would like to express our profound concern as to the current lack of sustainable harm reduction services in the South East European countries of Albania, Bosnia and Herzegovina, Bulgaria and Romania, respectively. Taking into consideration the successful results of the recent Sixth Replenishment Conference, we would like to invite the Global Fund to safeguard a part of the catalytic investment funds available for the 2020-2022, including multi-country grants, matching funds and strategic initiatives, in order to sustain life-saving services for people who inject drugs and other vulnerable groups and to incentivise domestic investment in harm reduction in each of these post-transition countries.

41 civil society organisations from Eastern Europe and Central Asia supported the letter. We hope that the Global Fund shall understand the situation and support our proposal.

The letter to the Global Fund is available following this link>>>