Civil society statement on ensuring continuity of essential life-saving treatments for Ukrainians in European countries

The Eurasian Harm Reduction Association (EHRA) initiated the Civil society statement on ensuring continuity of essential life-saving treatments for Ukrainians in European countries. The statement signed by 29 civil society organizations and networks, including DPNSEE.

The undersigned organisations, working with and representing the interests of communities of people living with and affected by HIV, tuberculosis, viral hepatitis and drug dependence in Central and Eastern European countries, call for the following urgent measures:

  • Organise medical data exchange with a particular focus on HIV and opioid dependence to ensure continuity of services between Ukraine and EU member states and among the EU member states;
  • As good clinical practice, ensure that previous diagnosis are accepted, people are prescribed the same regimens and take-home dosages of OAT as in Ukraine as much as possible;
  • To promote and follow the recommendations being set in the Standardized Protocol for clinical management and Medical Data-Sharing for people living with HIV among refugees from Ukraine[1] and to collaborate with WHO on the development of a similar protocol for the refugees from the Ukraine who are OAT patients
  • Support EU member states with emergency procurement and exchange of medications, as needed, to ensure methadone (tables), buprenorphine, dolutegravir-based antiretroviral therapy, pediatric antiretroviral medications and similar Ukraine-prevalent treatments are made available for continuation in all border and other neighbouring countries;
  • Establish a pool of translation support for clinicians and Ukrainian refugees and utilise automated translation services to overcome barriers in refugee services and clinical settings;
  • Support outreach and contacts by HIV and drug treatment experts and NGOs in refugee centres, including the sensitisation of staff and to urgently identify people in need of uninterrupted daily treatment;
  • Introduce simplified initiation of essential treatment to all Ukrainians with or without refugee status based on their passport data; and,
  • Ensure that monitoring systems and hotlines are available to clinicians and other service providers to immediately solve the health issues affecting Ukrainian refugees.

The Statement was sent to high level EU officials and authorities of France (currently holding EU Presidency), Czech Republic, Poland, Slovakia, Hungary and Romania.

To read full Statement, follow this link>>>.

 

An interesting discussion about the harm reduction crisis in SEE

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

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

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

Montenegro: Benchmarking sustainability of the HIV response among Key Populations in the context of transition from Global Fund support to domestic funding

The Eurasian Harm Reduction Association (EHRA) published document “Benchmarking sustainability of the HIV response among Key Populations in the context of transition from Global Fund support to domestic funding” within the framework of the regional project ‘Sustainability of Services for Key Populations in Eastern Europe and Central Asia’. This publication was prepared by Mr. Vladan Golubović, EHRA Consultant

The aim of this analysis is to assess the fulfillment of the commitments given by the Government of Montenegro aimed to ensure the sustainability of the HIV response among KPs in the context of the country’s transition from Global Fund support to national funding. The results of the assessment are expected to be used to assist CSO’s, key affected communities and partners to remain more informed and engaged in the monitoring of the transition process from donor to domestic funding and to thereby advocate for the implementation of activities that will lead to the sustainability of the national HIV response.

This assessment was conducted using the Methodological Guide and Transition Monitoring Tool (TMT) developed by EHRA. A number of national commitments contributing to ensuring sustainability of the HIV response were identified and prioritised and subsequently analysed based on available data, as well as information from key informants. The assessment was conducted and led by two national reviewers with the support of local HIV experts and representatives of affected communities from organisations involved in advocacy and service delivery for KAPs and PLHIV (the national reference group).

The analysis is available following this link>>>.

 

Taking stock of budget advocacy efforts in EECA

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>>>.

 

Fulfilment of HIV-related sustainability commitments given by the Government of Serbia

The Eurasian Harm Reduction Association (EHRA) have published the report Republic of Serbia: Benchmarking Sustainability of the HIV Response in the Context of Transition from donor to domestic funding.

The aim of this analysis is to assess the fulfilment of HIV-related sustainability commitments given by the Government of Serbia in the context of the country’s transition from Global Fund support to national funding and uses the EHRA methodology, Benchmarking Sustainability of the HIV Response in the Context of Transition from Donor Funding which seeks to evaluate the achievement of the commitments by the Serbian Government to ensure the sustainability of HIV programmes. As a part of this study, the government’s commitments have been identified and prioritised and data collected to inform the extent to which those commitments have been fulfilled as planned.

Overall, the Government of the Republic of Serbia has shown moderate progress in fulfilling its transition and sustainability-related commitments. During the assessment, the commitments made by different health system domains have been reviewed, as well as the status of commitments made by different HIV programmatic areas. Out of 6 health system domains, significant progress was achieved in service delivery and human resources; average progress in drugs, supplies and equipment, and in data and information; while moderate progress has been made in health financing; and fairly low progress in governance.

With respect to programmatic areas, significant progress has been made concerning human rights, while substantial progress has been made in the fulfilment of the commitments related to prevention, treatment and support.

This publication was prepared by Maja Stošić, MD, PhD, EHRA Consultant.

The publication was published within the framework of the regional project called “Sustainability of Services for Key Populations in Eastern Europe and Central Asia” which is carried out by the Alliance for Public Health, in a consortium with the 100% Life (All-Ukrainian Network of PLWH), the Central Asian HIV’ Association and the Eurasian Key Populations Health Network with the aid from the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

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

EHRA will hold a Webinar to present the assessment framework, methodology and results following by the discussion with webinar participants on Thursday 21 September at 14:00 Belgrade time. If interested, please register at  https://us02web.zoom.us/meeting/register/tZAtd-ivrzkqH9xWxSzIjWS3Gbh8n361iNqI.

 

COVID Technical Assistance Directory

Known as C19RM, the COVID-19 Response Mechanism supports countries to mitigate the impact of COVID-19 on programs to fight HIV, TB and malaria, and initiates urgent improvements in health and community systems.

All countries, including regional/multi-country recipients, that are currently receiving funding from the Global Fund, are eligible to receive C19RM funding.

More about the COVID-19 Response Mechanism is available following this link>>>.

The Eurasian Harm Reduction Association (EHRA), being the host of the EECA Regional Platform for Communication and Coordination supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), has collected information concerning the availability of HIV, TB and COVID-related technical support (TS) for non-governmental (NGOs) an community-based (CBOs) organizations in the region of Eastern Europe and Central Asia (EECA).

Information presented in this document was provided, and confirmed, by the organizations included and collected between February and April 2021.

To read this technical assistance directory, follow this link>>>.

 

Denis elected to the EHRA Steering Committee

During May 24 – June 6, 2021 Eurasian Harm Reduction Association (EHRA) conducted online General and Regional members’ meetings in Russia and South-Eastern Europe to elect new Steering Committee members.

In total the South East Europe region has 26 official EHRA members, who were eligible to vote. From those 26 members – 10 participated in the meeting and cast the vote for their candidate, which means, that quorum was met, because 38,46% of members from the region participated in the elections of the SC member.

DPNSEE Vice-President Denis Dedajić, proposed by his organisation Margina from Bosnia Herzegovina, is elected for 3 years term as EHRA Steering Committee member to represent South-Eastern Europe region.

We congratulate Denis and hope this will improve the cooperation we have with EHRA.

Letter of support for the decriminalization in Lithuania

Eurasian Harm Reduction Association asks you to help us urge the Members of the Parliament – the Seimas of Lithuania – to support the drug policy changes (decriminalization project) in Lithuania and sign the attached letter.

Until January 2017, possession of psychoactive substances in small amounts in Lithuania was considered an administrative offence, regulated by the Code of Administrative Offences and as a criminal offence, regulated by the Criminal Code. There were so-called legal collisions (conflict of laws).

In January 2017, procurement and possession of a small amount of an illicit drug with no intent to distribute became an offence punishable by community service, restraint of liberty, a fine or arrest. The same offence involving more than a defined small amount, became a criminal offence punishable by up to two years in prison.

Over the past 3 years alarming indicators have shown that drug policy in Lithuania is focused only on criminalization of people who use drugs and possess small amounts of drugs without intent to distribute them. For example, possession of illicit substance in small quantities without intent to supply accounted for 77% of all drug related offences committed in 2019. 63 % of the offenders were under the age of 29. Between 2014 and 2019 there was an increase by 53,9% of drug laws related offences without intent to distribute. Each year, about 750 people are serving a custodial sentence in prisons, which costs Lithuania around 10,5 million Euro per year. In 2019, 21,7% of all inmates were officially diagnosed with mental and behavioral disorders due to drug use. While in prisons there are no harm reduction services, and limited access to OST.

At the moment, the Seimas of Lithuania is considering decriminalization of small amounts of drugs without intent to distribute them. Civil society from Lithuania is looking for an international community support.

If your organisation wishes to support the letter, please fill in this form before 9th May (by midnight, Vilnius time). The letter will be sent to the Members of the Seimas before the final hearings.

Feel free to share this email with other organisations which may be interested in supporting the initiative!

In case you have any questions, do not hesitate to contact eliza@harmreductioneurasia.org.