The civil society monitoring report 2021

From the Correlation webpage

The Correlation – European Harm Reduction Network (C-EHRN) published their 2021 civil society monitoring report on 11 May 2022.

The main aim and purpose of C-EHRN monitoring activities is to improve knowledge and information and complement existing data and monitoring efforts in Europe in specific areas of harm reduction based on the perspective of civil society organisations (CSOs). The data collected helps to assess the implementation of certain drug and health policies at the national and local levels and supports our advocacy efforts at the European and EU Member State levels.

The adapted 2021 civil society monitoring incorporated the experiences from the past years. During evaluation meetings with expert groups, it was decided to keep most of the questionnaires in 2020 intact for 2021. That was done both because the questionnaire of 2020 has worked reasonably well and also to allow for comparisons between 2021 and the previous year.

C-EHRN kept our focus on the situation at the city level which allowed for more accurate and precise information. Consequently, the information provided in this report sometimes represents the situation in a particular city or region. Although this information is not representative of a country, it reflects the fact that the situation in a country is diverse and most often dependent upon the approach at the city level. Small modifications were made for clarity in the sections on essential harm reduction services, overdose prevention, Hepatitis C, civil society involvement and new drug trends. More modifications were made in the COVID-19 section to cover a new phase of the pandemic.

In addition to the survey, and on an experimental basis, the expert groups decided to try new forms of data collection. In 2 countries – Finland and the UK – online Focus Group Discussions (FGDs) will be performed to gather data on new drug trends. That was decided due to the low response rate in the online survey and also due to feedback from our Focal Points that this remains the most difficult section of the survey to complete.

More than one hundred organisations and individuals from 34 European countries have contributed to this Monitoring Report. Thanks go to our Focal Points and associated experts at the national and local levels who have filled in the online questionnaire and provided all information and data on time. Without their dedication and commitment, we would not have been able to produce this report.

To read the report, please 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

Harm Reduction Key Principles in Homeless Services

Correlation presented the Key Principles of Harm Reduction – an innovative set of tools developed through the HR4Homelessness Project. The innovation lies in their capacity to translate existing experiences and knowledge on Harm Reduction into actionable guidance through an open, iterative and evolving framework.

HR4Homelessness – Integrating Harm Reduction Services in Homelessness Service is an Erasmus+ Project aiming at improving Harm Reduction services for people experiencing homelessness in Europe. The project involves organisations working in the field of homelessness and drug use FEANTSA (Belgium), C-EHRN / De Regenboog Groep (NL), Rights Reporter Foundation (HU), Simon Communities of Ireland (Ireland), Health Team City of Copenhagen (DK), Norte Vida (PT) and SMES-B (Belgium).

The Key Principles aim to contribute to improving and transforming the services that shape access to and the quality of care that people experiencing homelessness who use drugs or alcohol receive. Further, they aim to support these services to respond to conditions that negatively influence marginalised and underserved communities’ social and health outcomes.

The document offers service providers to implement activities that respect the rights of people experiencing homelessness who use drugs or alcohol, which are informed by evidence. It also intends to advance social justice transformations, respect service user decisions and priorities, and contribute to eliminating stigma and discrimination of the communities they work for and with.

To access the document, please follow this link>>>.

 

Harm Reduction Lab on Funding and Sustainability challenges for HR services in Europe

Correlation offers Harm Reduction Labs as a space for collectively imagine what harm reduction can be. The Harm Reduction Labs will offer the possibility to explore collective solutions, as well to imagine what harm reduction can be. In addition to exploring current themes and approached within the harm reduction movement, each Lab will offer space to come together and to identify common and urgent future questions that address broader topics of social justice, bodily autonomy and care, among others. You can find more about this interesting serial following this link>>>.

During the Lab on Funding and Sustainability challenges for HR services in Europe that is offered for Thursday 14 October, Correlation want to address different problem areas and challenges, covering:

  • The lack of funding in different European regions (CEE, SEE and SE)
  • Lack of funding for community-led programmes
  • Lack of funding for advocacy and civil society engagement
  • Causes and impact of the funding challenge
  • Opportunities and needs for advocacy and action
  • Good Practice Examples
  • Innovative approaches

Our Executive Director will be part of the panel, as well as a few other colleagues from the region. The link to the Lab is https://us02web.zoom.us/j/85989331796.

 

Monitoring Report 2020 Executive Summary

A civil society-led monitoring of harm reduction can play an essential role in improving service delivery and contribute to the generation of crucial data for advocacy purposes. Civil society organisations (CSO’s) work directly for, and with, people who use drugs (PWUD) and have a good understanding of their daily needs. Their inside knowledge is critical in developing adequate drug policies and practices.

To complement the work of other monitoring agencies, and to bring insight into how the implementation of harm reduction occurs, Correlation -European Harm Reduction Network (C-EHRN) has published a report on Civil Society Monitoring of Harm Reduction in Europe since 2019. It gathers data on the experiences of harm reduction service providers and service users at ground level, building on a network of national Focal Points (FPs) in Europe. For the 2020 monitoring, C-EHRN includes 35 FPs in 34 countries, as shown in the map below. To get insight at the implementation level, and to profit from the experiences and expertise of FPs, the 2020 monitoring focuses mostly on cities rather than countries.

To read the Executive Summary, available also in several languages, follow this link>>>.

 

ARAS alarms on harm reduction crisis in Romania

ARAS – The Romanian Anti-AIDS Association sent an appeal to stakeholders in Romania to join forces in finding solution for the harm reduction crisis which hardly hits this country. Here is the translation of the appeal.

 

ARAS – The Romanian Anti-AIDS Association invites on this occasion to 21 days of action “Support, Don’t Punish”, in which we will contact the decision-makers at central and local level, the executive and legislative bodies, and we will initiate a public dialogue around this topic.

 We are inviting all stakeholders to take a position on the issues raised, to open the communication for solutions and to find support in initiating concrete actions to remedy this situation, which has become chronic.

 For a better explanation of the context and history of the chronic lack of national / local funding in risk prevention and harm reduction services, we send you, below, some relevant information and we are at your disposal for any further questions.

 In the last 20+ years, ARAS has provided harm reduction services for intravenous drug users in Bucharest, based on the recommendations of UNAIDS and WHO and within the limits of available funds. During all this time, we drew the attention of public institutions that, in order for these services to be constant and efficient, they must be supported by policies in the field and funding from the state budget, both at the central and local level.

 At present, ARAS implements harm reduction activities (testing and counselling, referral and support, social assistance), but does not have the funds necessary to provide prevention materials for injecting drug users (sterile syringes) and to cover the real need in the field. The pandemic caused by Covid-19 also strongly affected our area of intervention, especially access to testing, which decreased dramatically, as well as access to treatment and medical services. At the Titan Community Centre (opened by ARAS in 2008) we can no longer carry out harm reduction services, such as offering 1 ml syringes (which cannot be found in pharmacies either), because of lack of funds.

 Therefore, injecting drug users in Bucharest reuse syringes or share them with other users. The result is that HIV infection and viral hepatitis are already spreading, affecting again this category of vulnerable people and hence the community as a whole.

 We remind that the national authorities (Ministry of Health, National Anti-Drug Agency) have always relied on the support of external funding contracted directly by non-governmental organizations and which practically ceased to exist in 2020; still, the responsibility for the health of the citizens is with these institutions, and not with the NGOs.

 We are also stressing that many of the programs supported by public funds are exclusively for people who have an identity card, and some only for those who have health insurance. When public institutions have funded services implemented by NGOs, the contracts contained some limitations that make them completely inappropriate for working with vulnerable people. Moreover, local authorities do not include or budget in their strategies (clearly and explicitly) activities to prevent HIV and HBV and HCV infections, tuberculosis, dedicated to vulnerable people.

 Another important drawback: the National AIDS Plan drafted within a project funded by the Global Fund for AIDS, Tuberculosis and Malaria has been waiting to be approved by the responsible institutions since 2017 (!!).

 ARAS has drawn attention numerous times on these crises and on the optimization of access to services, and we even went to court (together with three intravenous drug users) against the Directorate of Public Health, which is supposed to give syringes for harm reduction. We lost our case and at present we are preparing our file for the European Court of Human Rights (ECHR).

 Romania is part of the global network International Drug Policy Consortium that promotes the objective and open debate on drug policies, and Bucharest is a signatory of the Fast Track cities initiative. The National Anti-Drug Strategy includes the principles of the European Union Strategy on Drugs. Still, the reality proves the contrary.

 On this occasion, we would like to open a dialogue on the need to update these national policies and strategies in order to align with international initiatives in this field, to secure the necessary budget for harm reduction and for prevention in general, and thus to promote the “support, don’t punish” approaches, both in the official documents and in the field.

 

Civil Society Perspective on Harm Reduction in Europe

Europe represents one of the regions of the world with the greatest number of harm reduction services.

There is no other region in the world where more than 90% of the countries have at least one NSP or OST site, and more than 90% of the countries reference harm reduction in their national drug policies. Nevertheless, stigma and discrimination against people who use drugs continue to exist, and much is needed in terms of supporting and securing access to services and human rights to all different groups of people who use drugs.

More such data can be exclusively found in the second civil society-led monitoring of harm reduction report The Civil Society-led Monitoring of Harm Reduction in Europe 2020 published by the Correlation – European Harm Reduction Network. With more than one hundred contributors and Focal Points from 34 European countries involved, the report aims to make a necessary and useful contribution to the development of drug policy in the region.

Compared to 2019’s report, the information provided in 2020, brings to the forefront of the situation in particular cities or regions showing the experiences of harm reduction providers on the ground. It also bring direct perspectives of people who use drugs. This significant approach will hopefully provide an understanding of the successes and challenges of drug policy and harm reduction implementation.

To read the Report, please follow this link>>>.

Global State of Harm Reduction 2020

Harm Reduction International, an NGO dedicated to reducing the negative health, social and legal impacts of drug use and drug policy, publishes report that provides an independent analysis of harm reduction in the world. Now in it’s the seventh edition, the Global State of Harm Reduction 2020 is the most comprehensive global mapping of harm reduction responses to drug use, HIV and viral hepatitis.

The 2020 report includes:

  • A chapter which looks at the impact of the COVID-19 pandemic and related lockdowns on the provision of harm reduction services worldwide
  • Additional thematic chapters on hepatitis C and tuberculosis
  • Examples of progress in harm reduction from across the world
  • Examples of legal and policy changes which impact harm reduction service provision
  • Foreword by Dr Tlaleng Mofokeng, United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
  • Data on the number of people who inject drugs and the number of people in prison for drug use globally

The report can be downloaded and read in full or by chapter following this link>>>.

DPNSEE have prepared a table with information on Epidemiology of HIV and viral hepatitis, and harm reduction response in South East Europe.

The document is available in PDF format following this link>>>.