Global HCV elimination efforts through point-of-care testing

The International Network on Health and Hepatitis in Substance Users (INHSU), in collaboration with the Coalition for Global Hepatitis Elimination (CGHE), FIND, The Kirby Institute, UNSW, and Clinton Health Access Initiative (CHAI), announced the release of a comprehensive report stemming from the INHSU Hepatitis C Point-of-Care Testing Forum, held during the Global Hepatitis Summit in Paris in April 2023.

Despite advances in treatment, an estimated 57 million people are living with chronic hepatitis C infection globally, with 290,000 people dying from HCV-related cirrhosis and liver cancer each year. Scaling up testing and utilising innovative testing methods are integral if the World Health Organization’s (WHO) 2030 elimination targets are to be met.

The Barriers and solutions to increasing access to point-of-care HCV testing report, developed in response to the urgent need for effective strategies to combat the global burden of HCV, explores the underutilised promise of point-of-care testing in simplifying diagnosis, improving access to treatment, and ultimately reducing the prevalence of HCV.

The report underscores the urgent need for action to address challenges in these five key areas and provides practical solutions for implementation alongside real-world examples of successful Point-of-Care programs from Catalonia, Iran, Denmark and more.  It is a valuable resource for policymakers, healthcare professionals, and organisations committed to advancing global HCV elimination goals.

 

Drug consumption rooms in Europe

From the Correlation website

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and Correlation – European Harm Reduction Network (C-EHRN) have published the latest overview on the situation of drug consumption rooms (DCRs) in Europe. The purpose of the report is to encourage evidence-based discussions around DCRs and the implementation of varied DCR models in Europe.

The report is based on a mixed-methods approach, including a review of documents published by EMCDDA and C-EHRN up to 2020, together with a structured literature search for new peer-reviewed (MEDLINE) and grey publications, including relevant health and public-order outcomes of drug consumption rooms and covering the most recent years (2020 and 2021).

DCRs are a fundamental health and social response that fosters the well-being of people who use drugs by providing hygienic and safer spaces where to use substances in the presence of trained social workers and/or healthcare professionals. DCRs are usually located in areas where there is an open drug scene and where injecting in public places is common. The primary target group for DCR services are people who engage in drug use patterns that can result in dangerous health outcomes.

According to the report, in 2022, there were over 100 DCRs operating globally, with services in several EU countries such as Belgium, Denmark, France, Germany, Greece, Luxembourg, the Netherlands, Norway, Portugal and Spain, as well as in Switzerland, Australia, Canada, Mexico and the USA.

Primarily, DCRs aim to prevent drug-related overdose deaths, reduce the risks of disease transmission through the use of unhygienic supplies and/or their sharing, and connect people who use drugs with support, health and social services. Besides this, they can also aim to minimise public nuisance.

In the report, two main operational models of DCRs in Europe are described: integrated DCRs, operating within low-threshold facilities, where the supervision of drug use is just one of the services offered, and specialised DCRs, offering a narrower range of services directly related to supervised consumption.

As frontline, low-threshold services, DCRs can support the monitoring of new and emerging local trends. For example, it has been found that in Europe, injecting heroin is less common in recent years, while the use of synthetic opioids and stimulants has increased in some countries. Over the years, following a dynamic drug landscape, many harm reduction services, including DCRs, have adapted to the needs of local clients. For example, some DCRs have started providing services for smoking as well as injecting and allowing the consumption of a wider range of substances within the facility.

DCR evaluation presents specific challenges, but currently available evidence support the positive impact of DCRs on the access to healthcare and harm reduction services among people who use drugs, and especially groups that are not reached enough by these services. DCRs do not increase crime in the areas where they are located and, instead, contribute to decrease of public drug use. Evidence also shows how DCRs contribute to reducing drug-related deaths.

In addition, an expert panel recently concluded that DCRs foster safer injecting practices and therefore can contribute to reduce the transmission rate of communicable diseases among people who inject drugs.

Among other measures to reduce cases of fatal and non-fatal overdose, the EU Drugs Action Plan 2021–2025 calls for DCRs to be introduced, maintained or enhanced ‘where appropriate and in accordance with national legislation’.

The report concludes that, despite the challenges encountered in conducting research in this setting, more studies are needed to support the work of DCRs by showing their contributions to reducing both individual and community harms.

Read the joint EMCDDA and C-EHRN Report on DCRs in Europe following this link>>>.

 

The path that ends AIDS

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>>>.

 

‘Right to asylum in the Republic of Serbia 2022’ report presented

The Belgrade Centre for Human Rights (BCHR) presented its annual report Right to Asylum in the Republic of Serbia 2022 at a press conference in the Belgrade Media Centre on 28 February. The report was presented by UNHCR Representative in Serbia Soufiane Adjali, BCHR Executive Director Sonja Tošković, BCHR Asylum and Migration Programme Coordinator Anja Stefanović, Report Editor Ana Trifunović and BCHR Asylum and Migration Programme Senior Integration Adviser Jelena Ilić.

According to the data of the Serbian Commissariat for Refugees and Migration, over 119,000 refugees and asylum seekers stayed in the Serbian asylum and reception centres in 2022, or twice as many as in 2021, said the Report Editor, Ana Trifunović.

Serbia issued 1,115 rulings granting temporary protection mostly to Ukrainian nationals, in accordance with the temporary protection mechanism activated after Russia’s invasion of Ukraine, said Trifunović.

The arrival of Ukrainian nationals in Serbia was facilitated by the visa-free regime and they applied for temporary protection on arrival. In BCHR’s experience, the application of the temporary protection mechanism was relatively smooth. The people who fled Ukraine mostly stayed in private lodgings and many of them have friends and relatives, even spouses, here. The Serbian Government designated the Vranje Asylum Centre for the accommodation of exclusively Ukrainian refugees,” Asylum and Migration Programme Coordinator Anja Stefanović said, adding that most Ukrainian refugees wanted to return to their country as soon as circumstances permitted.

Jelena Ilić, a Senior Integration Adviser with BCHR’s Asylum and Migration Programme, said that 230 refugees in 2022 asked BCHR to help them pursue their education or access the labour market in Serbia.

She said that BCHR in 2022 represented 94 Ukrainian clients, as well as clients from Burundi, Iran and Libya, in procedures for accessing their economic and social rights.

Only 23% of the foreigners between 20 and 56 years of age who asked us to help them access their right to work or education spoke Serbian. Four BCHR’s clients have enrolled in Serbian colleges since 2021,” said Ilić.

The report is available in Serbian and English.

 

EMCDDA new analysis on the drug situation in the Western Balkans

From the EMCDDA webpage

Drug-related health and security threats in the Western Balkans are highlighted in a new report published by the EU drugs agency (EMCDDA). Released in the framework of the agency’s latest Instrument for Pre-accession Assistance project (IPA7), funded by the EU, the report provides the latest picture of the drug situation in the region.

The report offers a top-level analysis of drug markets, their drivers, facilitators and consequences, as well as an overview of drug policy and the law, drug use, harms and responses. It concludes with a regional overview of each of the major drug types, focusing on use, production and trafficking. Additional challenges, such as corruption, violence and the internationalisation of organised crime networks are also considered.

The findings are based on EMCDDA data collected through structured questionnaires and complemented by information from studies, focus groups and scientific literature. It appears that drug-related information is overall relatively limited in the region, although this varies, to some extent, between the partners concerned.

The report presents a summary of ‘key findings’, including:

  • Available data show that overall drug use in the region appears to be lower than in the neighbouring EU, although notable differences in patterns of use can be observed between the Western Balkan partners. There is an ongoing need to better monitor harms associated with opioid and cocaine use in the region, as evidence suggests that use of these substances is evolving in ways that could have important implications in future.
  • Harm reduction services operate in all of the partners, but the provision of interventions appears to be generally insufficient and is often dependent on international funding. Data point to an overarching need in the region to increase the provision of treatment and other services for people with drug problems. In particular, responses targeting harmful patterns of use for non-opioid drugs appear to be currently underdeveloped, while, at the same time, demand for such responses may be growing.
  • Western Balkan criminal networks appear to have become key actors in both the regional and EU drug markets. This partly reflects the geographical position of the Western Balkans, which lie at the intersection of a number of major drug trafficking routes (e.g. Balkan route for heroin), but also, potentially, some emerging routes for other drugs, including cocaine. These criminal networks have a significant impact on security, governance and the rule of law in the region.
  • Some criminal networks from the Western Balkans have adopted a new business model of direct involvement in cannabis production within the EU. Their presence in a number of EU countries, primarily associated with indoor production facilities, has been noted. Patterns of cannabis cultivation in the region are shifting and diversifying. Significantly less cannabis is cultivated outdoors in Albania than in the past, while large-scale cannabis cultivation sites have been recorded in other parts of the Western Balkan region.
  • Violence associated with competition for drug markets and control of trafficking routes is a significant security threat. A number of homicides in the EU and elsewhere have been linked to Western Balkan criminal networks involved in the drug trade, particularly the cocaine business.

The report is available following this link>>>.

 

Youth and organised crime in the Balkans

Photo © Klub MASA Mostar

Across the Western Balkans, young people are engaged in or vulnerable to a variety of organized criminal activities, including the cultivation and trafficking of drugs, sex work, trafficking in human beings, extortion and car theft or as foot soldiers for criminal groups. Others decide to leave the country irregularly, are smuggled abroad and get involved in criminal activity, particularly in the EU.

What is the role of Western Balkan youth in organized crime? What factors make them vulnerable? What can be done to get them off the escalator of crime and prevent recidivism?

Although youth in the Western Balkans are exposed to and engaged in organized crime, civil society organizations (CSOs) either run by or working with them can be key sources of community resilience. Youth, generally accepted as people between the ages of 15 and 29, should be considered as an asset rather than a problem: a source of energy, innovation and courage, as well as fresh ideas and approaches to strengthen integrity and reduce the risk posed by organized crime.

The Strengthening resilience of youth to organized crime brief is part of the Global Initiative Against Transnational Organized Crime (GI-TOC) ‘Resilient Balkans’ series, which looks at topics of common interest to civil society organizations (CSOs) in the Western Balkans dealing with issues related to organized crime. This brief focuses on what makes youth vulnerable to organized crime in the region and looks at how CSOs are working with youth to strengthen resilience.

This report is an output of the GI-TOC’s Observatory of Illicit Economies in South Eastern Europe and the GI-TOC’s Resilience Fund. The report is based on data, information and analyses collected and shared by civil society actors based in the Western Balkan region

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

 

Sexual violence when out at night

From the Sexism Free Night project website

The research activities of Sexism Free Night were based in a Europe-wide websurvey aimed at collect information on the prevalence of sexism and sexual violence among over-18s in Europe, and to analyse its intersections with specific key factors such as patterns of drug use, participation in nightlife and party environments, nightlife mobility and beliefs about sexual violence.

We have asked questions about people’s nightlife experiences, acknowledging the COVID19 pandemic happening at the time of survey launching. The time frame included going out before the covid-19 outbreak and also going out in the context of social isolation (e.g. small parties or meetings at home, in nature or public spaces with friends, informal parties in hidden locations or video calls and live streaming events).

The survey was developed and translated into eight different languages: English, Spanish, French, Portuguese, Serbian, German, Latvian and Slovenian, while data collection was implemented from 25.11.2020 until 31.12.2020.

Total number of web survey respondents from European countries was 10.148, while 4534 people completed the survey in full and were considered for the analysis. Results of the survey also served for later design of our European Campaign and Training.

To read full report follow this link>>>.

 

Why DPNSEE is not accredited by ECOSOC?

The Drug Policy Network South East Europe applied for the ECOSOC membership in 2018. Since then, our application was 5 times differed with occasional questions of not a great importance, on which we provided accurate answers. Why this happens? The recent study prepared by the International Drug Policy Consortium explains.

 

Here is the extract from the IDPC webpage presenting the analysis of this phenomenon:

“Decision-making across the board, on development, on security, on social affairs, is more effective and legitimate when people from different backgrounds are able to contribute. Meaningful participation of civil society in international processes and bodies, including in the UN, relies on free and vibrant democratic spaces with effective participation channels for diverse groups at the national level. This, in turn, requires respect for freedom of expression and access to information online and offline, freedom of association and physical security for those who speak up and assemble peacefully”.

 The United Nations (UN) has long recognised the role of civil society as a key component of effective decision-making at all levels of governance. Yet, civil society continues to face significant barriers in accessing the decision-making table, including at the UN itself. One of these obstacles is the inability for many NGOs to obtain accreditation from the Economic and Social Council (ECOSOC), which would enable them to attend and engage in key UN policy-making fora such as the UN General Assembly, the UN Human Rights Council, and the UN Commission on Narcotic Drugs.

 According to the International Service for Human Rights (ISHR), no less than 41 NGOs have seen their application for ECOSOC status deferred for over four years. Similarly, research by the International Drug Policy Consortium (IDPC), which will be presented here, has shown that NGOs working on drug-related issues are facing increasing difficulties in obtaining ECOSOC status. This is mainly due to obstructive practices within the UN Committee on Non-Governmental Organizations (thereafter called ‘Committee on NGOs’ or ‘Committee’), which is used by some countries as a tool to limit NGO participation in UN policymaking processes.

 In this advocacy note, IDPC presents key research on how the Committee on NGOs has effectively restricted civic space for drug NGOs wishing to engage in UN proceedings, and offers key recommendations for member states as they are preparing to elect new members of the Committee on NGOs in April 2022.

You can access the report 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>>>.

 

COVID-19 vaccinations for prison populations and staff

People in prison continue to be left behind in COVID-19 responses despite facing heightened risk of infection and illness due to cramped and unsanitary living conditions and lack of hygiene supplies in many detention facilities, as well as the poorer health status of prison populations compared to the general population. Even in countries with relatively high standards for places of detention, people detained and working in prisons have been infected and died of COVID-19. The latest available figures indicate that as of July 2021, over 575,000 cases have been recorded in prisons and over 4,000 people in prison have died in 47 countries due to COVID-19.

Penal Reform International (PRI) and Harm Reduction International (HRI) carried out the first ever global mapping of policies & practices related to COVID-19 vaccination in prisons across 177 countries.

This report presents the findings of global mapping of COVID-19 national vaccination plans and their roll-out in prisons. It provides analysis on how, and to what extent, prisons are included (and prioritised) in national vaccination plans, and documents the progress to-date in rolling out the vaccine in prisons. In doing so, this report sheds light on a critical aspect of COVID-19 responses in prisons, namely vaccinations, which are an important tool for ensuring that people deprived of liberty – who too often remain invisible to society and at risk of infection or in need of medical care – are not forgotten.

The report is available following this link>>>.