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>>>.

 

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.

 

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>>>.

 

European Drug Report 2021 presented

From the EMCDDA press release

The EU drugs agency (EMCDDA) publishes its European Drug Report 2021: Trends and Developments, the latest annual review of the drug situation in Europe. Based on data from 29 countries (EU 27, Turkey and Norway), the report offers new insights into the health and security implications of a complex and evolving drugs problem and of a drug market resilient to COVID-19 disruption.

The report warns of the risks to public health posed by the availability and use of a wider range of substances, often of high potency or purity. It also describes how organised crime groups have intensified illegal drug production inside Europe to evade anti-trafficking measures, creating environmental, health and security risks. Drawing on the latest EMCDDA rapid assessment study, the report explores the recent effects of the COVID-19 pandemic on drug markets, use and services.

Presenting findings from the latest EMCDDA trendspotter study, the report illustrates how the drug market continues to adjust to COVID-19 disruption, as drug traffickers adapt to travel restrictions and border closures.

Key findings from the report include:

  • Cannabis use remains stable at high levels, but increased THC content raises health concerns — Rise observed in the THC content of cannabis resin (average range: 20%–28%). Health alerts warn of cannabis adulterated with highly-potent synthetic cannabinoids.
  • Record cocaine seizures, a worrying signal of potential for increased health harms — A record 213 tonnes were seized in 2019 (up from 177 tonnes in 2018). Cocaine purity has increased and more people are entering treatment for the first time. Preliminary seizure data in 2020 suggest availability has not declined in the pandemic.
  • Stable amphetamine demand makes domestic production near consumers profitable — Alongside the dismantling of production facilities in 2019, chemicals used to manufacture amphetamine were also seized in the EU, including 14 500 litres of BMK and 31 tonnes of MAPA (up from 7 tonnes in 2018).
  • Methamphetamine production and trafficking highlight potential for increased use in Europe — Both large-scale and smaller production facilities are being detected in Europe and large quantities of the drug are being transhipped through the EU to other markets.
  • Risks to health from supply of high-strength MDMA products — In addition to increases in the average MDMA content in tablets and the purity of powders, products with very high levels of MDMA are also being detected. Preliminary data from 2020 suggest there was less interest in this drug during periods of lockdown.
  • Harmful potent new psychoactive substances continue to emerge — Among these are new synthetic cannabinoids and new synthetic opioids. A total of 46 new psychoactive substances (NPS) were reported for the first time in Europe in 2020, bringing the total number monitored by EMCDDA to 830.
  • Are less commonly used drugs posing increasing challenges for public health? — These drugs include hallucinogens, ketamine and GHB. Worryingly, intensive patterns of use are reported in some settings.
  • Large heroin seizures signal potential for increased use and harms — Large volumes of heroin are still being seized in the EU (7.9 tonnes in 2019), raising concerns around the possible impact on levels of use.
  • Organised crime groups intensify illegal drug production within Europe — A total of 370 illegal laboratories were dismantled in 2019.
  • Drug law offences increase, with cannabis possession and supply predominant — An estimated 1.5 million drug law offences were reported in the EU in 2019; 82% were related to use or possession for personal use.
  • First-time treatment clients for heroin use continue to inject less — Although injecting drug use has been declining in Europe for the past decade, it remains a major cause of drug-related harms.
  • Scaling up treatment and prevention is required to reach HIV and HCV Sustainable Development Goals — Increased access to integrated testing and treatment services is an important part of reaching targets.
  • Overdose deaths driven by opioids and other drugs highlight need for service development — High-risk substance use and polydrug use continue to fuel drug-induced deaths in Europe.

The Report is available in various European languages including English (en) and those from our region Bulgarian (bg), Croatian (hr), Greek (el), Romanian (ro) and Slovene (sl).

 

Interim report submitted

DPNSEE have submitted today the Interim report for the first three months of implementation of the No risk, no borders for young people in South East Europe project. That included Narrative and Financial reports, Breakdown list of expenditures and all supportive financial documents.

The reporting period covers only first preparatory activities including Planning Team meeting, Call for the logo and visual identity, Open Call for youth activists and workers, Pre-task activity and come actions in preparation of the Workshop 1 scheduled for the end of May 2021.

 

Portugal’s Approach to Drug Policy – what works and what does not?

From Movendi’s website

The Swedish Drug Policy Centre (NPC) has published a new report Decriminalisation of Drugs: What can we learn from Portugal?, written by Pierre Andersson, about Portugal’s approach to drug policy and the lessons that can be learned from the country’s decriminalization of drugs.

In drug policy debates reference is often made to Portugal as an example of a country with a successful approach to drug policy. Often, the country’s good results in reducing the drug problem are attributed to the decriminalisation policy instituted in 2001. But knowledge and understanding of the exact policy and its results is not always accurate and well-informed. Therefore, Pierre Andersson has conducted a series of interviews on the ground in Lisbon and studied the reports on Portugal’s drugs policy published in scientific journals in recent years.

The report makes it clear that Portugal’s reforms in 2001 were more far-reaching than the abolition of penalties for using and possessing small quantities of drugs. Above all, they included major efforts to improve services for rapid and effective treatment, and good coordination between various healthcare interventions. This is likely to have contributed to the development that fewer people developed drug dependency, and, as a result, to a reduction in the number of drug-related deaths.

But, the report also shows that the drug-related death rate fell after the reform, when major efforts were made to expand healthcare, only to then increase again to almost the same level as before decriminalisation.

The Swedish drug policy debate often compares the figures for drug-related deaths between Portugal and Sweden. As the new report shows, these comparisons are flawed because the measurement methods differ from between countries. For example, over 75% of all deaths in Sweden that screened positive for drugs are ultimately classified as “drug-related” according to the definition by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

But the corresponding figure in Portugal is below 5%. The report also shows that Sweden undertakes twice as many post-mortem examinations and three times as many forensic analyses as Portugal. Comparisons between the figures make little sense when the methods differ as much as they do.

Concerning drug consumption trends in Portugal, the new report shows that cannabis use has increased among schoolchildren and is now at a higher level than that of the corresponding age group in Sweden.

Countries still have a lot to learn from Portugal’s drug policy, especially with regard to the short waiting time for treatment and the coordination between the various healthcare services. For example, Portugal’s Commissions for the Dissuasion of Drug Abuse (CDT), which people charged with possession or use have to appear before, is quick to make referrals to addiction specialists. The quick and effective response and follow-up increase in all likelihood people’s chances of overcoming – or avoiding – drug use disorders and addiction.

The report also highlights the risk of overlooking some really good lessons from both Portugal and other countries, overshadowed by the framing that decriminalisation in itself is the solution to all drug problems.

The purpose of the report is therefore to contribute to a focused and informed drug policy debate taking into view the initiatives that hold substantial potential to reduce and prevent harm, provide adequate services to all who need it and help prevent drug use and harm among children and youth.

The analysis of Portugal’s drug policy is complemented with a broader overview of ten more European countries which have decriminalised drugs. You can read the additional report “Decriminalization in Europehere>>>.

Comparison of the developments following decriminalisation in these eleven European countries shows that drug-related deaths increased in some countries and decreased in others. It therefore does not seem to be decriminalisation in itself that is the decisive factor in the developments.

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

 

Drug Decriminalisation: Progress or Political Red Herring?

From the INPUD website

Over the past decade there have been increasing claims that the world is moving towards a critical turning point in international drug policy, based on a growing recognition that governments must consider alternative approaches to drug policy which include decriminalisation. While this shift has been hailed as a sign of progress by many, INPUD believes there are still important and overlooked questions regarding the extent to which the needs and rights of people who use drugs are being prioritised in countries that have decriminalised drug use. In 2018, INPUD published a ground-breaking analysis of the Portuguese decriminalisation model – Is Decriminalisation Enough? Drug User Community Voices from Portugal – which for the first time assessed the impact of decriminalisation of Portugal from the perspectives of people who use drugs. The report noted how “interactions with the state and the police, and issues of violence, social exclusion, stigmatisation, and discrimination, are often entirely omitted from discussion and analysis of decriminalisation”.

INPUD is excited to present Drug Decriminalisation: Progress or Political Red Herring? This report, like our previous report on Portugal, is intended to open up the debate on decriminalisation and make clear the expectations people who use drugs have for future action on drug policy reform. Most importantly, it includes a call for full decriminalisation without sanctions as the new baseline for measuring progress on decriminalisation in the future.

Decriminalisation is often discussed as if there is only one model, leading to a view that decriminalisation anywhere equals progress. However, there are many different models of decriminalisation in operation, all with different impacts. This report was published because we believe current reforms have not gone far enough. This situation means that in the overwhelming majority of countries, people who use drugs continue to be criminalised, punished, and stigmatised despite decriminalisation. Furthermore, no existing reviews of decriminalisation models have specifically included the perspective of people who use drugs in their analysis, a glaring oversight which reflects the historical exclusion of the voices of people who use drugs within policy discussions.

INPUD believes it is time to disrupt the misconception that decriminalisation efforts unquestionably represent progress when they have been developed with little or no consultation with people who use drugs. This report amplifies the voices of people who use drugs through a series of interviews conducted with members of the community and their representatives in countries that have implemented various approaches to decriminalisation. Our hope is that this report can support peer-led advocacy efforts towards more inclusive, progressive, participatory and transparent drug policies which fully recognise the human dignity of all people who use drugs.

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

 

Taking stock of half a decade of drug policy

From the IDPC press release

Today, the International Drug Policy Consortium (IDPC) released a new report Taking stock of half a decade of drug policy – An evaluation of UNGASS implementation revealing the widening chasm between UN commitments on health and human rights, and the devastation brought about by punitive drug policies on the ground.

As the annual meeting of the UN CND opens with a commemoration of the 60th anniversary of the 1961 Single Convention on Narcotic Drugs, the legal foundation of the international drug control regime, IDPC’s report shows that there is little cause for celebration. Using wide-ranging data from UN, academic and civil society sources, the report illustrates the horrific human toll of the ‘war on drugs’ over the past five years, made worse by the COVID-19 pandemic:

  • 585,000 preventable drug use related deaths were recorded in 2017, the highest figure on record.
  • A staggering 2.5 million people worldwide are in prison for a drug offence, of which at least 475,000 are incarcerated for personal drug use only. Hundreds of thousands more are detained against their will in forced ‘treatment’.
  • From ‘stop and search’ and mass incarceration to the death penalty, drug law enforcement disproportionately targets women, racial and ethnic minorities, and other marginalised communities, fuelling poverty and inequality.
  • Globally, only 1 in 8 people living with drug dependence have access to treatment, while the availability of life-saving harm reduction services is severely restricted.
  • Subsistence farmers of crops like cannabis or coca leaf continue to be subject to violent forced eradication campaigns that deprive them and their families of their livelihoods.
  • 5 billion people worldwide live with limited or no access to pain relief and palliative care due to repressive drug laws.

 

April 2021 also marks the 5th anniversary of the 2016 UN General Assembly Special Session (UNGASS) on drugs, where all countries in the world committed to adopt a public health, rights-based, and development-oriented approach to drug policy. By comparing these commitments with evidence from the ground, the new IDPC report reveals a widening gap between rhetoric and reality.

The 60th anniversary of the global drug regime gives us little cause for celebration’ said Ann Fordham, Executive Director at IDPC. ‘In the past five years, some progress has been made, as countries moved to adopt welcome initiatives on the decriminalisation of people who use drugs, and the legal regulation of cannabis. However, in most parts of the world, governments remain wedded to draconian policies that have had a catastrophic impact on communities, and have resoundingly failed in their stated purpose of eradicating drug markets, or reducing illegal drug use.

Marie Nougier, Head of Research and Communications at IDPC, said: ‘With this report, we wanted to give a voice to those most affected by punitive drug policies. What communities tell us through our research is that they continue to face criminalisation, extrajudicial killings, the death penalty, acts of torture and ill-treatment, stigma and discrimination, and are systematically denied access to life-saving health services. We cannot wait for another 60 years to align drug policies with health, human rights and development.

The report is available following this link>>>.

 

EU crime threat assessment

From the Europol webpage

The EU Serious and organised crime threat assessment (SOCTA) 2021 is the outcome of a detailed analysis of the threat of serious and organised crime facing the EU, providing information for practitioners, decision-makers and the wider public. As a threat assessment, the SOCTA is a forward-looking document that assesses shifts in the serious and organised crime landscape.

The SOCTA 2021 sets out current and anticipated developments across the spectrum of serious and organised crime, identifies the key criminal groups and individuals involved in criminal activities across the EU and describes the factors in the wider environment that shape serious and organised crime in the EU.

The SOCTA 2021 provides an overview of the current state of knowledge on criminal networks and their operations based on data provided to Europol by Member States and partners and data collected specifically for the SOCTA 2021. In trying to overcome the established, and limiting, conceptualisation of organised crime groups, this assessment focuses on the roles of criminals within criminal processes and outlines how a better understanding of those roles allows for a more targeted operational approach in the fight against serious and organised crime.

Key findings of the report include:

  • Close to 40% of the criminal networks active in the EU are involved in the trade in illegal drugs.
  • Around 60 % of the criminal networks active in the EU use violence as part of their criminal businesses.
  • The use of corruption and the abuse of legal business structures are key features of serious and organised crime in Europe. Two thirds of criminals use corruption on a regular basis. More than 80 % of the criminal networks use legal business structures.

A whole section of the report is dedicated to The trade in illegal drugs in the EU.

Europol is the EU’s law enforcement agency and it assists the Member States in their fight against serious international crime and terrorism. Established in 2000, Europol is at the heart of the European security architecture and offers a unique range of services. Europol is a support centre for law enforcement operations, a hub for information on criminal activities, and a focal point for law enforcement expertise. Analysis is central to Europol’s activities. To give its partners deeper insights into the crimes they are tackling, Europol produces regular assessments offering comprehensive, forward-looking analyses of crime and terrorism in the EU.

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