“Money Can Buy Health If You Budget For It”: key results of the project

In January 2016 consortium of three regional networks’ three year project was supported by Robert Carr civil society Networks Fund (RCNF) to build the capacity of community-based organizations of key populations, foster exchange and partnership between different ISP groups in budget advocacy and HIV resource accountability, help them advocate for national and municipal budgets resources to be allocated to continuum of HIV care for all ISP in EECA. During project duration joint advocacy activities and community strengthening to expand funding for and accessibility of services for people who use drugs (PWUD), men who have sex with men and all trans* people (MSM and TG) and people living with HIV (PLHIV) along the continuum of HIV care in Eastern Europe and Central Asia (EECA) region were held on regional and national level.

Main achievements on regional level

EHRA worked on the budget advocacy capacities development, ECUO has been instrumental in developing advocacy plans for the communities and delivering guidance on PR and communication tools. ECOM on the other hand has launched its issue based inter-sectoral platform – Regional Platform on Policy Reform (RPPR), which consists of regional development partners and regional networks, national actors from state and civil society. This enables communities to come up with the joint strategy on how to find new and effective approaches to MSM and trans people health in EECA region.  We strive to achieve situation in which all members bring in unique expertise and input.

The Regional Community Action Plan was developed with leadership from ECUO based on research and consultation with community representatives, regional networks and other stakeholders and serves as the basis for joint planning and fundraising.

In April 2017 EHRN organized the budget advocacy training in Kyrgyzstan for 28 participants from regional and national consortiums. As a result 28 community members were trained and then practically involved in advocacy on regional and national level.

The tool for community led assessment of access and quality of services was developed in close cooperation with national consortiums and then approbated by them in the first year of the project.  Gaps in access to services identified by the communities, were then addressed in their advocacy work. It is planned to collect and try to unify all the existing methodologies of community led assessments during the Reginal methodological expert workshop in October, 2018.

Budget advocasy guide for community activists (BA guide short) developed by EHRA on the basis of conducted regional and national trainings for different communities is a great tool to share gained experience with members of regional networks and community leaders in EECA.

Our work together as a consortium made clear the necessity and all of the potential benefits of consortiums as a model for effective national and regional advocacy. That is why the specific training was organised and methodological guidelines (“We are different but act together”) were developed to summarize best approaches and to provide communities with practical recommendations on how to build effective consortiums working in budget advocacy.

Together with 6 other regional networks consortium members launched joint “Chase the virus, not people!” campaign at AIDS 2018 conference. EHRA, ECOM along with ECUO were the coordinating parties of the campaign. The aim of the campaign is to draw attention to the problems of key population groups, against the backdrop of the catastrophic situation with the HIV/AIDS epidemic in EECA for comprehensive support of the region by the world community. Increase the priority of actions to overcome the discrimination and stigmatization of vulnerable and communities – as a key condition for an effective response to the HIV epidemic in EECA countries.

National level

While the perfect model and mode for transition from donor to domestic funding is yet to be discovered, there have been decisive steps taken in a number of countries to improve the situation. We work with our community organizations within each consortium individually and try to look at the situation in relation to all ISPs in the country at large. This enables building a win-win partnerships, raising stronger voice for change, gives consortia more influence on decision making level, including on funding of ISP services.

In June, 2016 members of the PUD, PLWH, MSM and transgender communities from Armenia, Kyrgyzstan and Estonia gathered together at the training “Budget advocacy and assessment of investments and priorities related to HIV prevention, diagnostics, treatment and care”, learned about the project and agreed on joint actions to collect and analyze investments and priorities related to HIV services.

In 2016 MSM, PLHIV and PWID communities from Armenia, Kyrgyzstan and Estonia conducted community led monitoring of HIV related survices, presented the results to relevant stakeholders and formulate strategic plans of national consortiums based on it.

Armenian consortium prepared the “Armenian civil society opinion on government readiness for transition to state funding”. Transition processes in the country have been advancing recently and consortium members are involved in them.

In Kyrgyzstan PLHIV, LGBT and PWUD community organizations are widely represented in the platforms that have their say on national HIV response. They are part of discussion during planning national HIV program which include transitional and reforming state procurement mechanism for ARVs.

As the result of the community mobilization, it was possible to recruit a group of new activists for the PWUD community in the North-East of Estonia. The core group of PWUD activists gained access to the resources of community assessment and mobilization in the summer of 2016. By the end of 2016, it was possible to register an NGO based on the initiative group. 
Estonian consortium has been actively engaged with National Institute of Health Development to work on more community based and low threshold programs for ISPs. Technical assistance provided by ECUO helped national consortium develop National Advocacy Plan of the Estonian communities.

About Harm Reduction Funding

Guidance from World Health Organization (WHO), United Nations Office on Drugs and Crime (UNODC) and Joint United Nations Programme on HIV/AIDS (UNAIDS) suggests that reversing an HIV epidemic requires 60% of all people who inject drugs (PWID) to be reached regularly by a needle syringe program (NSP), and that 40% of all opiate users be enrolled in opioid substitution therapy (OST).

Governments of Central and East Europe and Central Asia (CEECA) provide less than 15% of harm reduction funding needed in the region, which indicates region’s strong dependency on international donors who support both NSP and OST. At the same time, many of the countries in the CEECA region are becoming ineligible to receive donor funding due to increasing GNP per capita level. There are no more countries in CEECA that are classified as low-income – the funding priority for key donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Epidemics among PWID cannot be reversed without greater and sustained state funding of harm reduction. Investments are needed to improve service quality and coverage level of both NSP and OST. Governments and other domestic sources have responsibility for meeting these investment needs. Their increased and sustained engagement is essential because the Global Fund is swiftly withdrawing from the region to concentrate on supporting low-income countries across the globe.

One of the key priorities of Eurasian Harm Reduction Association (EHRA) is to build capacity of PWID communities in CEECA in budget advocacy – a process enabling civil society organizations and communities to monitor and influence state decisions for the allocation of public funds towards harm reduction programs and better solutions safeguarding people’s health.

Budget advocacy by communities may have the greatest impact on actions of authorities, and in its turn, on the lives of people. With that in mind we believe that:

  • It is crucially important to engage PWID community in planning through estimating the unmet needs for harm reduction services and defining priority items for a policy agenda change and financing;
  • Allow for direct financing of civil society through social contracting or similar mechanisms, to deliver harm reduction and HIV and TB services to PWID, is the most evident way for the governments to sustain services and funding;
  • An important consideration is that cost-effectiveness can best be obtained not by cutting services, but by making them more efficient through their optimization.

Increasing national funding should go hand in hand with reversing harsh prohibition laws and change of enforcement policies that discriminate PWID. Otherwise scale-up in funding would not convert to increased program coverage.

About Drug Policy Reform

Representing different political, cultural and socio-economist contexts, CEECA countries continue to apply prohibition approach and punitive sanctions for drug possession for personal use.

Massive incarceration of people who use drugs is the most obvious, but not the only negative consequence of criminalisation of drug use or possession for personal use. Criminalisation affects health – the fear of police prosecution increases the use of unsterile syringes and thus fuels HIV and viral hepatitis epidemics; overdose mortality rates are also, to a big extend, driven by harsh drug policies. Punitive sanctions for drugs create barriers to social reintegration of people who use drugs decreasing their chance for employment, education and vocational training and, most importantly, building social and family relations.

Punitive sanctions for drug use and possession exit in various forms – it can be years of prison sentences, or arrest for several days, fines or correctional works. While an arrest or a fine cause less harm to health and social wellbeing of an individual than a longterm imprisonment, the substance remains the same – it is a sanction, a punishment, which is aim is to cause suffering, but not to help. Thus real alternatives to criminal sanctions for drugs are not administrative fines but programs that refer people who use drugs to health or social service that they need.

Such referral can be made at the point of arrest and include access to harm reduction programs, opioid substitution and other drug treatment, HIV testing and treatment, mental health programs, vocational training, employment, housing etc. There is growing evidence that diversion from arrest programs cost less and are more effective in terms of decreasing the criminal behaviour (for more information see https://www.leadbureau.org/).

In CEECA diversion from arrest programs only start to be implemented. Pilot programs are run in Estonia and Lithuania, while in a number of countries – Georgia, Ukraine, Kyrgyzstan and Tajikistan – their initiation is discussed by national stakeholders. However, the region will go a long way to reorient its drug policies to humanistic and right-based approach.

In fact, any social belief or stereotype built on the thesis that people who use drugs are less worthy of social benefits than those who do not use drugs is a form of violence in itself. Social stigma associated with drugs and criminalisation lead to systematic discrimination of people who use drugs in the healthcare system: they are often denied effective drug treatment such as opioid substitution treatment, HIV and viral hepatitis prevention and treatment, access to pain management, etc. In particular, women who use drugs suffer from disproportional damage: they are deprived of parental rights, they have limited access to sexual and reproductive health care services (especially during pregnancy), they are subjected to brutal police and domestic violence. Their stigmatisation is complex and multifaceted, which makes them much more susceptible and vulnerable to HIV and other infections.

In CEECA, in general, the institutes of the protection of human rights of vulnerable populations are underdeveloped, while there are significant differences in factors that explain low access to and limited efficiency in using human rights instruments. In addition to that, extremely low interest to human rights violations experienced by people who use drugs among ‘mainstream’ human rights and gender rights movements can be explained by extremely high stigma around drug-related issues. In this context, the central role in documenting human rights violation and analysing them through the prism of international and national legislation has to be given to people who use drugs and their ‘traditional allies’ – harm reduction programs.

Regional meetings of EHRA members to elect Steering Committee members in Russia and South-Eastern Europe

On 21 May – 4 June, 2018 EHRA conducts online Regional Meetings of it’s members to elect new Steering Committee representatives in the following regions:

  • Russia (Russia);
  • South-Eastern Europe (Albania, Bosnia-Herzegovina, Bulgaria, Croatia, Kosovo, Macedonia, Montenegro, Romania, Serbia).

All members (individual and organizational), who are from the above-mentioned regions and who are approved by the Steering Committee have a right to vote in the Regional meetings.

If you have any questions, please contact General Secretary of the Regional meetings – Eliza Kurcevič members@harmreductioneurasia.org

 

Russia

 

Alexander Levin

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Maxim Malyshev

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South-Eastern Europe

Samir Ibisevic

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Miso Pejkovic

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EHRA announces the General Meeting and Regional Meetings in Russia and South-Eastern Europe regions

On May 21 – June 4, 2018 Eurasian Harm Reduction Association (EHRA) conducts the General Meeting of its members. During the fortnight, members of EHRA will have online-voting for six main issues:

  1. Approval of EHRA financial report for 2017 year;
  2. Approval of Regulations of the General and Regional members’ meetings of EHRA;
  3. Approval of Regulations of the Steering Committee of EHRA;
  4. Approval to prolong terms for 2 more months for 5 members of the Steering Committee and shorten term of 2 months for 1 member;
  5. Approval of the timeline of the Regional meetings to elect Steering Committee members;
  6. Approval of EHRA Advisory Board.

All members approved by EHRA Steering Committee may participate in the General Meeting. At the moment, there are 205 members. The full list of members is available on the EHRA website – http://harmreductioneurasia.org/members/

Members from the regions of Russia and South-Eastern Europe will also vote for the Steering Committee members to represent their region. Please, find information about the candidates to the Steering Committee to represent Russia and South-Eastern Europe here: http://harmreductioneurasia.org/regional-meetings-of-ehra-members-to-elect-steering-committee-members-in-russia-and-south-eastern-europe/

Details on the voting procedure and participation can be clarified by contacting Eliza Kurcevic via e-mail: members@harmreductioneurasia.org

Monitoring and Evaluation (M&E) Expert is needed

The consortium of EECA regional community networks is looking for the Monitoring and Evaluation (M&E) Expert familiar with the Global Fund M&E requirements to join the team in preparing a multi-country advocacy and capacity building proposal.

The expected date of start of the contract is March 1, 2018. Deadline for providing all deliverables – 20th of April, 2018. Please see ME consultant ToR  for more information.

If you are interested in cooperation with EHRA on the subject, please send your C.V. and daily rate to info@harmreductioneurasia.org no later than 26/02/2018 11:59 pm.

 

EXTENDED: EHRA is looking for WordPress developers

Eurasian Harm Reduction Association is looking for WordPress developers to work with two existing WordPress websites. This includes introducing new functionality as well as existing functionality modification. Both websites are running on WordPress and shall be finished by 15th of March, 2018. The content of the websites shall be intact and work not interrupted.

Evaluation will be based on:

  1. Experience in developing similar websites
  2. Ability to finish both websites by set term
  3. Price for both websites, including technical assistance

Providing examples of similar work will be an advantage.

Please send your application to Irena Zubkova at irena@harmreductioneurasia.org by 25th of February, 2018.

Please see more information in the documents below

Terms of Reference

Application Form

EHRA is looking for WordPress developers

Eurasian Harm Reduction Association is looking for WordPress developers to work with two existing WordPress websites. This includes introducing new functionality as well as existing functionality modification. Both websites are running on WordPress and shall be finished by 15th of March, 2018. The content of the websites shall be intact and work not interrupted.

Evaluation will be based on:

  1. Experience in developing similar websites
  2. Ability to finish both websites by set term
  3. Price for both websites, including technical assistance

Providing examples of similar work will be an advantage.

Please send your application to Irena Zubkova at irena@harmreductioneurasia.org by 20th of February, 2018.

Please see more information in the documents attached

Terms of Reference

Application Form

Regional meetings of EHRA members to elect Steering Committee members in the Baltic States, Belarus-Ukraine-Moldova, Central Asia, Central Europe, South-Eastern Europe regions

On 15-29 January, 2018 EHRA conducts online Regional Meetings of it’s members to elect new Steering Committee representatives in the following regions:

1) The Baltic States (Latvia, Lithuania, Estonia);
2) Belarus, Ukraine and Moldova;
3) Central Asia  (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan);
4) Central Europe  (Czech Republic, Hungary, Poland, Slovakia, Slovenia);
5) South-Eastern Europe  (Albania, Bosnia-Herzegovina, Bulgaria, Croatia, Kosovo, Macedonia, Montenegro, Romania, Serbia).

All members (individual and organizational), who are from the regions, where elections are taking place and who are approved by the Steering Committee have a right to vote in the Regional meetings.

If you have any questions, please contact General Secretary of the Regional meetings – Eliza Kurcevič members@harmreductioneurasia.org

 

The Baltic States

Elena Antonova

Estonia

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Jurgita Poskeviciute

Lithuania

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Belarus, Moldova, Ukraine

Ala Iatco

Moldova

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Vitalii Lavryk

Ukraine

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Liudmila Trukhan

Belarus

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Central Asia


Sagyngali Yelkeyev

Kazakhstan

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Oxana Ibragimova

Kazakhstan

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Indira Kazieva

Kyrgyzstan

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Central Europe

David Pesek

Czech Republic

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Janko Belin

Slovenia

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South-Eastern Europe

Denis Dedajic

Bosnia and Herzegovina

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Eroll Shporta

Kosovo

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Samir Ibisevic

Bosnia and Herzegovina

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Yulia Georgieva

Bulgaria

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