Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services

Three Eurasian networks – EHRA, ECOM and EWNA united by the Eurasian Regional Consortium, met in Vilnius to discuss innovative approaches that will be used in the next three years in advocacy towards increased domestic investments in HIV services for key populations in EECA. Continue reading “Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services”

ENPUD Speech during the CND2019

15 March, 2019, Vienna, CND.

Eurasian Network of People Who Use Drugs (ENPUD) direct speech at the Interactive roundtable: “Safeguarding the future: enhancing our efforts to respond to the world drug problem through strengthening international cooperation, including means of implementation, capacity – building and technical assistance, on the basis of common and shared responsibility”:


I represent the Eurasian network of people who use drugs. Members of this network are people united by the idea of ​​fighting for their rights, and promoting people-oriented drug policy. The network brings together people from 13 countries in the region of Eastern Europe and Central Asia.

I would like to start speaking with the words of Albert Camus: “Can a policy that puts so many free people at a dead end be called realistic?”

We want to say that we all work together on the drug problem and are at different points of solving the problem.

And as for the EECA region, we want to say that, to date, in the EECA region, unfortunately, the most repressive models of drug policy are used.

The basis of which is criminalization, and repressions against people who use drugs:

– decriminalization of use in some countries cannot outweigh repressive measures

– these are arrests for storage of microscopic quantities of drugs,

– long term imprisonment,

– complete lack of or very poor access to opioid substitution therapy,

– curtailing harm reduction programs

– lack of access to other evidence-based approaches to solving the problem of drug use and addiction and other drug problem.

All this contributes to the demonization of substances and people.

There is a vector for complete non-use. Which is an impossible task and a tragedy for a huge amount of people.

The consequence of the requirement of complete failure is the existence of a zero tolerance policy in the region. It reinforces stigma at the state level

and leads to discrimination, conflicting with international agreements signed by countries. This is a huge problem.

Violations of the rights of people who use drugs are so frequent that it becomes the norm. Often even lawyers do not see problems in

that people who use drugs are humiliated, denied in the right to health, education, protection from violence, and torture in prisons, to obtain the necessary evidence from investigators in cases involving drug trafficking.

Repressive drug policies also have a negative impact on the distribution of government budgets.

Criminalization and the detention of hundreds of thousands of people is very expensive for states.

In fact, the money is spent on the hunt for people who use drugs. And not on the support of evidence-based methods for solving problems.

Use is decriminalized in some countries, but microscopic doses are already a criminal liability, which eliminates such important work of decriminalization.

Willingness of the leadership of the countries of the region to support civil society in a decision-making process based on a humane approach, and and discussing issues related to the drug problem with the community of people who use drugs is the key to mutual respect for rights and respect. I think everyone will agree that it would be a mistake to ignore the whole experience and opinion of a huge number of people inside the problem.

State drug policy in our countries, from the NPO side, is often regarded as a call for use, and turns into drug propaganda charges, fines, harassment and closure of non-governmental organizations. Many have experienced it for themselves. But we are not enemies!

We understand that we are part of the world process related to the solution of the drug issue. Today is the next stage. And now – the Eurasian network of people who use drugs considers that one of the main tasks of civil society is the effective organization of the process of supporting the development and strengthening of the community drug users, for discussion at all levels. And wide community interaction with government agencies. This is necessary for meaningful community participation in drug policy reform processes. And solving the problem of drugs in the region, in accordance with the most humane and scientifically based approaches that exist in the world.

We are pleased that we have an opportunity to contact governments at international platform. But we would like to see more platforms for

political and civil dialogue on drugs in Eastern Europe and Central Asia.


ЕСЛУН на CND2019

15 марта, 2019, Евразийская сеть людей, употребляющих наркотики (ЕСЛУН). Интерактивный круглый стол: «Защита будущего: наращивание наших усилий по реагированию на мировую проблему наркотиков посредством укрепления международного сотрудничества, включая средства реализации, наращивание потенциала и техническую помощь, на основе общей и совместной ответственности».

Posted by Eurasian Harm Reduction Association – EHRA on 2019 m. kovo 15 d., penktadienis

Promises to improve health outcomes for people who inject drugs remain unfulfilled as 99% do not have adequate access to HIV and harm reduction services

New report by UNAIDS highlights the urgent need to implement a human rights and evidence- informed approach to reach people who inject drugs with essential health services

Continue reading “Promises to improve health outcomes for people who inject drugs remain unfulfilled as 99% do not have adequate access to HIV and harm reduction services”

People who use drugs vs Governments of Estonia and Kazakhstan at the 65 session of the CESCR

Geneva, 65 session of the UN Committee on Economic, Social and Cultural Rights

February 18 – March 8, 2019

In February, 2019 during the 65 session of the UN Committee on Economic, Social and Cultural Rights (CESCR*) in Geneva EHRA in partnership with Canadian HIV/AIDS Legal Network, joined by community representatives from Estonia and Kazakhstan and legal experts from the Human Rights Clinic from Miami University School of Law presented the statements on the enjoyment of rights among women who use drugs in Estonia and access to opioid substitution treatment for people who use drugs in Kazakhstan, and addressed the questions of the Committee.

Continue reading “People who use drugs vs Governments of Estonia and Kazakhstan at the 65 session of the CESCR”

ToR for the consultant to develop research methodology for community-based assessment of patient satisfaction with OST services

The transition period from the Global Fund resources to public budget affected sustainability of opioid substitution treatment services in CEECA countries. State and NGOs implement different variants of OST programs:  covered by public or municipal budget and free for patients; fully or partially self-paid by patients. Alongside with those changes, EHRA started receiving information from national partners and OST patients about the worsened quality of services.

Continue reading “ToR for the consultant to develop research methodology for community-based assessment of patient satisfaction with OST services”

How are we doing? We’re summing up the first two years of “teal” self-government

Ganna Dovbakh, Executive Director of EHRA

It’s rare when you have a proper reason to tell how everything works inside the organization. You always praise the celebrant on their birthday and that is why today when it’s 2 years from the date of EHRA’s registration, I want to say a few words about us.

The first two years for us were the time of drafting new rules and looking for new approaches – both for our team and for me personally.

What is the added value of the regional network?

This question is usually the first to arise in all discussions, from discussing the development of a new project to information leaflets. Our members are doing national advocacy in their countries, while the regional organization becomes a source of new, unfamiliar, ways to achieve goals, learned from other countries or invented in a heated discussion of the team. We gathered together to invent and look at the world from a different perspective. That is why it is important to involve all members in the discussion. We strive to reach a consensus on the most important issues among 251 organizations and activists during our online meetings. I’m sure it would be perfect…

We come up with our ideas and then we think our common goals through and that is why the participants’ views are changing. For example, in 2018 we collectively developed the position of EHRA on drug policy, and even major experts in harm reduction discovered something new during the discussion. It has become clear to me that drug control is designed to fund law enforcement agencies and prisons. Money is the only indicator of national priorities. Drug policy does not exist separately from advocacy for sustainability of harm reduction services. We collected data to estimate criminalization costs and proved that those millions of dollars could have been spent on social services, which lack so much funding. How is it possible to convince decision-makers to spend these resources on the harm reduction services? We are still searching for the answer.

What do we really have in common? EHRA brings together both organizations of people who use drugs and organizations that provide and develop harm reduction services. We unite very different, sometimes even warring states: the EU members, the countries that want to join the EU and the countries of the Eurasian Customs Union. Despite visible differences, politicians regard the needs of people who use drugs in a similar way in all these different counties, and therefore our overall objectives remain the same.

The elections to the Steering Committee of EHRA were held in different sub-regions and within a community of people who use drugs in 2018. Our new SC is very diverse but their members are united in their vision of priorities, which can be observed in decisions they make – from the choice of strategic partners to the selection of project performers.

My heart filled with great pride when a member of the Steering Committee justified the decision of the Association on partnership to one of our international partners. It was clear that this decision was balanced, wise and unanimous. There wasn’t even a single thought that the Secretariat could compromise. That’s exactly why we have the Steering Committee, its main purpose is to make decisions. Democracy is a painstaking and time-consuming process. Activism requires resources and, most significantly, it requires time.  And here I would like to thank EHRA members and especially our SC for the efforts they made and the time they spent on the development of our organization.

How do you make a horizontal management structure effective?

The Secretariat is an executive structure, it consists of project managers. I think it’s foolish to gather a team of great experts while being unable to give them the opportunity to come up with ideas and make decisions. It’s impossible to know, understand and feel everything that 13 people understand, feel and know.

The management systems where each employee can invent something and influence decisions have different names. They were once called partnership management structures, horizontal structure, or “empowering” management. All these approaches have been recently united into the concept of “turquoise/teal teams”. I can’t say that our Secretariat is already turquoise but we’re learning.

Frédéric Laloux describes such organizations of the future as living organisms. They are notable for self-organization, integrity and evolutionary goals. Staff of such organizations perceive their companies as a living creature with a soul rather than a lifeless mechanism or machine, they think that their organizations are able to develop themselves without managerial control or fixed strategic annual plans. Teal companies have moved from “pyramid structure” to “teals”: from rigid hierarchical structures with supervisory control to distributed leadership and project teams. Employees are perceived as individuals rather than tools. One of the “teal” indicators which is so important for me is that it’s comfortable to work here for people who use various substances, people with children or pets. You definitely could recognize “therapy dogs” in our office from our posts on social networks.

The experience of these two years of our “dream team” shows that we are the most effective in actions which are developed and experienced by people. Only when staff believe in action with all their hearts, success could come.

Access to information for all is the most important thing to ensure if you want to implement the principle of involving every team member in daily management. Our mailing list makes it possible to discuss events and plans and is very helpful for me. Anyone from the team can write there to alarm others of problem we have and almost immediately get various solutions to it.  All Secretariat team members discuss and develop goals, not just the management. With knowledge of accessible information about the region and the situation in the countries and rooting for the common cause, people come up with the simplest and most effective solutions. Thus, the movement of drug feminists, our assessments and new projects were born. When each employee and member is provided with opportunities to create and implement their crazy ideas, then we are able to act “out of the box”. The next challenge is to try and fit it into the overall organizational strategy and inspire the donors with these ideas.  If we believe in it, we could prove and justify, then we will be able to involve even the most bureaucratic donors with the most abstract priorities.

How do you become an effective Executive Director of the “teal” team?

When we gather together a team of high-level professionals who are always in the information flow and maintain constant contact with countries, it’s absolutely possible for them to make key decisions in their areas. The role of the executive director is to align all the activities with the overall strategy and use the wisdom of compromise.

I once found a short description of the leader’s tasks: identify the environment for your team (the context in which we operate, the players and all the challenges we might face on our way), set goals and then tirelessly thank people for their ideas and day-to-day work. My task is to inspire the team to reach ambitious goals and connect all the different ideas and people. I also should be an expert on experts, gather partners and like-minded people.

Someone asked me if it is possible for an anarchist to become a director. It seems possible to me, if we are aware that we are all equal in the team and recognize the importance of each other.

There are a few simple rules that help me avoid mistakes every day. They might be useful for you:

– Answer emails and read documents. Reading key documents, calls for proposals and position papers should be included in your work plan, the same as you do with meetings. An outside perspective for our documents make the message clearer and help us get rid of excessive emotions and too much passion.

– Don’t make quick decisions, give yourself time. Sometimes in order to make a decision you have to walk a few kilometers or get a night of quiet sleep. If you don’t have enough information to make a decision, specify it and consult others.

– Every director should be responsible for supervision and staff development.  Avoid petulance and hasty judgements, as hard feelings wrench a creative spirit. And trust is inspiring.

We are only setting off on our interesting journey. We are strong when we are together!