Support. Don’t Punish. 2021

26th June is well known as a global day of action, where activists around the world become part of the “Support. Don’t Punish” campaign, to remind governments to end the “war on drugs” and place health and human rights in the center of drug policy-making processes.

This year is no exception. Community of people who use drugs activists from Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, and Uzbekistan joined a global campaign that brought together 260 cities from 96 countries. Local actions were supported by the Eurasian Harm Reduction Association (EHRA) and the Eurasian Network of People who Use Drugs (ENPUD).

Activists who are truly concerned about the current situation with health, dignity and freedom of people who use drugs in EECA region countries marched in their cities, organized flash mobs, shared their fact-based opinions through social networks and media to draw the attention of the general public and decision-makers to start changing harsh government policies towards people who use drugs. 

Based on their own stories and experiences, activists showed how the state should express support for people in need. Volunteers bought and packed food boxes, personal hygiene kits, medicines and delivered it to those who need it most, who are treated in hospitals or at home and cannot move around on their own. 

The worsening situation with COVID-19 affected the plans in some countries, but it didn’t stop delivering the main message of the campaign – the “war on drugs” is lost, repressions don’t work, it’s time to support, not punish!

ENPUD works to ensure that people don’t become dependent on drugs, and those who get sick stay alive, healthy and free. The living experience in a repressive drug policy environment has taught us a lot about what punishment means.

The value of this year's campaign is that it is open for everyone to participate meaningfully, from concept to its implementation.

Through this campaign, we desire to support community, to give hand of help to people whose lives are affected by economic crisis and by illness and despair, we want to create welcoming meeting and working spaces, we keen to find allies.  This year we decided to support community allies and to award handmade diplomas "Friend of the Community" to two drug treatment doctors from Moldova.

Olga Belyaeva

ENPUD Program Coordinator

Lili Fedorova, chief narcologist of Chisinau, receiving a certificate of merit. Moldova. ©PULS Comunitar


In the framework of the campaign in Belarus, activists from the association “Your Chance” have provided (video) financial support to people who are in acute need of such help. Eight people from Minsk, Gomel, Grodno, Mazyr and Barysau who have difficulty moving due to severe leg diseases and cancer received funds to cover transport expenses to OST clinics. This money should be enough until August this year when the Ministry of Health promises to adopt regulations allowing home delivery of OST.

Activists of the association "Your Chance", Belarus. ©


Actions prepared by the association of organizations of people who use drugs “GeNPUD”, were aimed at changing the current repressive drug policy, which contradicts fundamental human rights and focuses on punishment. Actions were also aimed at changing the outdated rules in OST programs, where take-home OST prescription is not available. With the support of the Georgian Harm Reduction Network and Médecins du Monde, France-Georgia “GeNPUD” prepared a petition to Prime Minister Irakli Garibashvili, and on June 26 they came out to public protest in front of the Georgian State Chancellery in Tbilisi. Outside the capital city in Kutaisi, Ozurgeti and Batumi public protests were organized by “GeNPUD” member organizations – “Rubikon”, “Phoenix 2009” and “Imedi”. Media outlets were invited to the rallies and covered the campaign events.

Other conducted events included a meeting between representatives of “New Vector” and friendly MPs from the “Girchi” party, participation of “GeNPUD” representative in a conference organized by the Center for Mental Health and Drug Abuse Prevention, and release of a short video in which community talks about the problems caused by stigma and discrimination.

Free mobile testing for HIV, viral hepatitis and syphilis in Batumi, Georgia. ©Union "Imedi"
A protest in Tbilisi against repressive drug policies in front of the State Chancellery of Georgia. ©GeNPUD


People who use drugs activists in Kazakhstan, from Karaganda, Temirtau, Taraz, Ust-Kamenogorsk, Pavlodar, Almaty, Saran and Balkhash, prepared and published 14 short videos and 7 social media posts, drawing the attention of a wide audience of Internet users.  The content included personal stories, interviews with health professionals and representatives of partner organizations, outreach workers, people who use drugs.

For the first time, we decided to roll out our campaign via Instagram reaching diverse audiences, those people who are far from thinking of drug policy issues or about what kind of support is needed. But these people left positive feedback that it's very right that we talk about important things, they thanked people who wrote posts and recorded videos, for courage, honesty, and fortitude.

Valentina Mankieva

Coordinator of the Campaign in Kazakhstan


Community activists from Association “Harm Reduction Network” prepared a short video in which people who have suffered from repressive drug policy in Kyrgyzstan and have lost years of their life in prison talk about what “support” means to them and why it is important.

As part of the campaign, volunteers on their own improved the grounds of the Social Hostel “Phoenix” – they built a shelter and assembled two tables and two benches from wooden pallets. The new space will allow organize meetings and trainings for up to 15 people.

Volunteers built a shelter, assembled tables and benches on the grounds of the "Phoenix" Social Hostel in Bishkek, Kyrgyzstan.​


To draw public attention to the problem of people who use drugs in Moldova, including young people, community-led organization “PULS Comunitar”, organized an auto rally and street action in front of Balti City Hall. In meeting with drug treatment specialists, community representatives symbolically handed out diplomas “Friends of the Community” for 2 doctors, as a sign of gratitude for the friendly attitude and support to the community of people who use drugs in Moldova. During the meeting further joint actions to broaden possibilities for the community, to expand the geography of OST programs and to access buprenorphine in all OST sites were discussed. Provision of OST through family doctors, pharmacies, and commercial medical facilities was also discussed.

“PULS Comunitar” managed to establish effective communication with media, thus events were widely covered in local internet sources and social media, and the total coverage reached 8000 people.  

Car rally in Balti to draw attention to the problem of drug addicts in Moldova. ©
A street installation, "Would You Punish Them Too?" with posters of famous people who have had drug experiences. Balti, Moldova. ©PULS Comunitar
A street installation, "Would You Punish Them Too?" with posters of famous people who have had drug experiences. Balti, Moldova. ©PULS Comunitar


The activities in Russia have primarily involved direct and practical aid to those in difficulty.

In Ekaterinburg, food packages were provided to six people who use drugs livingwith HIV and tuberculosis, who were being treated in a tuberculosis hospital, a woman living with HIV who was in an oncological dispensary with inoperable cancer, and a man who needed help after treatment in a psychiatric hospital.

In Perm, a sanitation service was paid to kill cockroaches and bedbugs in the living place to prevent the mother from losing her parental rights due to poor sanitary living conditions of her small child. Another young mother with an infant and no income was paid for visits to child therapist.

I was threatened that they [a child protection service] would take my child away for unsanitary conditions, but no one ever helped me to kill the cockroaches and put things in order. Thank you to everyone who provides this support, who actually helps people like me. Support, but not punishment, this is what gave me the desire and faith to go on living!

Feedback from a client from Perm

In Togliatti, the organization, recognized as a foreign agent, has no funding, but continues to help clients by providing harm reduction services. Ointments, bandages, disinfectant wipes, antiseptics, soap supplies and diapers for the bed-ridden patients were purchased to continue the work of this organization. During the summer, handouts will be distributed to the city’s most needy people who use drugs.

Volunteers in Togliatti collected and delivered medicine, medical and other supplies for those who need it most. ©EHRA


In the framework of the campaign, the NGO “SPIN Plus” organized a meeting with activists from the community of people who use drugs from Dushanbe, Gissar, Tursunzade, Rudaki and Vahdat, and staff from the Drug Control Agency and personnel of the Ministry of Internal Affairs of Tajikistan. The purpose of the meeting was to establish relationships with police officers to protect the rights and interests of the community of people who use drugs. The meeting noted the important role of the community of people who use drugs in providing harm reduction services and in preventing drug use among young people. Participants agreed to meet regularly and work together to implement the President’s Strategy on Prevention and Modern Approaches to Treatment of Drug Dependence.

Other activities included the development of community centre “DROPIN” and conducting training on harm reduction basics for personnel of AIDS Control and Prevention Centre, municipal drug treatment centre, and health centres.

Staff of the city HIV/AIDS prevention and control center, the city drug treatment center, and the city's health centers at the "Spin Plus" training on the basics of harm reduction. Dushanbe, Tajikistan.©Spin Plus


On 26th June, a mobilization meeting of two community initiative groups – women who use drugs and Global Fund outreach workers was organized in Tashkent. Participants have shared their personal life stories, as almost everyone had suffered from the repressive drug policy.

Unfortunately, many of those invited to the meeting were not able to attend it due to stricter COVID-19 related quarantine measures and travel restrictions in Uzbekistan. Thus one of the “hot” topics of the meeting was compliance with protective measures in the face of the pandemic.

Online course: “Sustainability and Survival: Resilience for civil society organisations working with key populations in Central and Eastern Europe and Central Asia”

EHRA invites you to apply for the online course: “Sustainability and Survival: Resilience for civil society organisations working with key populations in Central and Eastern Europe and Central Asia”.

This collaborative and interactive skills development course is specifically designed for non-profit, civil society and community-based organizations from countries of the CECCA region, that advocate and/or provide direct services for key populations.  The course will help you, as a CSO or CBO working with key populations, to acquire skills and confidence for organisational resilience and a more diversified and sustainable funding model. By the end of this course, we expect you to be better equipped the challenges of the current and future evolving funding environment.

Specifically we will be supporting you in:

  • Strengthening the effectiveness and resilience of your organisation;
  • Development of the strategy and plan for sustainability and piloting specific income generation approaches;
  • Ensureing that your income generation streams and targets are aligned with organisational strategy, and respond to the current funding environment that you are facing;
  • Compareing the characteristics of a range of new income sources and analysing their potential fit for your organisation (e.g. crowdfunding, social enterprise, membership models, social contracting);
  • Facilitation of creative approaches to income generation with your colleagues.

The course offers the chance to join three 3-hour live and interactive online training workshops which will take place on June 1, 4 and 9, to view a series of webinars in your own time, and to undertake exercises to embed the learning between events. You will also have a mentor, who will be able to support you to practice and implement the learning, through a project of your choosing. Certificates will be issued to those that complete the course.

The course will be delivered in English and Russian language.

Authors of the course:  Anya Sarang, Dermott McDonald, Rachel Haynes, and Victoria Ireland.

Trainers of the course: Masha Plotko (EHRA) and Rachel Haynes

Сourse materials could be found HERE.

Who can apply? The programme is open to officially registered civil society / community-based organizations working with or for key communities (people who use drugs, men who have sex with men, LGBTQI+, sex workers) or people living with HIV, operating in one of 29 CEECA countries.

Participants must be employees of these organisations, that have been involved in one or more income generation activities of the organization. You must be able to commit  to the course in June and must be able to speak and write in Russian or English.

If you would like to participate, please complete this online survey by May 28. We will be letting you know if you have a place by May 31, 2021.

PLEASE NOTE: Participation in the course is free. The number of seats is limited to 10 organizations, 2 people from each organization (program and financial). The selection of participants will be on competitive bases, based on the quality of completed applications. Filling out the online survey does not guarantee participation in the course. We will inform you about enrolment in the group by May 31, 2021.

The course is delivered in the framework of the Eurasian Regional Consortium project “Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services”, funded by the Robert Carr Fund for civil society networks.

Extended: Terms of Reference for the EECA Regional Platform sub-regional Focal Points to help generating the CRG Technical Assistance Requests


Since 2017 Eurasian Harm Reduction Association is being the host of the EECA regional Platform for Communication and Coordination. One of the EHRA responsibilities in its role as EECA Regional Platform is to promote the Global Fund’s Community, Rights and Gender (CRG) Technical Assistance Technical Assistance Program among civil society and communities’ representatives involved into the Global Fund related processes in EECA countries.

To better motivate and support CSOs and CBOs in the region to use the Technical Assistance (TA) available within this Program in 2021, EHRA is planning to sub-contract 4 experts to serve as the sub-regional EECA Regional Platform Focal Points aimed on generating the demand for the Global Fund’s CRG TA.

EHRA is looking for the experts to serve as the EECA Regional Platform Focal Points in the following 2 sub-regions: Caucasus (Armenia, Azerbaijan, Georgia), and second block – Belarus, Moldova, Russia, Ukraine.

Key tasks to be conducted by the consultants

 Each expert selected to become the EECA Platform CRG TA Focal Point is expected to assist the civil society and communities’ representatives in relevant sub-regions in development and submission of at least 3 successful requests for the CRG TA per sub-region in 2021 (1 per quarter on average).

The CRG TA Request to be considered as successful if it is approved by the Global Fund’s CRG Department for TA provision.

In particular, the EECA Platform CRG TA Focal Points are expected to:

  • Initiate a dialogue with the civil society and communities’ representatives involved into the Global Fund related processes in each county of the selected sub-region about the opportunities available within the CRG TA Program.
  • Provide the civil society and communities’ representatives with all relevant information about the Global Fund CRG TA Program if needed.
  • Help the civil society and communities’ representatives to identify their needs for such TA, including identification of the potential problems which may need to be addressed, formulation of the objectives of such CRG TA in the context of the identified problems, as well as identification of the activities needed to be implemented as a part of the TA to address the identified problems and reach the set objectives.
  • Help to ensure the coordination of the content of the TA Requests among the key national civil society stakeholders, CCM and Fund Portfolio Manager before its submission.
  • Review the content of the draft TA Requests before the submission, help with its finalization if needed.
  • Help to follow up with the GF CRG Department on the results of the TA Request consideration.

 Online training on the key aspects of the CRG TA Program will be provided for the selected consultants by EHRA at the beginning of March.

Also, the EECA Platform CRG TA Focal Points will be expected to do the mapping of the civil society and community-based organizations being the principal, sub and sub-sub-recipients of the Global Fund HIV and TB grants in all countries of the relevant sub-regions, where the Global Fund programs are implemented. The template Excel form for such mapping will be provided by EHRA.

Deliverables and Time frame

 3 CRG TA Requests per each sub-region being developed, submitted with the support of the EECA Platform CRG TA Focal Point and approved for the TA provision by the Global Fund CRG Department in 2021.

Mapping of principal, sub and sub-sub-recipients of the Global Fund HIV and TB grants in the countries of relevant sub-regions conducted.

Cost of services and payment order

 Payments will be done for each successful CRG TA request being generated with support of the EECA Platform CRG TA Focal Point – 700 USD per TA request (not more than 3 requests per sub-region altogether in 2021). Of this amount 350 USD will be paid after the fact of the submission of the TA request is confirmed, and other 350 USD will be paid after the request is accepted and approved for TA provision by Global Fund CRG Department. In case the TA request is rejected by Global Fund CRG Department – the second half of the 700 USD will not be paid to the Focal Point.

Also, 300 USD to be paid after the submission of the result of mapping of CSOs and CBOs – PRs, SRs and SSRs of the Global Fund grants in all countries of the relevant sub-region, where the Global Fund programs are implemented.

Payment should be executed for the completed services after receiving invoice and act of service rendered.

The total contract cost for the work of one consultant under this ToR in 2021 should not exceed 2 400 USD (including all taxes).

Evaluation Criteria

An evaluation panel will assess the extent to which proposals submitted in response to this announcement meet the evaluation criteria below.

The minimum technical score is 90. Only candidates with a minimum score of 90 points out of a maximum of 100 are considered eligible for the assignment. Consultants with proven work experience in the community organization would be given a priority.

The candidates with the highest technical score that meets the requirement will be invited for negotiation of the agreement.

Criteria Weighting
Good understanding of the Global Fund CRG TA Program (should be clear from LoI) 25 points
Knowledge of, and access to the relevant civil society stakeholders involved into the Global Fund related processes in the countries of the particular sub-region as well as established contacts with the GF Secretariat (regional team and CRG Department in particular) (should be clear from LoI) 25 points
Experience of undertaking similar TA related assessments or other relevant work experience (should be clear from CV and LoI) 25 points
Proven set of communication and writing skills (should be clear from LoI) 25 points
Total 100 points

Additionally, the consultants should have:

  • No conflict of interest (should be declared in the Letter of Interest);
  • Fluent English and a language most relevant for the sub-region the expert is interested to work with.

How to apply

 The individual consultants are invited to submit their CV and the Letter of Interest (LoI) by e-mail referenced under the title “EECA Platform CRG TA Focal Point for [name of the sub-region you are interested to work with]” to by COB 21 April 2021 24:00 EET.

New words in 2020

Looking back over the past year, the Eurasian Harm Reduction Association has found that several words have become solidly integrated into everyday use.

We have learnt a lot this year and we have a lot to look forward to in the New Year, 2021. You can call us eternal optimists, but we believe that we will make it through the difficulties, safe and strong! May we all have a strong spirit and new achievements!

This year we really want to greet everyone personally and wish something unique and unusual. We have hidden our wishes in a gift, and it takes only one click to receive it!

In progress: Drug consumption rooms in Croatia


Life Quality Improvement Organization “FLIGHT” or just “FLIGHT” (in Croatian: LET) was registered in early 2003 and has been implementing needle exchange programs since its beginning. Besides direct work with people who use drugs, FLIGHT was always focused on promoting the effectiveness of harm reduction programs, conducting research, developing publications, working at EU level at number of networks, including the EU Civil society Forum. FLIGHT is the only organization providing programs for sex workers, twice per week at night hours in the center of Zagreb.

Organization has 4 staff members, including two social workers and two outreach workers, and has been implementing so called mobile outreach (with two vehicles) and has established 22 sites where users can come and exchange their used needles and syringes with the new ones, as well as ZAGREB ZOVI- where we deliver syringes to the users that live outside of those 22 sites.

Could you please share, why you decided to focus on drug consumption rooms as harm reduction service in Croatia?

Drug consumption rooms were included as a possibility or one of the measures in the National guidelines on harm reduction. So, we thought that now was a great moment to work and develop more detailed information on it, because governmental bodies are planning a review of the guidelines. And it would be great if drug consumption rooms are better explained in the guidelines.

During the project, you conducted a needs assessment among PWUD in Croatia. Could you please share the main results from this assessment? How people are reacting to the suggestion to start opening DCRs in Croatia?

We collected responses from 120 people who use drugs from 5 cities. Most of them are in favour of safe injecting rooms. During needs assessment, 80% of them answered that DCRs are needed. What is more, they would like additional services to be provided in DCRs, such as: opportunity to get a coffee or soup. Also, it would be useful to have an access to psychosocial counselling. The only issue, that might occur with opening the site is the local neighbourhood and its residents, who wouldn’t be happy about DCR.


Another activity which was implemented by you – development of the policy paper on safe consumption rooms. Could you please share what this policy paper includes and for whom it’s developed?

This policy paper provides answers if DCRs should be opened in Croatia and what are the main obstacles. It includes a theoretical basis about injection rooms, data on injection rooms in Europe, analysis of legislation, and recommendations for further work. It will be used for the development of new Guidelines on harm reduction in Croatia. The policy paper will be presented to representatives of national and local authorities to raise the issue of DCRs opening.

Are there any legal barriers to open DCRs in Croatia? If yes, could you briefly share what they are, and are there any possibilities to overcome it.

According to the existing criminal legislation in the Republic of Croatia, it is not possible to implement a harm reduction program that includes the establishment and operation of drug injection. Criminal Code, Article 191 criminalizes venues that enable consumers to use drugs. We were working together with a lawyer in producing the analysis and came to conclusion that there are two options: 1) an Ireland model- they made a lex specialis on DCR in 2017 or 2) change the Criminal code (Article No. 191)- where the questionable issue in providing the venue for injecting is raised. In that specific article all types of assisting in injecting drugs are mentioned and some would argue that even existing needle and exchange programs are illegal, there has been a national consensus since 1996 that giving new equipment to users wouldn’t be seen as assisting in drug use. There are adjusting national documents such as strategy on drug abuse and HIV prevention that mention harm reduction in a positive manner. But the issue of “venue” remains problematic.

What do you think should be the next steps in starting/ promoting safe consumption rooms in Croatia? And what should be civil society’s role in all this?

We need to continue to lobby and raise awareness on the positive aspects of the DCRs. NGOs that implement harm reduction programs are very important in raising awareness and educating other stakeholders.

We have updated the website as well as our main website and will continue to promote the need for DCRs. Policy paper and leaflets will be available for raising awareness and I will be speaking at the national conference and presenting the work we have done with support from the Robert Carr Foundation and EHRA.

We have now access to international documents provided by our international speaker at the conference and desk review we did.As each developmental project it might take time to open a DCR but at least we have a good starting point:

  1. Users are eager and would like this kind of service
  2. Analysis was provided and will be included in the National guidelines on harm reduction
  3. Capacities of FLIGHT and BENEFIT organizations have been developed and
  4. We are talking and promoting harm reduction and its efficiency.

Text me on Telegram: online peer-to-peer consultations in Kazakhstan

Forum of people who use drugs (PWUD) Kazakhstan

Forum of people who use drugs (PWUD) Kazakhstan is a civil forum, a community of people who use drugs and their supporters, activists and experts in the field of drug policy, who areunited by  common goals and interests. The mission of the Forum is to mobilize people who use drugs for joint action and structural changes in Kazakhstan drug policy in accordance with the interests and needs of the PWUD, based on standards of human rights and fundamental freedoms, as well as standards of medical care and social support for the PWUD recommended by the World Health Organization (WHO). Currently, the Forum has 21 people - these are activists from 7 regions of Kazakhstan.

How did you decide to focus on the topic of peer-to-peer consultants? Why is this topic relevant in Kazakhstan?

Starting from 2014, there is a growth of the NPS market in Kazakhstan. Compared to other Central Asia countries, Kazakhstan has the highest number of NPS reported. More about NPSs in Kazakhstan can be found in the report “New psychoactive substance use in the Republic of Kazakhstan: Research results.

Most harm reduction services in Kazakhstan are oriented at opiate users, although the drug scene is changing: the opiate market is slowly disappearing. As a result, fewer people with opioid dependence are registered each year, while NPS appear on the market. With the changing drug scene, outreach work to support people with opioid dependence has become less effective.  Activists from the community of PWUD in their 30s are those who have been clients of harm reduction programs and started to use synthetics. Young people aged 12-30 who have never tried opiates now snort and smoke, prefer to smoke NPS, and mix substances with tramadol and stimulants (part of this group are directly related to darknet advertising, distribution, etc.) and then switch to injecting.

No one in Kazakhstan has previously implemented projects aimed at supporting people who use NPS in the online platforms. This topic was also new for us, but we already had little experience in consulting people who use NPS on social networks (Telegram) as volunteers in darknet. The project became an opportunity for us to do it more professionally and qualitatively with the ability to pilot its results to all interested parties to expand the package of services and subsequent implementation of the online consultation componentfor PWUD at the country level.

What is an online peer-to-peer consultation? How does it work? Tell us more about how you do these consultations.

Online peer consultation is the work in a variety of online formats:
-publications, posts with information on safe drug use that we collect and prepare ourselves (types of NPS, characteristics, effects, consequences of use; poly-drug use);
– thematic photos, GIFs, videos;
– trip-reports (when people share their personals stories related to substance use). It is a great  material, and it is always interesting to read it. It can also inform people about the negative consequences of using a substance they are trying for the first time;
– peer-to-peer psychological support is a support without shaming or blaming person, with the opportunity to share personal experience;
– referral to specialized professionals (psychologist, addictologist, infectious diseases specialist);
– online lawyer of the Forum of PWUD Kazakhstan;
– consultations on HIV/ AIDS, hepatitis, STIs;
– HIV testing;
– consultations on access to social and medical services;
– informing about the activities of PWUD Kazakhstan Forum, ENPUD, EHRA – organizations that support PWUD in the region;
– invitations to participate in open discussions, online webinars for PWUD;
– invitation to participate in the campaigns with the international community of PWUD;
– referrals, accompanying, personal face-to-face meetings;
– thematic surveys (HIV, hepatitis, on the content of the channel).

What problems did you face, when you started to provide online consultations?

The difficulties that we faced, when we started to provide online consultations are the distrust and closeness of users of Telegram channels. Even now for people who use NPS it is difficult to trust and understand that there are people in Kazakhstan, who are providing harm reduction services, who are openly speaking at one’s own risk about themselves, their experience of drug use, and support you psychologically. The difficulty is in the communication and personal contacts because some help implies private meetings, for example, social accompanying, and this kind of activity is excluded by the rules of Telegram users.

Only few people contacted the project lawyer. According to the results of a face-to-face survey, we realized that people simply do not trust such a service. It is something new for them, and it is difficult for people who use drugs to talk to a person with a legal background about personal use or to solve similar issues.

Please share your achievements in this small grant.

One of the most significant achievements of the project was the launch of three Telegram channels, where around 400 people subscribed. These are people who receive information on harm reduction,, what to do in case of overdose, receiving social, medical and legal assistance. The most important thing is that in case of any problems they know where and whom they can ask for help or advice.The audience also participated in two campaigns: on August 31 in the World Overdose Awareness Day and Support Don’t Punish (World Drug Day).

Users have also noted the value and necessity of the publications in the channels, as well as the existence of such content and the service in general.

Medical workers, the expert community, GFATM, representatives of international organizations in Kazakhstan also share this opinion. At the moment the information about piloting the service online – consultations were presented on two platforms, where all interested state parties (Kazakh scientific center of dermatology and infectious diseases, Republican Scientific and practical center of mental health,, CCM, etc.) and international organizations (UNAIDS, UNODC, GFATM, etc.) were present.

We mastered the skills of running Telegram channels, learned how to work through bot-support, and learned a lot of useful information while compiling and selecting material for publications. We gained experience in creating promotional materials focused on the needs of the community of people who use NPS.

Consultations and support for people who use NPS is also a new experience for us, and we are pleased with the result we got. Acceptance and trust is the most important thing.

Now that the project is over, people from other regions have joined the channels, and one of them asked us for support. Our consultant helped us to create a channel, and now we have another additional resource where we can talk about harm reduction.

Your recommendations for donors/government to promote this approach. What are the next steps?

  1. The Forum has planned further steps to improve and expand online services. For example, attracting funds to provide services of addictologist, psychologist, distribution of informational material on harm reduction. We submitted one grant application, now we are waiting for the results.

-Technical support (laptops, software to work with video, create promotional materials, etc.) is needed for the implementation of such projects;
– educational pieces of training, offline seminars;
– capacity building of the team, psychological support for online consultants;
– development of a security plan with the involvement of specialists as NPS attracts the attention of the police;
– organizational and personal security;
– IT security
– contacts of friendly lawyers, psychologists

  1. There is a need for intensive outreach work with NPS users. Access to prevention programs for new people will become more effective if information about services will be disseminated through Internet resources, pharmacies, mobile sites, nightclubs.
  1. It is not known precisely how many people are members of groups where sexual contacts are connected with the use of NPS. It is worth noting that offers of substance use in exchange for sexual services for girls are common in Тelegram channels. This type of “leisure” is popular.

The risks of HIV infection and other STIs are increasing significantly. Therefore, it is necessary to develop services aimed at the sexual and reproductive health of women who use synthetic substances, involving medical specialists (gynecologists, dermatovenerologists). It is essential to educate project consultants on specific topics of counseling, to provide lubricants, female condoms, etc. in larger quantities.

  1. Creation of an international online platform for communication on harm reduction for NPS users:

– Implementation of projects towards online consultation on NPS (sharing experience)
– Mobilization and support for people working with NPS issues
– trainings
– development of new concepts, plans, materials on NPS

Harm Reduction in Eurasia 2020 published in Russian

November 27, 2020, Vilnius

The Eurasian chapter of the Global State of Harm Reduction 2020 was presented and published today in Russian language.

This is the seventh edition of the Global State of Harm Reduction Report 2020, prepared by the Harm Reduction International, now in the year when public health took a leading position in the world news. COVID-19 and response measures introduced around the world continue to disrupt our lives. The report provides the most up-to-date information on existing programs, the situation with HIV, viral hepatitis and tuberculosis among people who use drugs, as well as analysis of harm reduction programs in the context of the COVID-19 epidemic. The parts of the report describing the situation in the Central, Eastern Europe and Central Asia region were gathered and summarized by the Eurasian Harm Reduction Association (EHRA).

A short summary of the report is presented to the public during an online discussion today. In total, the region is home to approximately 3 million people who inject drugs, 66% of whom are living in Russia and 77% in Russia and Ukraine together.

Syringe exchange programs operate in 27 of the 29 countries in the region, except Turkmenistan and Bulgaria. Unfortunately, the programs experience problems in many countries, particularly with sustainable funding, especially in transitioning from donor to domestic funding sources. The report shows challenges in unit cost, scope and quality of harm reduction services over the past two years.

Opioid Agonist Treatment (OAT) programs are implemented in 26 of the 29 countries in the region, except Russia, Uzbekistan and Turkmenistan. Unfortunately, we can state that most people who use drugs in the region live in countries where OAT programs are prohibited. In the transition of OAT programs from donor support to domestic funding, the biggest challenges are the availability and coverage, quality, and sustainability of program funding.

The key problem areas for harm reduction implementation in the CEECA region are as follows:

  • Criminalization
  • Decrease in funding
  • Lack of political support
  • Pressure on civil society

As a result, we see low coverage of harm reduction services and poor quality of programs.

The report provides detailed information on the situation with HIV, TB, hepatitis, and COVID-19 response programs for people who use drugs in the CEECA region. It provides an analysis of the programs, as well as challenges in accessing services.

The report provides an opportunity to learn about innovative harm reduction practices being implemented in the countries of the region. Substitution therapy for amphetamine users, kits for smoking and oral use, drug checking, safe consumption rooms, harm reduction for women who use drugs and for new psychoactive substance users, as well as for those who use drugs in Chemsex practices (LGBTQI, sex workers) are all being actively implemented in the region by the community- and harm reduction organizations.

EHRA sincerely thanks its colleagues who helped us prepare this report through individual interviews and verification of data from countries and the region.

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Review of harm reduction programs in the situation of the COVID-19 crisis in 22 CEECA countries is published

In most countries of the CEECA region, opioid substitution therapy (OST) and sterile needle/syringe programmes (NSP) – key components of an evidence-based and comprehensive harm reduction (HR) programme – continue to operate under COVID-19 quarantine measures. Such work requires flexibility, readiness for mutual partnerships and strong advocacy by community and harm reduction activists. Unfortunately, the practice of amnesty of prisoners for drug-related crimes because of COVID-19 quarantine requirements has not been implemented in the region.

Key changes in harm reduction services include the following:

Provision of takehome OST. For many countries of the region, OST medications have been made available to take home for the first time, for periods of 5 to 14 days and sometimes up to one month. The opportunity to get take-home OST (both buprenorphine and methadone) became available to all clients in every country of the region except for Azerbaijan, Belarus and Kazakhstan. Initially, there were difficulties in some countries in enrolling new clients onto such programmes. Some countries developed partnerships, such as mobile outpatient clinics, to deliver OST medications and, often, together with antiretroviral therapy (ART) drugs to clients in remote locations.

Harm reduction works remotely. In all countries of the region, organisations have managed to deliver a range of commodities such as– sterile needles and syringes, masks, disinfectant, hygiene materials, naloxone, tests, and information materials for people who use drugs (PWUD). As a result of the restriction in movement caused by COVID-19, such service providers have found it necessary to deliver sufficient supplies at one time to cover the needs of an individual for 1-2 weeks. Often, materials are provided by mobile outpatient clinics, including social workers delivering such assistance by use of their own car or through use of a courier. Organisations have arranged online counselling for clients and, wherever possible, HIV testing through self-test kits delivered to clients. In providing such remote services, social workers and psychologists have needed to urgently develop additional skills and the management of organisations have had to introduce a flexible system of monitoring for the new service modalities.

Providing the essentials – food and shelter. For a large number of problematic users of psychoactive substances, quarantine restrictions and curfews have restricted access to temporary accommodation and made it impossible for them to earn money to find drugs. Responding to such basic needs, some organisations have re-planned budgets (as has been the case, for example, for EHRA members in Czechia, Kazakhstan, Montenegro, and Slovakia), or organised crowdfunding campaigns to be able to feed those in need (as undertaken by the Pink House in Bulgaria). In some countries, partnerships have been established to make it possible to provide shelter to PWUD and women who are victims of violence. In Azerbaijan and Kazakhstan, harm reduction organisations have helped their clients to receive specific assistance for unemployed people in connection with COVID-19.

Partnership in the integration of services. In most countries, the crisis situation has prompted medical centres and non-governmental organisations (NGOs) of various types to partner in the daily provision and delivery of necessary preventive materials, substitution therapy and ART drugs, and food supplies to clients, especially in remote areas.

Flexibility of services in response to changes in the drug scene. Due to the closure of international borders as a result of COVID-19, the drug scene has changed in many countries, with access to some drugs becoming more difficult, resulting in people having to use everything that they can find, including various prescription drugs mixed with alcohol. Many clients need advice to reduce harm in using new psychoactive substances (NPS), as well as help to prevent overdose. In some countries, such as Kazakhstan, Lithuania, and Serbia, such consultations are already under development. In Prague, because crystal methamphetamine is less available, community organisations have pushed for the introduction of substitution therapy for stimulant users.

Risk of service interruption due to deficiencies in the supply chain. The closure of international borders has also led to a disruption in the supply of substitution therapy medications in Moldova; similar risks exist in other countries. In addition, government authorities responsible for OST and other harm reduction programmes in several countries have not issued a tender for the purchase of medications from public organisations providing harm reduction services; this is particularly critical in Bulgaria and Montenegro.

As Ala Iatco, the EHRA Steering Committee member from Moldova, has noted: “Now we need to transform the harm reduction system. In different countries, the situation is different and depends on many factors, but the pandemic is not only a crisis but also a chance to move new services forward.” Online discussions organised by the Steering Committee of the Eurasian Harm Reduction Association (EHRA) were held between April 14 and April 23, 2020[1], with 51 members of the Association in seven sub-regional groups concerning the state of harm reduction programmes during the COVID-19 pandemic in 22 countries of the Central and Eastern Europe and Central Asia (CEECA) region. During discussions, members of the Association identified the main tasks of national and regional advocacy to overcome the crisis at the national and regional levels.

[1] Information was also updated as of 19 May 2020.

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