Author: Ganna Dovbakh, EHRA Executive Director
The International Harm Reduction Conference (HR19) is like a family gathering for us – it’s a regular occasion that we are looks forward to. We are getting ready for it, gathering news to share and dressing up because everyone will be there. New members who only just joined (we need to get to know each other, find common topics of conversation), as well as those we’ve known for a long time, those who only need a supportive hug like “Hang in there, brother, we’ll get through this! Proud of you, sister!”. This event can only nominally be used for advocacy because the politicians, scientists and officials who attend are mostly “our people”. They are instrumental in developing the strongest arguments for the importance of investing in harm reduction and reforming drug policy. Majority are there to share practical approaches, how they developed it, piloted and what recommend for other countries. The three days of the conference encompass everything from birth and love to death.
HR19 was very timely, taking place only a month before EHRA’s strategic planning started. It generated several important ideas not just to mull over or bemoan, but to decide what to do about them in our long-suffering post-Soviet region. I want to share my thoughts here to explore them and to encourage you to reflect on them.
- Populism is sweeping the planet
It’s no secret that it’s populist politicians who win elections all over the world. It’s simple – pick a few slogans that would appeal to more than 90% of the population and faithfully promise to fulfil them all (it doesn’t matter if they’re out of your competences, unachievable or would be plain harmful to the country). The majority of population usually support very simple ideas:
– I must hold onto my resources (not share it with poorer territories or groups);
– My country is for me (not for migrants, outsiders and misfits);
– I want higher income and lower spending, and
– I want to feel proud and important.
Populists have no ideology. They include these simple ideas in their campaigns, come up with catchy brands and slogans (like “Brexit”, for example – it’s punchy and simple, and no one even remembers “Remain”), and come to power. After that they must deliver on at least some of their promises. The economic aspirations often prove unrealistic but social policy is one area where it’s possible to exhibit strength and integrity. Marginal groups are minorities, sometimes less than 1% and politicians could scarify them as not an important group of voters. That’s when legislative initiatives to limit immigration, repressive drug policy or step up the fight against the so-called “promotion of homosexualism” appear. That’s when populism becomes extremely dangerous for people, for social policy like drug policy and harm reduction services. The masses like slogans about finally putting an end to the problem of drug use, about the need to rehabilitate or jail all the “problem” people. Our region has no tradition of democracy or tolerance towards different ways of life and as a result populism may lead to harassment and persecution.
In such circumstances, as Magdalena Dabkowska perfectly put it, public organizations either fight to the last, hide or unite.
We already work well together with LGBT people, sex workers and people living with HIV. We share their vision of threats and goals (as, for example, in the public campaign for decriminalization – http://chasevirus.org/). But this is clearly not enough. We need to get in touch with other “ghettos”, with those whose principles and goals are in tune with ours, with those for whom populism is just as dangerous. Feminist movement, migrants rights protection movement, human rights activists, groups fighting for transparent budgets, democratic elections, inclusive schools and cities. Most likely, their knowledge of drug policy and harm reduction is as superficial as that of the general population, and most likely they don’t want to be associated with those issues. But we should all unite in the face of the common threat.
Here’s the famous quote of the pastor Martin Niemöller:
“First they came for the socialists, and I did not speak out—because I was not a socialist.
Then they came for the trade unionists, and I did not speak out— because I was not a trade unionist.
Then they came for the Jews, and I did not speak out—because I was not a Jew.
Then they came for me—and there was no one left to speak for me”.
It’s clear that if we don’t speak out about the Istanbul Convention, if we don’t support the LGBT rights movement, then very soon the response to HIV and provision of services to people who use drugs will stop being a health and safety issue but become an issue for political opposition.
- «There’re only a few of us left, us and our pain…»
At the political summit organized by UNITE before the conference, Miriam Aroni Krimsky, director of Fair and Just Prosecution from the United States, said: “I feel less depressed in comparison of US with other countries. Misery does love company.”
The key question now is – who can be our ally when we demand a drug policy reform or funding for harm reduction? There is a field that we’re already familiar with. At the conference, we talked a lot about ways to convince HIV/AIDS or TB specialists that a change in drug policies is vital for effective implementation of health care programs for people who use drugs. Feminists can be our allies. Not all of them understand the problems faced by women who use drugs, but the 120 organizations that signed the Barcelona Declaration on #Narcofeminism are a great force.
The conference saw several inspiring sessions which highlighted the need to build relationships at the national level with child protection services and social services, with shelters for women who suffered violence. Because for now the unfortunate narrative is like “Using drugs? Do not dare give birth and raise children!”. This is the cruel message sent by governments of our region to every woman who uses drugs through social security and health care system. Violations of the reproductive rights of women who use drugs in Estonia, Russia and the eastern oblasts of Ukraine were summarized for the HR19 participants by Dasha Matyushina, EHRA’s associate and expert and adviser to UNAIDS. (https://www.facebook.com/EHRAssociation/videos/287907672152813/)
We’ve also gained new allies in the form of prosecutors. The law activist from the United States mentioned above spoke about her experience in persuading young prosecutors to introduce alternatives to imprisonment: “Our experience shows – prosecutors and law enforcement could bring public health understanding into court instead of idea of imprisonment. We need to bring prosecutors at the table with community, those who have lived drug use experience”. With prosecutors come lawyers. I’m not at all sure that all the lawyers in our region who handle drug-related cases are aware that the law allows referrals to substitution treatment and other forms of social assistance.
What message are we sending to our allies? It’s absolutely clear that it’s not about help or pity, it’s about making governments stop preying on peoples’ lives and ruining them. Members of Parliament from different countries talked during the conference and came to a common understanding: «Decriminalization of drug use and possession is needed, but it is not enough. In many countries decriminalization is on the paper, but people are living in harsh policy on the street. In reality, decriminalization could lead to serious penalizing of people with fines so high that it ruins families and peoples’ lives».
3. «Zina, where’s the money?»
The situation with funding for harm reduction around the world is critical. About 2/3 of the total funding comes from the Global Fund to Fight HIV, Tuberculosis and Malaria. While funding for programs in middle income countries (according to the World Bank classification) is gradually being reduced and withdrawn, the only hope rests on the countries themselves, on national and municipal funding. There were quite a few pessimistic presentations given at the conference because there had been reluctance on the part of decision-makers to allocate funds for harm reduction.
We’re often told that the government has no money for harm reduction. That’s not true – it does. At the conference, EHRA shared the findings of a study on the cost of criminalization. The findings suggest that if the state provided people who use drugs with harm reduction services such as substitution therapy, counselling provided by peer community members, and help with employment and reintegration instead of imprisonment, it would save a significant amount of public funds. The data was gathered in 26 countries of the region. It can help harm reduction activists in their advocacy effort because it supports the argument that keeping a person in prison costs more than providing them with harm reduction services. In some countries the cost of imprisonment is 2, or 4 and even 11 times higher than the cost of health and social services.
Even if the state starts paying for harm reduction services, as is already happening in Kazakhstan, Ukraine, Georgia, Moldova, it’s unlikely to fund advocacy efforts. Only genuine democracies can afford to pay for something that may be critical of them. In our case, advocacy groups and community organizations have to fight for their survival. Some pharmaceutical companies understand the role community plays in changing the market for their products and therefore are ready to support advocacy. This is quite common in European countries even though it’s associated with a difficult moral choice. Each organization need to choose how to be independent in their advocacy agenda if pharma as donor will demand or kindly ask to correct something in it. We have yet to make that choice.
There are still a few private foundations that support harm reduction and advocacy in our CEECA region. Among them is the Elton John AIDS Foundation that has now begun to allocate substantial resources for the HIV response among affected groups. We hope that this and other private foundations won’t stop at financial support but will also speak loudly and proudly about the harm reduction programmes.
- We need to fix harm reduction
The issue of quality has now become the cornerstone of harm reduction services in the countries where harm reduction is supported by the state or the Global Fund. Ambitious goals are set for coverage with the cost per client below minimum. Comprehencive consultations with a social worker, support with necessary legal documents, counselling and legal support have long been considered a luxury. The situation when sticking to a indicators and meeting the targets are more important to an organisation than supervising consultants and searching for the best ways to help people who use drugs has become the norm. Everyone understands that people with addiction need a safe space where they can have a cup of tea, have something to eat, wash, rest, use a drug without risking an overdose. However, this level of service has almost become a thing of the past and is perceived now as the “golden age” of harm reduction.
What technical help do we need to fix harm reduction? How do we agree on the criteria for the proper, real harm reduction, especially for the most affected groups, the 10% who need not just a syringe but social help and therefore are difficult to reach?
As new drugs appear, the principles of harm reduction based on non-judgemental help remain unchanged. What has to adjust is the information – we need to educate about the risks the new drugs usage, we need to be able to check what’s in the drug and provide other ways to use safely. For me personally one thing has become clear following our discussions – flexibility and adaptability to people’s needs are the main criteria on which we can judge the quality of harm reduction services. It’s very important to set our professional criteria for harm reduction now. We, as a regional professional association for harm reduction, will be able to use them to improve the quality of our own work.
Renardo Batista Leir, a Portuguese MP, put it very well at the opening of the conference: “Harm reduction and true love are similar – they must be unconditional in order for them to work.” And it sounds like a good slogan to support each other on our difficult path.
 Thanks to Dasha Matyushina for the phrasing.
The Eurasian Regional Consortium invites you to fill in forms to take part in the call for proposals to receive small grants for community-led monitoring of service quality and satisfaction.
The call for proposals and the workshop to develop the skills and knowledge in monitoring of service quality and satisfaction are organized with financial support of the Robert Carr civil society Networks Fund (RCNF) within the project “Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services”.
The Eurasian Regional Consortium joins the efforts of the Eurasian Coalition on Male Health (ECOM), the Eurasian Women’s AIDS Network (EWNA) and the Eurasian Harm Reduction Association (EHRA) to effectively address the lack of financial sustainability in prevention, treatment, care and support programs for the key populations vulnerable in terms of their rights violation and the risk of HIV.
Activities of the Eurasian Regional Consortium within the Project: Learning cycles of the Project implemented by the Eurasian Regional Consortium are composed of five interlinked thematic areas: Organizational sustainability; Building broader coalitions for budget advocacy; Community-led advocacy for comprehensive quality standards for HIV services based on national needs and international recommendations; Budget monitoring and accountability and Community-led monitoring of quality of services.
1. Within the Project component “Community-led monitoring of quality of services”, the Eurasian Regional Consortium 1) organizes a workshop, and among the workshop participants 2) initiates a call for proposals for small grants to conduct research studies.
The workshop for community-led organizations is organized to provide the tools and develop the skills to conduct community-led monitoring of service quality and satisfaction. During the workshop, research developers and practitioners will share their expertise and train the participants how to use the following monitoring tools:
- “Secret client”, adapted for assessing government services by the Eurasian Coalition on Male Health
- “Access to sexual and reproductive health services”, developed by the Eurasian Women’s AIDS Network
- “Community-led monitoring of the satisfaction with OST programs”, developed at the request of the Eurasian Harm Reduction Association.
Quotas. The expected total number of workshop participants is 18 people, with equal quotas for each community:
- 6 people representing the community of people who use drugs/OST participants
- 6 people representing the community of gay/bisexual men/trans people
- 6 people representing the community of women living with HIV and vulnerable to HIV
Working languages of the workshop: Russian and English, dates July 3-4, 2019
2. The call for proposals for small grants will be initiated among the workshop participants.
The goal of the call for proposals: ensure practical use of the acquired skills for the community-led monitoring of service quality and satisfaction. Six grants will be awarded. The total budget of the call for proposals is USD 35,000, with the maximum amount of one grant being USD 5,800.
Quotas. The following quotas are set forth for each of the communities:
– 2 grants for the community of people who use drugs/OST participants;
– 2 grants for the community of women living with HIV and vulnerable to HIV;
– 2 grants for the community of gay/bisexual men/trans people.
Criteria to select grant recipients:
- The group/organization is delegated by, accountable to and led by one of three above-mentioned communities.
- The group/organization has an experience of organizing/participating in research studies.
- The group/organization has an experience of advocacy through the government decision-making mechanisms.
- The group/organization operates in one of 16 countries: Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Montenegro, Northern Macedonia, Russia, Tajikistan, Turkmenistan, Ukraine or Uzbekistan.
- The applicant presents a clear and specific plan/budget describing the use of grant funds as per the goals of the call for proposals.
! All other things being equal, preference will be given to the groups/organizations, which are active members of EHRA, ECOM and EWNA.
Each proposal will be considered by secretariats of the organizations, which are members of the Eurasian Regional Consortium, and the decision on composition of the workshop participants will be taken considering the agreed quotas.
If you meet the above-mentioned criteria, please fill in the form to confirm your intention to conduct community-led monitoring of service quality and satisfaction.
Deadline. The proposals will be accepted by 23:59 on May 29, 2019 (Vilnius time).
Till June 5, 2019, the members of the Eurasian Regional Consortium team will contact you: ECOM – Paata Sabelashvili firstname.lastname@example.org, EWNA – Svetlana Moroz email@example.com and EHRA – Olya Belyaeva firstname.lastname@example.org.
On 6-20 May, 2019 EHRA conducts online General Meeting of its members. During those two weeks, all members of EHRA will be voting for two main issues:
- Approval of EHRA financial report for 2018 year;
- Approval of new candidates to EHRA Advisory Board.
WHO HAS VOTING RIGHT IN EHRA ONLINE GENERAL MEETING?
All members (individual and organizational), who are approved by the Steering Committee, can participate in the General Meeting. The list of members eligible for voting you can find on EHRA website: https://harmreductioneurasia.org/membership/ehra-members/
One member shall be entitled to one vote in a General meeting of members.
Supporting members do not have a voting right in the General Meeting.
Details on the voting procedure and participation can be clarified by contacting Eliza Kurcevic via e-mail: email@example.com
Eurasian Harm Reduction Association (EHRA) would like to inform you about the possibility of obtaining resource assistance/funding for initiative groups and organizations of the community of people who use drugs to achieve necessary objectives.
The competition is announced jointly with the Eurasian Drug Users Network (ENPUD). Community expert capacity is a significant resource for EHRA and partners in countries in the processes of organizing, implementing and discussing the results of resource support.
Taking into account EHRA Position Paper on Drug Policy, we are striving to make international and national drug policies recognize the fact that drug use is a complex socio-cultural phenomenon and acknowledge at the legislative level that:
- People use drugs for various reasons, including for socialization or leisure purposes;
- Drug use is not the evidence of mental illness or antisocial behavior in most cases;
- Certain patterns of drug use carry health-related risks, and therefore drug policies should be based on harm reduction principles.
The Eurasian Harm Reduction Association would like to offer its assistance by providing necessary resources to promote humane drug policy, including (but not limited to) four sub-grants for organizations/initiative groups.
Implementation time June – November 2019
Languages: Russian and English
We are going to provide our assistance to: initiative groups and organizations that either have a legal status or not legally registered, managed by the community of people who use drugs.
The total budget for sub-grants is $17,500. 4 groups/organizations will be selected to receive the funding in the amount of 4,375 USD each for a period of 3 to 6 months.
Our approach to grant allocation.
The practical implementation of one of EHRA’s principles – our work starts with a request and ends with the result, requires allocation of resources to implement the activities that have already obtained interim results during the previous allocation period of 2017-2018, as it is possible that further assistance is required in such cases.
In this regard, EHRA uses the following quotas for grant allocation:
– two grants in the amount of 4,375 USD each will be allocated to the countries that have already taken part in the previous allocation period of 2017-2018 so that the activities already started will have a practical effect.
List of the countries and the results achieved:
Belarus – new OST regulation was signed, new services of the OST program are implemented: take-home methadone, out-patient treatment/hospital admission/detention without interrupting treatment. Description of previous activities can be found here.
Georgia – promoting drug policy reform based on previous experience of civil society mobilization. The history of the White Noise Movement can be found here.
Kazakhstan – documentation of the process of expanding OST coverage, advocacy to make the OST program stable in the country; advocacy for implementation of the recommendations received from the UN Committee on Economic, Social and Cultural Rights (CESCR*) on drug policy in Kazakhstan. Description of previous activities can be found here. Here you can find out how the community managed to prevent closing the programs with the help of regional and international funding.
Kyrgyzstan – amendments to the Code of Misconduct as a result of the community-led monitoring of negative consequences. Here you can find out what was done in Kyrgyzstan in 2017-2018 thanks to the resources provided.
Lithuania – drawing attention to the need of drug policy reform in the country, including by promoting harm reduction services during festivals; harm reduction training of night club employees. The experience of the Lithuanian youth movement is described here.
Estonia – advocacy for implementation of the recommendations received from CESCR during the 65th Session on drug policy and HIV in Estonia. Description of previous activities can be found here.
– two grants of 4,375 USD each will be allocated to two organizations/groups in the following countries: Azerbaijan, Albania, Armenia, Bulgaria, Bosnia and Herzegovina, Hungary, Kosovo, Latvia, North Macedonia, Moldova, Poland, Russia, Romania, Serbia, Slovakia, Slovenia, Tajikistan, Turkmenistan, Uzbekistan, Ukraine, Croatia, Montenegro, Czechia.
Deadline for submitting applications: 12:00 am 24 April 2019 GMT+3.
Information on resource assistance for the community
to change drug policy in member countries of the Eurasian Harm Reduction Association
The assistance is jointly provided by secretariats of ENPUD and EHRA as part of the project “We Will Not End AIDS Until We Adopt Harm Reduction and End the War on Drugs” of the International Harm Reduction Consortium, which now involves eight international and regional networks of people who use drugs and harm reduction and drug policy organizations, such as International Drug Policy Consortium (IDPC), European Network of People who Use Drugs (EuroNPUD), Eurasian Drug Users Network (ENPUD), Youth RISE, Harm Reduction International (HRI), Middle East and North Africa Harm Reduction Association (MENAHRA), Eurasian Harm Reduction Association (EHRA), and Women and Harm Reduction International Network (WHRIN).
Here you can find the description of the processes and results of the joint work of the country teams of the movement #Narconomics: from street to government &EHRA & ENPUD & members of the International Harm Reduction Consortium in 2017-2018.
The project was implemented with the support of Robert Carr Fund.
You are free to submit an application for any issue directly related to opportunities to change either your life or the lives of your peers who use drugs. Your application should contribute to the achievement of the objectives of the group/organization in the field of drug policy and available harm reduction services meeting the people’s needs in accordance with the EHRA Position Paper on Drug Policy.
We will do our best to find funding or opportunities to implement the maximum number of grant proposals, if we receive more applications for resource assistance in drug policy than we can actually finance.
Criteria for prioritizing the provision of assistance:
- Evaluation criteria: the group/organization has already collected evidence and data to build the evidence base of the problem – up to 10 points
- The group/organization has formulated its objective for 2019, provided the activities plan and documented its previous actions to solve the problem – up to 10 points.
- The group / organization understands what results it is going to achieve and what actions are necessary to take to do this – up to 10 points.
- Small grant allocation budget provided – up to 10 points.
In turn, EHRA and ENPUD agree to obtain approval from the groups/organizations on the information to be published on the decisions taken, as well as before and during the implementation of the project.
|Activity||Result||Deadline||Person responsible/focal person|
|Call for proposals||Published on the EHRA website and social media||12 April 2019||Igor Gordon, EHRA, Program Team Lead Igor@harmreductioneurasia.org +37063652650|
|Submission of applications from the community of people who use drugs||The full list of received applications provided to the experts||Until 29 April 2019||EHRA, Advocacy manager and an expert on drug users community advocacy firstname.lastname@example.org +37063036691|
|Commission members review and evaluate applications||Commission members provide the evaluation sheet||26 April – 5 May 2019||Team of experts on resource assistance|
|Informing applicants on the results||The list of priority topics for resource assistance is provided, the results of discussions and consultations are published on the EHRA website and social media||Until 10 may 2019||Team of experts on resource assistance sign the Agreement. The Agreement is published. Person responsible for drafting and publication of the Agreement: Olga Belyaeva email@example.com +37063036691|
|All applicants are informed about the results to determine who is ready to seek resources further.||The list of all requests is agreed upon with all the applicants and published to find additional funding or opportunities.||Until 10 June 2019||Igor Gordon, EHRA, Program Team Lead Igor@harmreductioneurasia.org +37063652650|
|Preparation and signing of agreements on provision of the basic package of financial support for 4 groups/organizations||Work plans agreed, ageements signed||Until 10 June 2019||Tatiana Fomicheva, EHRA, Head of the Finance and Administration Team firstname.lastname@example.org|
|Providing resources for 4 groups/organizations on priority issues||Documentation of the advocacy process.||June – December 2019||Team of experts. Responsible for communication Olya Belyaeva, EHRA email@example.com +37063036691 Alexander Levin, Specialist on drug policy, ENPUD firstname.lastname@example.org|
|ENPUD will organize an Internship in Germany for small grant recipients to get acquainted with progressive drug policy and acquire practical skills in its implementation. Here is a video about the drug policy model of Portugal, which the group members studied in theory and practice as part of the Project "#Narconomics: from street to government" in 2017.||Representatives of 4 groups/organizations together with the resource assistance team developed, agreed upon and conducted the internship. The information is published on the websites and social media of ENPUD and EHRA.||August-September 2019 (dates will be specified until June).||Alexander Levin, Specialist on drug policy, ENPUD email@example.com Olga Belyaeva EHRA, Advocacy manager and an expert on drug users community advocacy firstname.lastname@example.org +37063036691|
|Communal effort to find opportunities to provide resource support for all groups that have requested assistance. Communication with groups waiting for assistance and seeking opportunities to expand resource assistance based on existing requests.||Seeking funds from other projects, informing donors and partners about requests for resource assistance, receiving funding or submitting requests to partner organizations. The implementation of the request. Documentation. Informing the general public using media.||June – December 2019||Igor Gordon, EHRA, Program Team Lead Igor@harmreductioneurasia.org +37063652650 Specialist on Advocacy, ENPUD (will be selected after the applications will have been received)|
|Analysis and evaluation of actions, results, experience and next steps - together with EHRA, ENPUD and the group/organization of the community of people who use drugs.||The monitoring, assessment and lessons learned questionnaire completed.||November – December 2019||Olga Belyaeva, EHRA email@example.com +37063036691 Alexander Levin, ENPUD firstname.lastname@example.org|
|Informing the members of EHRA, ENPUD, their partners and donors about the activities implemented by the community and its partners, as well as suggestions for further actions.||The description of actions, country advocacy and general regional overview are prepared, proposals for future activities are provided.||January – February 2020||Олą Belyaeva EHRA email@example.com +37063036691 Alexander Levin, Specialist on drug policy, ENPUD firstname.lastname@example.org, and Specialist on Advocacy, ENPUD|
The group of experts to analyze and evaluate the requests according to the criteria and to formulate a priority list of resource assistance: Eliza Kurcevic, Masha Plotko and Olga Belyaeva (EHRA), Alexander Levin, Expert on Drug Policy (ENPUD/EHRA Steering Committee Member); Larisa Solovieva, ENPUD Coordination Council Member. Igor Gordon and Tatiana Fomicheva – managers of the resource assistance program for EHRA community.
We also involve experts from EHRA Steering Committee and Executive Board and experts from partner organizations in implementation processes of resource assistance according to the topic of the request. Here is a link to detailed information about the people who will help us prioritize and implement resource assistance.
All experts are professionals in their field, have a solid background and understanding of the topic and achieved high performance in their countries, at the regional and international level, and protect the interests of the community of people who use drugs.
Questions and feedback
To get the answer to your question as soon as possible, submit comments or provide feedback, please refer to our contact persons:
Olya Belyaeva, EHRA, e-mail: email@example.com, tel.: +37063036691
Igor Gordon, EHRA, e-mail: Igor@harmreductioneurasia.org, tel.: +37063652650
- Law Enforcement and HIV Network (LEAHN), The Netherlands
- AFEW International, The Netherlands
- Harm Reduction International, UK
- Fiji Network for People living with HIV and AIDS (FJNPLUS), Fiji
There are 7 individual supporter members of EHRA. Due to European Union General Data Protection Regulation, EHRA can not publish the data of the individual members. If you would like to check if you are a registered as supporter member of EHRA, please, contact Eliza Kurcevič firstname.lastname@example.org