Representatives from Belarus, Georgia, Kazakhstan, Moldova, Ukraine and Tajikistan grouped under the Global Fund-supported Eurasian Harm Reduction Network met on 19-20 May to launch a regional project seeking to encourage more domestic spending on harm reduction programs.
The 'Harm Reduction Works -- Fund It!' regional initiative will run for three years to engineer a smooth transition towards public sector financing of outreach and prevention activities among people who inject drugs.
Traditionally these activities have been almost fully funded by the Global Fund and some other international donors in the Eastern Europe/Central Asia region, while government budgets have been focused primarily on treatment and care activities, including the purchase of test systems and anti-retroviral drugs (ARVs).
According to the EHRN, just 7% -- some $160 million -- of the $2.13 billion needed to carry out harm reduction activities across the 26-country region is available, most of which comes from the Global Fund.
In order to expand domestic focus to include prevention, the regional advocacy and technical support project of EHRN seeks to encourage dialogue between activists, government representatives and international organizations with technical expertise in human rights for health.
EHRN has long been committed to the idea that one of the best ways to find the resources to support harm reduction is to reallocate funds that are spent on prosecuting and punishing drug users to the provision of effective prevention and treatment.
But according to Ala Iatco, director of the Moldovan Union for HIV Prevention, the fundamental challenge is in persuading governments that harm reduction is a cost-effective and high value-for-money initiative that should be considered as part of their comprehensive HIV response.
The best way to convince them, she said, was to develop an evidence-based argument relying both on international models and national-level data. The 150 participants, among them drug users in recovery, received preliminary training in use of the intervention tools of harm reduction investment and service monitoring on national and community level but she acknowledged that more training was needed.
The three-year project funded by the Global Fund will begin with service quality assessment and data collection on current investment into harm reduction, to be carried out by EHRN and five NGO partners. Regular forums will be convened to assess progress against incremental targets that will eventually yield a country-level advocacy plan to be implemented by 2016 as well as to support community of people using drugs in their advocacy effort.
Presenting best practice lessons learned were representatives of Estonian and Czech national harm reduction programs, both of which have received state financing.
Each of the countries involved in the EHRN program are at different stages in their efforts to encourage better domestic participation in harm reduction. In 2014 from the regional project EHRN team could have investment comparison between countries within region.
Maintaining continuity within public health policy even across changes of government will be critical to ensuring sustainable state funding for harm reduction, Iatco said, which only emphasizes the need for a policy-driven approach.
The policy-driven approach must also respond to the particular needs and realities of drug-users. More than 50 recovering injected drug users from across the region were invited to share their stories and contribute to the development of advocacy strategies as part of the regional policy.
“Advocacy must come from the vulnerable communities themselves, and one of our main tasks with this forum was to develop effective regional support and figure out ways to coordinate community groups so they can approach decision makers," said Anna Dovbakh, deputy director for technical support and information of EHRN.