Harm reduction service provision ends in Montenegro due to lack of funding

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Harm reduction service provision ends in Montenegro due to lack of funding

3 July 2015

Tijana Žegura, Director of Harm Reduction Program Juventas

We regret to inform you that harm reduction service provision ended in Montenegro on June 30th 2015 because Montenegro is now classified as an upper- middle income country and, as such, is no longer eligible for further funding by Global Fund for Tuberculosis, AIDS and Malaria.

Namely, with participation of numerous governmental organizations, National AIDS Strategy was implemented throughout a project named „Support to NAS implementation“, supported by the GFTAM and UNDP, CO Podgorica. Within this project preventive services for most at risk populations, were provided in community based NGOs.

Although one of the goals of 9 year long program was to secure service provision sustainability, our Government did not fulfill it, regardless supporting opinion of Ministry of Health and Institute for Public Health, who emphasized importance of these kind of services in community.

Today, Harm Reduction program is consisted of only 1 Drop in centre for PWID, while all other centres are closed, as well as mobile outreach program.

In cooperation with School for Public Health „Andrija Stampar“ from Croatia, Institute for Public Health of Montenegro gave an estimation of the number of people who inject drugs in August 2012. Data received show that 1282 (0.7% of total population) PWID live in Podgorica. In the same time Juventas provided services for 596 PWID in Podgorica- 46% of the estimated number. Increment of number of persons who use Juventas’ services can be correlated to increment of number of people who inject drugs in Montenegro.

At the other hand, in 2014, Juventas provided services for around 627 PWIDs (15% female) and 157 FSWs in the city with 187 805 citizens, where lives 1/3 of total Montenegrin population. Through 5 191 contacts with PWID and 1 686 with SWs we provided them with 22 355 needles, 15 663 syringes and 16 330 condoms. We provided 1123 counselling for 293 prisoners during the same period.

Although the HIV prevalence among PWID is still low (1% of total number of registered cases), viral hepatitis C prevalence is 55%, and figures from harm reduction service providers show that there is constant increment of number of PWID in last several years.

Cost effective analyses shows that preventive services for one client cost from 6 to 10 Euros per month, while HIV infection treatment costs from 1200 to 1500 Euros, and hepatitis C infection from 1500 to 2000 Euros monthly on a monthly basis in Montenegro.

Due to the fact that the Government of Montenegro, despite supporting expert opinions of Ministry of Health and Institute for Public Health, as well as excellent recommendations of international donors, has not shown political will to secure sustainability of prevention services in our community, we are obligated to inform you that most services are closed on June 30th, while we are coping to secure funds for the next 3 months with minimum capacities (needle and syringe program implemented by 2 persons). This means that we are going to be forced to close the only Center for harm reduction service provision on October 1st latest and leave persons from most-at-risk populations on their own, exposed to a much higher risk of contracting HIV and viral hepatitis C.

Additional difficulty that we encounter in our way to provide support for the services not to be closed is the silent campaign against harm reduction program among key- decision makers, carried out by NGO fellows working in the field of drug prevention, following UNODC guidelines on the issue.

Having in mind all said, we would very much appreciate if you are able to provide as any kind of support in the months to come. Please contact Tijana Žegura at: janap@gmail.com.

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