Eurasian Harm Reduction Association (EHRA) is a non-for-profit public membership-based organisation, registered by the initiative of harm reduction activists and organisations from Central and Eastern Europe and Central Asia (CEECA) in 2017.

Eurasian Harm Reduction Association

The Eurasian Harm Reduction Association (EHRA) is a non-profit, public membership organization uniting activists and harm reduction organizations from Central and Eastern Europe and Central Asia (CEECA), with the mission to actively unite and support communities and civil societies to ensure the rights, freedoms, health and well-being of people who use psychoactive substances in the CEECA region.

The activities will be implemented within the Regional project "Sustainability of services for key populations in Eastern Europe and Central Asia (EECA)” – 

, implemented by a consortium of organizations under management of the ICF "Alliance for Public Health", with the financial support of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Repressive drug policy in CEECA region causes constant and severe human rights violations of people who use drugs. Every year thousands of people who use drugs go to jail for victimless crimes, they are denied treatment, discriminated by social services, abused by police, have limited job and educational opportunities. Most of those rights are guaranteed by national constitutions and international human rights treaties and states are obliged to ensure and protect them.

Each year, EHRA is documenting and preparing country reports, which are 

submitted and presented to UN Treaty Bodies

. In 2025 EHRA is planning to make submissions on Kazakhstan to:

the Human Rights Committee on the International Covenant on Civil and Political Rights (ICCPR), and

the Committee on the Elimination of Discrimination against Women on the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW).

the Committee on the Elimination of Discrimination against Women on the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), and

the Committee on Economic, Social and Cultural Rights on the International Covenant on Economic, Social and Cultural Rights (ICESCR).

The objective of this consultancy is to support the development of submissions to UN treaty bodies on the human rights situation of people who use drugs in Moldova and Kazakhstan (to the above mentioned bodies). The consultant will:

Conduct a comprehensive review of relevant UN treaty body documents on Moldova and Kazakhstan.

Engage with communities of people who use drugs in both countries to identify key human rights concerns, challenges, and individual cases.

Develop a well-researched and evidence-based report for submission to relevant UN treaty bodies (up to 10-15 pages per country/ per report).

To be eligible, consultants must comply with the EHRA 

 on the Russian military aggression in Ukraine.

Applicants must submit a CV and Letter of Interest reflecting competency, proposed number of working days, costs (in euros) to info[@]harmreductioneurasia.org with the RFP number and their name in the subject line.

1. Consultant must speak and write fluently in English and/or Russian.

2. EHRA will sign an agreement with one selected consultant. The contract will define a detailed work plan and payment terms.

3. EHRA reserves the right (but does not commit itself to obligations) to enter into negotiations with one or more applicants in order to obtain clarifications or additional information, as well as to agree on the timing of work.

4. The winner must confirm his/her/their daily rate before signing of the agreement.

5. Results will be announced by March 20, 2025. Each candidate will be contacted individually.

6. Any questions regarding this RFP should be sent to eliza[@]harmreductioneurasia.org until

RFP: EHRA is seeking consultant for development of submissions to UN Treaty Bodies on Moldova and Kazakhstan

58th session of the Human Rights Council (September-October 2024)

Statement delivered by the International Drug Policy Consortium

This statement is made jointly by IDPC and 2 other organisations.

We are highly concerned by the wide-ranging human rights violations committed in the name of drug control in all corners of the world - ranging from the use of the death penalty, to extrajudicial killings, arbitrary arrests and detention, police violence, the denial of access to life-saving harm reduction services and essential medicines, and widespread cases of discrimination. And yet, the global drug control system seems stuck in inertia, unable to put an end to these egregious human rights abuses.

We welcome the leadership role played by the Office of the High Commissioner for Human Rights in calling for transformative change in drug policy. We also welcome the efforts by the UN human rights system to elevate this issue in Geneva - in particular last year’s landmark reports on harm reduction by the UN Special Rapporteur on the right to health.

At this juncture, the involvement of the UN human rights system is absolutely critical to realign global and national drug policies with human rights.

We therefore urge you to consider strengthening the role of the OHCHR and the Human Rights Council in drug policy matters via the adoption of a new resolution on drugs and human rights. This would ensure that they can systematically document and report on the human rights abuses resulting from drug policy - and work with policy makers, civil society and affected communities to urgently change policies and practices on the ground.

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Panel discussion on the realization of human rights in sustaining and increasing the gains made in the HIV response and leaving no one behind

I am making this statement on behalf of the International Drug Policy Consortium and Harm Reduction International.

Key affected populations remain disproportionately impacted by the HIV epidemic – and yet, the funding dedicated to HIV prevention, treatment and care among people who use drugs, sex workers and men who have sex with men has traditionally been insufficient.

Today, we are raising the alarm regarding the catastrophic impact of recent US funding cuts on people who use drugs and other key affected populations.

According to HRI, in 2022, PEPFAR was the second-largest donor to harm reduction in low- and middle-income countries.

The consequences of these cuts are devastating. Funding for essential harm reduction services has been halted overnight. Globally, service providers have been dismissed without notice. Peer workers have suddenly lost access to HIV and HCV medications, medical and support and their income. Many will die.

Harm reduction is a proven public health intervention endorsed by the entire UN system. Investing in harm reduction is not just a moral obligation; it is an investment in global health, security, and human dignity.

We therefore call on governments and donors to take action now:

First, by investing in harm reduction within their domestic budgets.

Secondly, prioritising investments in the Global Fund, as the largest donor to harm reduction in low- and middle-income countries.

Finally, by ending the criminalisation of people who use drugs.

Human rights, harm reduction and drug policy: Redoubling efforts reform and funding efforts - IDPC statement at the 57th session of the Human Rights Council

In response to the call from the Special Rapporteur on Extreme Poverty and Human Rights, Mr. Olivier De Schutter, the Eurasian Harm Reduction Association (EHRA) has submitted a detailed report for inclusion in the thematic report “Welfare and Control: The Paternalism of Support,” to be presented at the 80th session of the UN General Assembly in October 2025. The report will examine critical concerns in child protection services, including safeguards to ensure that poverty alone is not treated as child neglect, protection of family privacy in interactions with child protection authorities, and measures to prevent parents from avoiding social services due to fear of losing custody of their children.

Developed by EHRA, the regional analysis highlights the profound impact of repressive drug policies in Eastern Europe and Central Asia (EECA) on parental rights, particularly for individuals registered as people who use drugs or those receiving opioid agonist treatment (OAT). In countries like Belarus, Estonia, Kazakhstan, and others, punitive legal frameworks often lead to the unjust removal of children from families. Women who use drugs face systemic human rights violations, including forced drug testing, breaches of medical privacy, and barriers to shelters in cases of gender-based violence, along with limited access to healthcare services. These policies not only deter parents from seeking essential support but also expose families to institutional violence and discrimination, exacerbating social inequalities and undermining public health efforts. The report underscores the urgent need for policy reforms to ensure that child protection systems are not used as punitive tools against marginalized communities but instead fulfill their purpose of safeguarding children while upholding fundamental human rights.

Addressing the intersection of poverty, child protection, and drug policy in EECA - Contribution to the upcoming report of the UN SR on extreme poverty

We are pleased to announce the release of a new briefing paper that examines the challenges faced by marginalized communities with intersecting identities in accessing healthcare and social services. Developed through collaboration by SWAN, ECOM, EHRA, and EWNA, this paper explores the experiences of LGBT individuals, people who use drugs (PWUD), sex workers (SW), and people living with HIV (PLHIV) across Central and Eastern Europe and Central Asia (CEECA). Drawing on comprehensive research and community feedback, the paper provides insights and practical recommendations to address stigma, discrimination, and structural inequalities impacting these groups.

This briefing paper explores the impact of intersecting identities—such as LGBT, people who use drugs (PWUD), sex workers (SW), and people living with HIV (PLHIV)—on health access, agency, and social justice in the context of structural inequalities and stigma. Using the framework of intersectionality, it examines how overlapping identities shape lived experiences of discrimination, influencing mental and physical health outcomes and access to healthcare services. The paper is based on cross-regional consultations conducted across 14 countries in Central and Eastern Europe and Central Asia (CEECA), including surveys and focus group discussions with 103 individuals with multiple intersecting identities.

The insights gathered aim to deepen understanding of intersectional stigma and discrimination while offering practical recommendations to improve service provision, rights-based programming, and advocacy efforts. By addressing the unique vulnerabilities and strengths of marginalized communities, this paper provides actionable guidance for healthcare providers, advocates, and policymakers to design inclusive interventions that mitigate stigma and promote equitable access to health and social support systems.

Tackling intersectional stigma in healthcare access for marginalized communities in CEECA

 Until recently, Bulgaria was seen as a place where harm reduction services had 

, with the situation quite bleak. Now, it seems that things have changed. Can you tell me more about when and how this happened?

 You know about the Pink House—the project began in 2019. We started as a low-threshold center for people who use drugs in Sofia. Initially, we provided basic support such as food, clothing, and access to a bathroom. Over time, we identified additional needs, such as a lack of personal documents and disconnection from the social and healthcare systems. These challenges make reintegration into society nearly impossible. In response, we expanded our efforts to address these issues. We developed a program for social inclusion that helps individuals obtain new IDs, access social support, receive social pensions, and secure housing. We also began covering medical expenses for those without health insurance and assisting those with some social support to maintain their health insurance, which is a “must” for accessing healthcare in Bulgaria. For the first two years, we covered all expenses through crowdfunding and made efforts to secure government funding, but it didn’t work out In the following two years, we managed to fund our work through several projects, primarily related to addressing the consequences of the COVID-19 pandemic. Then, in 2023, we had a breakthrough. The government, through the Sofia municipality, provided funding, and we signed a five-year contract for all Pink House activities. Additionally, we received a grant from an international donor at the same time. With this support, we started expanding services—outreach, needle exchange, and IBBS (Integrated Biological and Behavioral Surveillance) for our clients. Things took off from there, and now we’re opening a branch in Plovdiv, which has a large Roma community. The new facility is expected to be fully operational by the end of the year. We choose Plovdiv not only because it is the second-largest city in Bulgaria but also because there is a well-trained team from another foundation that has been working in the area for years.

 What services are now supported by the government, and what does the other grant cover?

 The Municipality of Sofia supports all activities related to social services we offer. This includes meeting basic needs such as clothing, shoes, and food; offering social support for our clients; social and healthcare case management; and covering some health expenses, such as medical examinations and medications. Additionally, the municipality funds all team salaries, including those for the psychiatrist, psychologists, nurse and social workers, as well as the rent and overhead costs of the facility.
The other donor covers everything related to outreach, including the supply of consumables such as needles and syringes, smoking kits; IBBS, testing and the costs medical staff. We’re also working on securing long-term government funding for these kinds of activities. We applied and were chosen for a public tender, but the funding available is very limited and the process complicated. However, we’re now in a serious collaboration with the Ministry of Health, which is something we couldn't achieve for years.

 Did something change within the Ministry?

 People changed. We’re in a serious political crisis here, with upcoming elections—eight in four years—so stability is rare. Currently, though, we have allies. The municipality’s deputy mayor supports us, and we’re planning many new initiatives with them.

The only challenge the Municipality has struggled to address is securing a permanent location for our facility. In May 2024, we had to leave the premises where we had worked for five years. This has become a serious problem, as we have not yet been able to find a suitable alternative. Currently, we are operating out of a very small municipal space that does not meet our needs.

The mayor of the Serdica region in Sofia made a significant effort to help, securing a plot of land where we could place a movable house. In response, we launched our largest crowdfunding campaign to date and raised €52,000 in just one week to purchase the house.

Unfortunately, this progress coincided with consecutive elections, which allowed a far-right party to gain visibility. They organized protests against us, and as a result, the commissions of the Municipality parliament decided to reject our project for the house at the proposed location. We are now in the process of securing another site for the house.

 Are you the only organization providing harm reduction services in Bulgaria?

 Does the state funding cover needle exchange services?

 No, the funding is so limited that it barely covers partial staff costs, not supplies like needles. Thanks to another donor, we’re currently able to run a needle exchange, but it’s unclear what will happen when that funding ends. The current HIV Strategy also ends in 2025, and we’re hopeful there will be political will to extend it. Just recently, I met with a Ministry of Health official who seemed very supportive, which is promising. The numbers are stark—we’ve tested over 900 people this year, and 82 are HIV positive, with 60% also having Hepatitis C.

 So, the government funding really only covers staffing?

 Yes, it’s enough to partially cover staff costs but not actual services or supplies. However, considering that seven years ago we had nothing, it’s still progress. We started with crowdfunding, and I was the only staff member. Now, we have 13 people in our team. The real challenge will come when another donor funding ends. The goal is to secure a sustainable funding mechanism for harm reduction across Bulgaria.

 are only active in Sofia. In Plovdiv, harm reduction was previously provided by another organization that closed and donated their van to Ukrainian refugees. Now, we’re actually borrowing that van for outreach! It’s old and in poor condition, but it’s something. The Ministry of Health also has mobile units that we could use, but they must be staffed by medical personnel from the regional health inspectorates, who aren’t familiar with our community or practices. Still, this problem will be minimalized when we open the Pink House – Plovdiv in the end of the year. We have a contract with the Municipality of Plovdiv and are repairing the building now.

 Can you describe what services the Pink House currently offers?

 The Pink House functions as a day center where people can come and spend time. But it’s small, without a bathroom, which is challenging, especially with winter coming. We’re hoping to find a bigger place, but locations that meet municipal requirements are limited. Ideally, we’d have our own mobile or movable building so that if there’s a change in political support, we can relocate.

 It sounds like the public is also more supportive now. Has that made a difference politically?

 Absolutely. In the beginning, no one talked about harm reduction, and I was seen as a lone voice. But now, the public has become much more supportive, and that’s influenced political action. Harm reduction isn’t seen as a "junkie" issue anymore but as an important social cause. I’ve even become an advisor to a few politicians who are using drug policy messages in their campaigns. So, the public’s support has pushed this issue into the political spotlight, which has been a huge change.

 It’s impressive that you’ve also gained support from the Ministry of Social Affairs. What has that experience been like?

 That’s been a revelation. The Agency for Social Services Efficiency understand the problem better than health officials because harm reduction involves social issues that are more visible to people than health risks. The Social Ministry is much more open to support our work. Looking back, I think focusing solely on the Ministry of Health was a mistake. Social services deal with people’s daily lives, so they understand the urgency. This collaboration has even set a precedent for government funding of harm reduction in Bulgaria.

From crowdfunding to government support: How Bulgaria’s only harm reduction center secured public support and government resources 

As part of the BOOST Project, a series of webinars will be held in November for harm reduction organisations that are currently providing or planning to offer services in the fields of HIV and viral hepatitis.

The webinars aim to enhance the knowledge and skills of community-based and community-led organisations, helping them apply good practice models, tools, and methods to scale up integrated screening, testing, treatment and care for communicable diseases across Europe. Below we share the sessions, dates and registration links.

Community-led approaches to HIV/VH/STIs screening, testing, treatment and care for people who use drugs

Optimising data collection: a guide to COBATEST standardised data collection tools

Current best practices on community-based HIV/VH/STIs services

Improving linkage to care in harm reduction settings

BOOST’s peer-to-peer capacity-building webinar series

HFHR, HRI, IDPC and EHRA submit this briefing to the UN Committee on Economic, Social and Cultural Rights (hereinafter, “the Committee”), in relation to the 7th periodic report of Poland. 

We welcome the fact that the Committee included under the Right to Physical and Mental Health (art. 12) of the List of Issues prepared ahead of the country review a request (no. 23) to: 

provide information on any follow-up measures taken, and their impact, with regard to the National Programme on Countering Drug Addiction 2016–2020. Please also provide information on any follow-up measures taken, and their impact, to increase access to opioid-substitution treatment for drug dependence. 

We note challenges in the field of harm reduction and opioid-substitution treatment as is now more commonly referred to as opioid agonist therapy (OAT) as well as the human rights consequences of drug policy in Poland. The content of this submission comes from the long-lasting monitoring of in-country situation but is also heavily influenced by information and insights provided by local organizations during the civil society consultations conducted jointly by the EHRA and the HFHR for Human Rights between June 2023 and January 2024 with the aim of supporting the upcoming CESCR’s General Comment on Drug Policy.

HFHR, HRI, IDPC and EHRA recommend that the Committee considers including the following in its concluding report to the Polish government:

ground drug policy in human rights, scientific evidence and reliable data 

decriminalize drug use and possession for personal use (which should include the removal of all sanctions, both criminal and administrative), and consider transformative change to the country’s punitive drug policy, as recommended by the OHCHR 

increase the coverage of, funding for, and diversify the range of harm reduction measures, including access to naloxone, both in the community and prison settings and ensure that such services are tailored to the specific needs of women, LGBTQI+, youth, migrants and other particularly vulnerable groups of people who use drugs 

ensure equal access to evidence-based prevention, harm reduction and treatment services on a non-discriminatory basis, taking into account the specific needs of particularly vulnerable groups 

actively combat stigma and discrimination against people who use drugs, including by developing a campaign in consultation with people who use drugs to counter stereotypes and raise awareness of the rights of people who use drugs.

Joint submission to the UN CESCR regarding opioid agonist therapy (OAT) and human rights in Poland

Over the last years an increasing number of governments in Central Eastern Europe & Central Asia (CEECA) are adopting new laws and practices that constrain civic space (restricting rights and liberties of civil society), thereby exerting additional pressures and burden on already criminalized populations (LGBTQI+, people living with HIV, people who use drugs, sex workers). Russia’s war against Ukraine has intensified the negative human rights trends of previous years, leading to increased insecurity. It caused disruption of access to treatment and basic medical and social services, increased vulnerabilities to HIV in Ukraine, and in countries affected by the refugee crisis, and throughout the region, where economic and social upheaval and changing patterns of migration are felt.

The confluence of geopolitical turmoil, rising authoritarianism and the resulting shrinking spaces for civil society, criminalization of key populations and donors’ narrow view and scope in addressing HIV brought us to this boiling point where, more than ever the robust and pragmatic approaches in addressing interconnected issues of HIV, public health, gender equality, civil and human rights are needed.

The purpose of the Communique is to acknowledge and coordinate efforts among communities, civil society, politicians, experts and professionals, and other national and international stakeholders to address the shrinking space for civil society and communities to act in the spheres related to public health (including HIV), sustainability and security in the CEECA region.

Secure the future: Civil society and human rights imperative for public health and HIV response in Central and Eastern Europe and Central Asia

The 67th session of the United Nations Commission on Narcotic Drugs (CND) took place from March 14-22, 2024, in Vienna, Austria. For the Eurasian Harm Reduction Association (EHRA), it was an opportunity to engage with delegates from the CEECA region countries, co-sponsor side events, participate and ask questions in the informal dialogues with WHO, UNAIDS and UNODC, and advocate for progressive drug policies centered around public health and human rights.

Webinar will be in English and Russian languages.

Eurasian Harm Reduction Association

Region

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