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

 Press Center of Ukrinform (Hall 2) - Kyiv, str. Bohdan Khmelnytskyi, 8/16. 

On July 31, 2023, the Ministry of Health published 

a draft order of the Cabinet of Ministers of Ukraine

 "On the approval of the State strategy of drug policy for the period until 2030 and the approval of the operational plan for its implementation for 2023-2025". The participants of the event will focus on the first results and further steps of the public discussion of the draft state strategy on drugs until 2030.

 - Chief specialist of the department for the prevention of non-infectious diseases and circulation of narcotic drugs of the Ministry of Health of Ukraine.

- Head of the Viral Hepatitis and Opioid Dependence Department of the Public Health Center.

 - Executive director of the Eurasian Harm Reduction Association (EHRA), deputy head of the Vienna NGO Committee (Vienna NGO Committee - VNGOC)

 - Lawyer, public association DRUGPOLICY.UA

 - Professor of the Institute of Physiology named after Bogomolets National Academy of Sciences of Ukraine, NGO "Higher Medical School", "MIST"

- Executive director of the International Drug Policy Consortium (IDPC), member and ex-chair of the UN Strategic Advisory Group on Drug Use, HIV, Health Care and Human Rights

 - Secretary of the Drug Policy Commission of Eastern and Central Europe and Central Asia (ECECACD)

Ukraine's drug policy strategy: What is the government planning?

Drug-related policies impact women and men differently, with women being stigmatised to a greater degree than men. Existing gender inequalities often compound this stigma. Despite some positive changes in recent years concerning gender equality and human rights, many women who use drugs are still subjected to discrimination, criminalisation, and structural and intimate violence, which can take shape in many forms, such as physical assault, rape, sexual violence, stalking, harassment, and coercive and controlling behaviour.

Women who use drugs are especially vulnerable to gender-based violence from intimate partners and law enforcement personnel and have limited options for support. For example, the rules and procedures of shelters and refugee centres often prohibit the provision of accommodation to women who use drugs, which may include those receiving opioid agonist treatment (OAT). Additionally, women who use drugs are often caught in a vicious circle of drug use and gender-based violence, where the trauma of violence contributes towards increased drug use, and, in turn, escalated drug use and its associated behaviour expose women to a higher risk of violence. EHRA’s guide Help Impossible to Ignore notes that in the CEECA region, the main problems of women who use drugs and experience gender-based violence are difficulties in processing paperwork and accessing safety, support services, and psychological help, as well as intense stigmatisation of the issue of female drug use and dependence.

Women who use drugs, some of whom sporadically or regularly engage in sex work and have relatively limited access to sexual and reproductive health and rights (SRHR) services, are also at a higher risk of contracting blood-borne viruses, including HIV. Significant barriers to opioid agonist treatment (OAT), such as unequal coverage between urban and rural areas, repressive drug policies, lack of gender-sensitive staff training and knowledge, and abstinence-based approaches, contribute towards a low OAT uptake among women who use opiates. This impact is amplified by a lack of gender-sensitive drug treatment opportunities, which prevents women from accessing OAT and other harm reduction services, such as needle and syringe programmes (NSP).

Access the full report via the 'Downloads' link on the right hand side.

CHECK magazine - Women who use drugs - 3rd issue

Harm Reduction International (HRI), the South African Network of People who use drugs (SANPUD), VOCAL Kenya, Rumah Cemara and the Eurasian Harm Reduction Association (EHRA) shared key harm reduction messages for the 49th Global Fund Board Meeting (10-11 May 2023, Hanoi).

Investment in harm reduction from international donors and governments in low and middle-income (LMI) countries was just 5% of the US$2.7 billion UNAIDS estimates is required annually by 2025 for an effective HIV response among people who inject drugs. Global Fund Grant Cycle 7 represents a crucial moment for harm reduction programming and for community-led programming. However, as Window 1 and 2 countries progress to funding request submission, we are witnessing the serious obstacles that remain to ensuring harm reduction receives due prioritisation within funding requests.

We call on the Global Fund Board to utilise all evidence, tools and strategies available to ensure that HIV prevention for people who use drugs and wider key populations, including community-led responses, are central to Grant Cycle 7 HIV programming, in line with the Global Fund Strategy 2023-2025, the Global AIDS Strategy and Global Health Sector Strategies.

We call on Board Delegations to factor in the following priorities:

Grant Cycle 7 must uphold the Global Fund Strategy 2023-2025 commitment to communities and community-led programming, in keeping with the UNAIDS 30-80-60 targets

The Global Fund must do more to protect harm reduction as a ‘Program Essential’ in Grant Cycle 7

The reduction in catalytic investments threatens the delivery of the Global Fund Strategy on maximising health equity, gender equality and human rights

Grant Cycle 7 must fund efforts to increase domestic investment in harm reduction, and broader key population programming

Funding for harm reduction in crisis must be protected and prioritised

Harm reduction messages for the 49th Global Fund board meeting

 collaborated on this briefing to support harm reduction advocates in Global Fund application processes for Grant Cycle 7 (2023-2025).

Global Fund Grant Cycle 7 (GC7) is an important opportunity for countries to access funding for comprehensive harm reduction services for people who use drugs and supportive structural interventions such as advocacy for legal and policy reform, including decrimalisation. In order to make a strong case for funds to be allocated to harm reduction, the impact of these investments on HIV outcomes must be highlighted in funding requests. 

This briefing compiles key information to support advocacy for the inclusion of harm reduction within GC7 funding requests. It provides an overview of important changes for Global Fund funding for harm reduction under GC7; compiles key data, evidence and references to support advocacy for harm reduction inclusion within Grant Cycle 7 processes. It also provides related observations and recommendations from the Global Fund Technical Review Panel, who are responsible for reviewing submitted country funding requests. Lastly, the relevant modules and indicators from the Global Fund modular framework are compiled for easy reference. This information may be useful for organisations of people who use drugs and harm reduction advocates in your negotiations with decision makers, as well as members of the application writing teams and Country Coordinating Mechanisms (CCMs).

Harm reduction in Global Fund Grant Cycle 7: A compilation of evidence to support advocacy

The Eurasian Harm Reduction Association (EHRA) presents „Regional analysis of the provision of drug checking services in the Central and Eastern Europe and Central Asia region“.

Illicit drug use in the Central and Eastern Europe and Central Asia (CEECA) region continues to be a public health concern. The prevalence of opioids, new psychoactive substances (NPS) and amphetamine-type stimulants (ATS), including polydrug use (very often NPS combined with other traditional drugs), is observed not only among experienced drug users, but also among young people and other key populations. Injection is a common route of administration for opioids and NPS and the CEECA region has one of the highest prevalence of injecting drug use worldwide. Overdose remains highly underreported due to poor data collection and reporting mechanisms from the responsible agencies at local and national levels.

Repressive policies remain in place in relation to drug possession and supply which, in turn, affect the access and quality of harm reduction services and the implementation of novel interventions. The harm reduction philosophy is acknowledged by the vast majority of CEECA countries and recognised in national health and drug strategies. However, the harm reduction goals are mainly connected to HIV responses. The harm reduction infrastructure is mainly designed to cover the needs of people who use opioids and are not yet ready to cope with the problems of people who use NPS. Addressing the challenges of illicit drug use requires the implementation of effective and innovative strategies and interventions.

 are not only a harm reduction intervention but also a valuable monitoring mechanism that provides reliable data on the drug market, its changes and developments, supporting policymakers and public health experts to respond to newly emerging needs.

In the region, drug checking services are in the infantile phase, with small-scale interventions operating in several countries supported by the government or donor initiatives and private donations. They operate in a legal grey area, limited in terms of modes of operation, with staff not allowed to handle drugs and clients at risk of prosecution.

Overcoming barriers that impede the adoption, leverage and scaling-up of drug checking services requires a careful examination of the country’s political and social context. However, the evidence currently available suggests that drug checking services can be piloted and/or implemented in the CEECA region, taking into consideration some recommendations from countries where these programmes have been operating for many years.

Regional analysis of the provision of drug checking services in the CEECA region

This document was developed by Lana Durjava for the Eurasian Harm Reduction Association (EHRA) as part of the project “Sustainability of Services for Key Populations in Eastern Europe and Central Asia”. It presents a brief guide with recommendations for harm reduction service managers on how to launch a new – or improve an existing –online harm reduction service aimed at people who use drugs (PWUD). The guide entails step-by-step practical tips regarding web outreach programme design, implementation, and evaluation. The purpose of this guide is to provide managers of harm reduction services, as well as representatives of other organisations working with key populations, with all the essential information needed to start an online outreach programme compiled in one place and presented in the form of concise, evidence-based, easily implementable recommendations.

The recommendations included in this guide can be adapted in line with the needs and resources of individual organisations, local contexts, and characteristics of the target population. They can also be adapted for web outreach with other key populations, such as people living with HIV, sex workers, or men who have sex with men.

This guide aims to complement a number of existing resource materials on the topic of online outreach, such as EHRA’s “Digital Help: 

 on Digital Services for Key Population”, EHRA’s “Peer-to-Peer Counsellor 

 for Online Counselling”, and UNODC’s “

: Web Outreach for People Who Use Drugs”. The links to these materials, as well as other resources, are included in the Annex of this guide.

Recommendations for setting up online harm reduction services

The Eurasian Harm Reduction Association (EHRA) presents Matrix for analysing trends in human rights violations against people who use drugs. The purpose of this Matrix is to facilitate the analysis of documented human right violations by grouping violations into strategic blocks that are easy to use for the subsequent reporting to human rights treaty bodies and/or as part of follow-up advocacy at national level; and to equip human rights activists with knowledge/skills in how to prepare/ write reports for a human right body. The Matrix aligns the analysis with the environment in which human rights treaty bodies and national governments develop human rights practices, surrounded and mediated by community-led monitoring.

The assessment of each block of violations corresponds to state human rights obligations according to international human rights covenants and, where appropriate, specific human rights conventions. Each item in a block can become the subject matter of simultaneous assessments under different sections of international treaties.

Matrix for analysing trends in human rights violations against people who use drugs

: To understand the short- and long-term responses of drug services to a major flux of displaced people and the related challenges.

: COVID-19 has raised attention in Europe, and globally, on the importance of monitoring preparedness towards potential emergencies.

Europe was again put to test with the start of the war in Ukraine. The massive flux of displaced people challenged the health services in Ukraine, in its neighbouring countries as well as in the rest of Europe.

The EMCDDA published a preliminary Trendspotter study in July 2022 to investigate the overall situation (an update is planned for 2023).

In this webinar we would like to highlight both sides of the coin: the challenges of a country at war and the responses implemented by the receiving countries.

The participation of experts based in Ukraine is confirmed although we need to be prepared for possible a black-out during the webinar.

Mrs Olga Gvozdetska, Deputy Director General of the Public Health Center, Ukraine

Dr Kostiantyn Dumchev, Scientific Director at the Ukrainian Institute of Public Health Policy, Ukraine

Mrs Stela Bivol, WHO strategic advisor for TB, HIV, hepatitis and STIs, WHO Geneva

Mrs Ganna Dovbakh, Executive Director, Eurasian Harm Reduction Association (EHRA), Lithuania

Dr David Otiashvili MD PhD, Director, Addiction Research Center Alternative Georgia, Georgia

Mr Artur Malczewski, Polish Reitox Focal Point - National Center for Prevention of Addictions, Poland

: Jane Mounteney, Head of unit, Public health

: EMCDDA opening remarks, panellists’ questions, guided discussion, Q&A.

: The webinar is open to all upon registration, after which the person will receive a link to connect.

: 14 December, 12.00-13.30 Lisbon time 13.00-14.30 (CET)

https://us02web.zoom.us/webinar/register/WN_-2yEi4w0QiSPS5mLmDrIhQ

Displaced people and European Union preparedness and response — lessons from Ukraine

Harm Reduction International (HRI), UNAIDS, the Eurasian Harm Reduction Association (EHRA), the Global Fund Advocates Network (GFAN) and the Network of Asian People who Use Drugs (NAPUD) invite you to a 

webinar on the implications of the Global Fund replenishment on harm reduction on December 5th at 1:00-2:30pm GMT.

The webinar presents the opportunity to regroup and take stock of the replenishment outcome and what is means for harm reduction in NFM4; to share actions to support inclusion of harm reduction programming in country grants and to strategise around the challenges that remain. We will also hear from the Global Fund Secretariat on their new guidance for harm reduction programming. The over-reliance of harm reduction on the Global Fund will be highlighted and the importance of other donors and national governments increasing their investments to address the funding gap for harm reduction will be emphasised.

There will be translation into French, Spanish and Russian.

Eurasian Harm Reduction Association

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