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 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.

Harm reduction, the 'Vienna spirit', and the pro-reform coalition - Follow-up to #CND67

The BOOST project, a collaborative effort aimed at combating HIV/AIDS and viral hepatitis in Europe, supports EU and neighboring countries through community-based and led harm reduction initiatives. This response, vital due to the disproportionate impact of these diseases on people who use drugs (PWUD) and marginalized populations, is structured around four main pillars: Inform, Improve, Support, and Connect & Act, which focus on data collection, capacity building, best practice enhancement, and advocacy, respectively.

This Advocacy Strategy provides an overarching framework and sets priorities for regional harm reduction and community-led networks working for EU and neighboring countries. The objectives of the Strategy will serve as a basis for developing joint regional advocacy actions for comprehensive health and harm reduction services for people who use drugs.

The Strategy aims to enhance the quality, accessibility, and coverage of harm reduction services. It focuses on increasing political will and financial sustainability, promoting community-driven harm reduction, ensuring access to specific health services, and advocating for comprehensive health and social care. The strategy emerged from an inclusive consultation process, including extensive online dialogues, surveys, and strategic meetings, which identified key barriers to service access and outlined objectives for improving harm reduction efforts across the continent.

Through this collective approach, the BOOST project and its partners aim to address the critical health needs of people who use drugs, advocating for changes that support harm reduction, health rights, contribute to the priorities of the EU Drugs Strategy 2021-2025, and ultimately, the goal of eliminating HIV/AIDS and viral hepatitis as public health threats by 2030.

United for change: Advocacy strategy for comprehensive health and harm reduction services for people who use drugs in Europe

The CLM initiative led to policy changes in Ukraine, Georgia, Montenegro, and Moldova. For instance, in Ukraine, the research revealed gaps in psychological and social support within the OAT programme, prompting advocacy efforts to address these deficiencies. In Georgia, the findings influenced decisions on take-home dosing, while in Moldova, they sparked a formal investigation into programme outcomes. Additionally, the research led to increased access to buprenorphine in Moldova and improved staffing at a central clinic in Montenegro.

Furthermore, CLM enhanced the capabilities of community organisations by providing them with new research skills and in establishing partnerships with professional researchers. Getting approval from ethics committees added credibility to the community organisations, allowing them to engage with institutions and to strengthen their advocacy. This initiative also boosted the confidence of communities and helped them fine-tune their advocacy goals.

Overall, CLM not only generated crucial knowledge about OAT programmes but also transformed community organisations, enabling them to play a more influential role in advocating for positive changes in policy and practice.

Based on the findings, the following recommendations are proposed:

Quality of life and client satisfaction should be frequently and routinely monitored as part of the M&E approach to OAT programming.

Community-led monitoring should be leveraged for the monitoring and evaluation of OAT programmes as such enabling collaboration with communities allows are more informed understanding on how best to improve quality of life and client satisfaction.

Referral systems should be strengthened between OAT programmes and HIV, hepatitis C virus (HCV), and tuberculosis (TB) related prevention, testing, treatment and support programmes.

Psychosocial support provided at OAT sites should be enhanced.

OAT service hours should be adjusted to enable OAT participants to more easily pursue employment.

Individual approaches to take-home doses should be enabled.

Decriminalisation would reduce imprisonment of OAT clients and until decriminalisation is instituted, continuity of access to OAT programming should be guaranteed for people experiencing detention.

Quality of life and client satisfaction studies can be leveraged to counter efforts to cut costs, or to “optimise” spending, which would otherwise push for the elimination of psychosocial support as a service that is too costly.

Community-led monitoring of opioid agonist treatment

EHRA and team of researchers presented and discussed assessment findings of opportunities for optimal access to mental health care services for people who use drugs in the CEECA region. This exploratory study inquired as to how mental health care services are rendered to people who use psychoactive substances in the region of Central and Eastern Europe and Central Asia (CEECA) region.

Data for this study were collected during in-depth research of the situation in four selected countries of the region: Czechia, Estonia, Moldova and Poland. This was followed by an analysis of research publications/literature on mental health services and services available for selected target groups. In addition, semi-structured interviews were conducted with health service providers, harm reduction service staff and patients/clients. Reflections on the situation in the region were also utilised from a multidisciplinary expert group meeting, ‘On barriers, challenges and needs on accessing mental health care and support services for people who use drugs during COVID-19, people who use new psychoactive substances (NPS), as well as migrants and refugees’.

Although all four participating countries of the study have relatively developed structures of both mental health and treatment facilities for people who use psychoactive substances, all of them find significant obstacles when mental health services are needed for people who use psychoactive substances, as integration of these services has not yet become a reality. Similarly, although mental health care is expected to start at the primary level of healthcare, only in some countries are general practitioners ready to provide an initial assessment of the mental health status of a patient.

The study team believes that the assessment findings and recommendations can be used as background for improving harm reduction programmes, and specific health and social care programmes for people who use psychoactive substances (including Ukrainian refugees) to achieve optimal access to mental health care. It could be used to overcome systematic barriers created by mental healthcare authorities and for improving cooperation between agencies providing – or those who could potentially provide – mental health care support to people who use psychoactive substances.

During the launch of the report lead researcher Dr. Tatiana Andreeva, PHD presented 

key regional findings of the assessment, barriers, and recommendations common for all EECA region

. Country researchers presented situation 

. Discussion of opportunities and possible next steps for integration of mental health and HIV response and harm reduction.

With this research, we hope to start systematic advocacy to integrate harm reduction and systems of provision of mental health support. We need to change the systems and approaches to stop “football by people”, sending people in pain between institutions and organizations supposed to help.

Linking Dots: Assessment of opportunities for optimal access to mental health care services for people who use drugs in the CEECA region

We are happy to present key findings of the report 

“Linking Dots: Assessment of opportunities for optimal access to Mental Health Care services for people using drugs in the CEECA region. Regional overview based on country cases of Czechia, Estonia, Moldova, Poland.”

 English and Russian with simultaneous translation

Presenting key regional findings of the assessment, barriers, and recommendations (20 min)

Short overview of country cases (Czechia, Estonia, Moldova, Poland)

Discussion of opportunities and possible next steps for integration of mental health and HIV response and harm reduction.

 for this meeting to receive the direct link on event.

Mental health care for people who use drugs in EECA: Discussing findings of the assessment

The objective of this webinar is to discuss the provision of high-quality harm reduction services tailored to the specific needs of young people who use drugs.

The need for youth-specific harm reduction strategies is urgent, given the unique set of legal and ethical challenges posed by punitive drug policies in EECA countries. This webinar aims to shed light on these issues and pave the way for innovative harm reduction services that meet the unique needs of young people who use drugs.

Presentations by “Mandala” from Georgia and “Drogart” from Slovenia (40 minutes)

Closing Remarks and Next Steps (10 minutes)

Monday 9th October, 11.00 (EEST/Vilnius time) - 

Simultaneous Russian-English translation will be provided.

If your organization has experience in working with youth and would like to share your insights as a presenter, please don't hesitate to contact igor@harmreductioneurasia.org. Your input would be invaluable in enriching the discourse and contributing to EHRA’s ongoing efforts to enhance the quality of harm reduction services.

Your active participation is crucial for the mobilization of harm reduction advocates and the communities we serve. Together, we can ensure the sustainability and efficiency of harm reduction services and advocate for non-punitive drug policies based on public health approaches and human rights.

Quality harm reduction services for youth: Sharing good practices and innovations

 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

Eurasian Harm Reduction Association

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