Best practices in strengthening civil society’s role in delivering harm reduction services

The HIV epidemic in the Middle East and North Africa has continued to grow, aggravated by an increase in injecting drug users with high-risk practices such as sharing contaminated syringes. An approach known as harm reduction has been proven to be effective in reducing negative health consequences among this vulnerable group. Yet the provision of harm reduction services to this population has been hindered because drug use and HIV are considered taboo in many parts of the region. Nongovernmental organizations in civil society can fill this gap, but their potential has been underdeveloped.

These were the challenges addressed by the formation of the Middle East and North Africa Harm Reduction Association (MENAHRA). MENAHRA provided a framework through which practitioners in civil society reached out to colleagues in other civil society organizations throughout the region to strengthen their active role in harm reduction while engaging policy-makers to lessen obstacles to the acceptability of harm reduction. Guided by a vision combining public health and human rights, MENAHRA became an umbrella for the empowerment of civil society

This document was produced to share the experiences of the establishment and development of the association. The challenges and accomplishments of launching MENAHRA provide useful lessons and best practices in strengthening civil society organizations in the response to HIV, increasing their involvement in effective interventions and advocacy, and overcoming obstacles.

The document begins by describing the nature and extent of HIV and injecting drug use in the Middle East and North Africa. It explains the concept of harm reduction as an approach to these challenges, as well as the uniquely valuable role that can be played by civil society. After describing the impetus that led to the creation of the association, the document describes the structure and achievements of the association in each of its components. The concluding section considers lessons that were learned during the project period that led to the association’s graduation into a self-organizing initiative with independent funding.

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