Author: Igor Gordon

Support. Don’t Punish. 2022

Posted on by Igor Gordon

For many years Eurasian Harm Reduction Association has been actively supporting the global initiative and activities of “Support. Don’t punish!” campaign, which is celebrating its 10th anniversary this year.

The year 2022 became no exception for us. Joining the broad coalition for drug policy reform, decriminalization and community advocacy, which includes over 280 cities from 91 countries, EHRA has supported with small grants[1] 4 harm reduction organizations of activists in Kazakhstan, Lithuania, Montenegro and Tajikistan.

The small funds that EHRA allocated to each organization helped each of them to undertake their own unique activities aimed at community advocacy, drug policy reform, and decriminalization of people who use drugs in these countries.

[1] Small grants are provided by the EHRA  Secretariat as part of the project

‘Ending Inequalities for People who Use Drugs: Strengthening Harm Reduction to Elevate Rights, Health and Capacity” of the International Harm Reduction Consortium.

Kazakhstan

Activists from NGO “Nursemin” located in Karaganda decided to create short video messages from people who use drugs from different cities in Kazakhstan. In these messages, people say based on personal experience that punishment does not work, and that people need support and assistance in accessing medical, social and legal services primarily. Also, the messages from medical professionals and psychologists assisting the campaign were recorded to support these appeals.

The video was shared on the most popular social networks and messengers (VKontakte, Instagram, Twitter Facebook YouTube Telegram, TikTok) as well as on advertising banners over the city.

“We have great faith that the voice of the community has been heard, including the decisions making people,” – hopes Natalia, the action organizer and head of NGO “Nursenim”.

Lithuania

Activists and volunteers from the youth organization “Young Wave” organized public presentation of the film “Breaking the Taboo” in Vilnius. The documentary, made in the UK and Brazil, argues that the common struggle of world states against drugs has failed because, despite the efforts of the UN, the situation has only been getting worse over the past 40 years. Instead of reducing, drugs traffic has been growing over time, and new drugs have become more available and cheaper. After watching the film, the organizers initiated a discussion during which the participants talk about the ideas and conclusions presented in the film. During the discussion it was said that in order to fundamentally solve the issue, there is no need to fight with people, but it is drug policy that needs to be changed towards humanization.

“We were able to involve 20 young people to watch the film, and the particularly useful thing was that these people took part in the discussion around the idea voiced in the film: liberalizing of the drug policy is one of the most effective tools for harm reduction.” said Linas, one of the event organizers.

Montenegro

The community of people who use drugs is traditionally at the centre of events organized by the NGO Juventas in Podgorica. In the memory of Davor Karadzic, a Montenegro harm reduction activist who died from COVID-19 and was one of the initiators of the harm reduction programme in Montenegro, the workers of the harm reduction centre initiated mural creation with his image on the front wall of the Juventas NGO centre in Podgorica. The community was actively involved in preparing this mural. Unfortunately, due to the abnormal heat in Podgorica, work on the mural had to be halted, but very soon people of the city will be able to see the image of Davor, who has become a symbolic figure in the fight against the punitive drug policy in Montenegro.

Also, during the month of June, meetings with the community were organized to discuss how existing legal solutions are affecting the lives of people who use drugs and what changes in drug policy people would like to see.

“During these meetings, people from the community were very keen to give their opinions as well as suggestions on how certain things could be improved, especially those related to legal provisions that either do not exist in Montenegro or should be changed. By involving people from the community, we aim to improve cooperation with the community, to help the community make its voice heard.”, stressed Maria, event coordinator, Juventas Centre officer.

Tajikistan

On June 26, the NGO SPIN Plus held a series of meetings with law enforcement officials in Dushanbe. The events were held under the slogan “Treatment, not punishment!” The meetings were attended by more than 50 people from the district police, the Drug Traffic Department of Ministry of Internal Affairs, as well as staff and volunteers from SPIN Plus. During the event the information about the work of Harm Reduction Programme in Tajikistan was presented. Also, a separate session highlighted the work of the opioid agonist therapy programme. There was a session on opioid overdose prevention and treatment.

Information materials in the form of booklets, brochures and posters were handed over to the staff of Firdavsi district police and Drug Traffic Department. Also first aid kits with first aid items specially prepared and procured by UNDP in Tajikistan were handed over. Naloxone 10 ampoules, syringes and condoms were added to the first aid kit.

“The event was held positively. During the discussion, the police officers asked many questions about the work of the harm reduction programme, the use of naloxone, HIV prevention and treatment measures in Tajikistan. All the questions were adequately answered. It was important that we were able to reach an agreement on regular interaction with Drug Traffic Department officers directly and local police officers to conduct informational and awareness-raising activities, as well as to equip them with relevant information and prophylactic materials”. – Pulod, head of the NGO SPIN Plus, shared the results of the event.

RFP EXTENDED UNTIL AUGUST 14: EHRA-07-28: Consultant to develop a brief guide for managers: how to set up and deliver harm reduction services remotely or online

Posted on by Igor Gordon

REQUEST FOR PROPOSALS (RFP)

We are looking for a consultant to develop a brief guide for managers: how to set up and deliver harm reduction services remotely or online

RFP Number: EHRA-07-28
RFP Title: Consultant: Recommendations for setting up online harm reduction services
RFP Closing Date and time: 24:00 EET on August 14, 2022
Proposal Submission E-mail: info@harmreductioneurasia.org

Background

Eurasian Harm Reduction Association (EHRA) is a non-for-profit public membership-based organization uniting harm reduction activists and organisations from Central and Eastern Europe and Central Asia (CEECA) with its mission to actively unite and support communities and civil societies to ensure the rights and freedoms, health, and well-being of people who use psychoactive substances in the CEECA region. This call for proposals is organized within the project “Sustainability of Services for Key Populations in Eastern Europe and Central Asia”.

The Internet is playing an increasingly important role in selling of drugs, as well as in the availability of information about drugs. It’s important that harm reduction services keep up with trends and provide important services remotely or online.

A number of resource materials[1] have now been developed that can be used for setting up online harm reduction services, but community leaders and managers need a concise guide, with all the useful information at one place: how to effectively launch harm reduction services, what changes in service delivery needed, what investments needed.

Aim of the consultancy:

Develop a brief guide with recommendations for community leaders and managers on how to launch new, how to improve existing online or remote harm reduction services.

The guide can be developed in English or Russian.

Objectives of the consultancy:

  1. Develop and agree with EHRA a manual structure.
  2. Conduct a literature review of existing information materials on online harm reduction services / online services for key populations
  3. Develop and agree with EHRA the text of the manual, including recommendations for decision makers and managers. The manual should not exceed 15 pages. In addition, the manual should include an annex with a list of available online resources on this topic in Russian, English and, if possible, other languages that are most commonly used in the CEECA region.
  4. Prepare and deliver a presentation at a webinar, where the key messages and recommendations of the manual will be discussed.

Proposed timeline: 

All tasks are to be completed by 31 October 2022. A detailed plan will be agreed separately once the agreement with the selected consultant has been concluded. 

Evaluation Criteria

Submitted applications will be evaluated by the evaluation panel of the Eurasian Harm Reduction Association.

A two-stage procedure will be utilized in evaluating the proposals:

  • evaluation of the previous experience (portfolio) via technical criteria – 80% in total evaluation;
  • comparison of the costs (best value for money) – 20% in total evaluation.

Cost evaluation is only undertaken for technical submissions that score a minimum 80 points out of a maximum of 100 as a requirement to pass the technical evaluation. A proposal which fails to achieve the minimum technical threshold will not be considered further.

 To assess submitted applications, the following technical criteria will be used (80%) (maximum possible number of points is 100):

Evaluation criteria:

 

 Points
Knowledge and experience of providing online harm reduction / other online services to key populations 40

 
Experience of working with key populations 30

 
Experience in developing tools, writing manuals, technical reports 30

 
Maximum possible number of points 100

Cost proposal (20%): EHRA will allocate same importance to the provided portfolio and recorded experience as to the cost of the services. The cost proposal will be evaluated in terms of best value-for money to EHRA in EUR, price and other factors considered

Condition

This announcement shall not be construed as a contract or a commitment of any kind. This request for proposals in no way obligates EHRA to award a contract, nor does it commit EHRA to pay any cost incurred in the preparation and submission of the proposals.

How to apply

To be eligible as a EHRA consultant, any organization or individual must comply with:

Applicants must submit the following documents:

  1. CV
  2. Letter of interest

The CV and letter of interest should clearly state the competencies and experience of the candidate required for the task, the daily rate in euros and the number of days required for each of the tasks.

 

Please submit your proposal to the info@harmreductioneurasia.org. In the subject line of your e-mail please indicate the RFP number (EHRA-07-28) and your name.  Otherwise, the application will not be considered.

General terms

Interested consultants should pay attention to the following conditions:

  • EHRA will sign an agreement with the winner of the competitive selection. The contract will define a detailed work plan and payment terms.
  • 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.
  • The winner must confirm his/her daily rate before signing of the agreement.
  • Results will be announced by August 10, 2022. Each candidate will be contacted individually.
  • Any questions regarding this RFP should be sent to igor@harmreductioneurasia.org till August 1, 2022.

[1] Рекомендации «Веб-аутрич для людей, употребляющих наркотики» https://www.unodc.org/res/hiv-aids/new/publications_drugs_html/RecommendOutreachRU.pdf

Помощь онлайн: Картирование цифровых и дистанционных медико-социальных услуг для ключевых групп в связи с ВИЧ в регионе ВЕЦА. https://ecom.ngo/library/online-care_rus

Помощь онлайн: Лучшие практики в предоставлении цифровых и дистанционных медицинских и социальных услуг в связи с ВИЧ https://ecom.ngo/library/online-care_best-practices

RFP EXTENDED TILL AUGUST 19: EHRA is looking for national consultants in Poland, Czech Republic, Estonia, Moldova to develop approaches of ensuring optimal access to Mental Health care services by key populations in emergency situations related to COVID and war crisis in respective countries

Posted on by Igor Gordon

 

RFP Number EHRA-06-26
RFP Title National consultant in Poland, Czech Republic, Estonia, Moldova to develop approaches of ensuring optimal access to Mental Health care services
by key populations in emergency situations related to COVID and war crisis
RFP Closing Date and time: 24:00 EET on August 19, 2022
Proposal Submission Address: info@harmreductioneurasia.org

Background

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

EHRA is looking for national consultants in Poland, Czech Republic, Estonia, Moldova to conduct a mapping of existing systems of the mental health care and an assessment of existing and potential barriers hampering the access to mental health services available to people using drugs involving war refugees from Ukraine, in emergency situations connected to COVID and war crisis in respective countries.

Living a healthy and positive life is not possible without adequate mental health; mental health problems may have a significant impact on daily life and its quality without being treated effectively.

People who use drugs, like all people, should have an appropriate access to mental health support. Mental health issues and drug dependency can be brought in by the same factors, like poverty, lack of access to healthcare and other services, homelessness, stigma and discrimination; people may also start or continue using drugs to deal with mental health issues. Providing adequate access to mental health services for people who use drugs “without framing drug use and/or dependence as mental health issues in absolute terms” should be considered a priority. People who use drugs should be able to exercise their right to have a choice regarding their physical/mental health and relevant ways to encourage better access to mental health or barriers hampering such access should be identified and properly analysed.

For the past several years certain factors have influenced the optimal access to mental health services:

  • influence of COVID-19 pandemic on mental health issues was obvious due to increased stress situations, lockdowns and growing waves of home and gender-based violence as well as extra strain on health care systems all over the world.
  • the most recent war in Ukraine caused nearly one third of its population (over 14 million) to flee the violence and abandon their homes in search of safe haven inside the country or abroad, with over 6 million Ukrainians having crossed the borders and living as refugees abroad, while over 8 millions are internally displaced within the country. Many of these people are or will be in the nearest future in dire need of essential mental health support, also to mention the more specialized services needed for key populations, including people who use drugs, OST clients and NPS users including war refugees from Ukraine.
  • some specific mental health challenges are encountered by a more specific group of people using NPS (new psychoactive substances). Services for NPS users are usually not available in existing harm reduction packages of services (syringe exchange, distribution of condoms and disinfectants, overdose prevention, testing for HIV and other infections, psycho-social assistance, etc.) and, therefore, opportunities to receive help with mental health or behavioural disorders due to the use of NPS is limited. Only a few countries in the region have established clinical protocols for the diagnosis and treatment of mental health and behavioural disorders by the use of NPS and even those are not widely used due to lack of knowledge among health professionals, resulting in lack of adequate medical assistance for NPS users.
  • continued stigmatisation/discrimination in health institutions and judgmental attitudes toward people who use drugs from the general public, still remain a barrier for those who may be in need of mental health services.

These and other significant factors influencing the provision of mental health services should be assessed, carefully studied, and relevant recommendations formulated for further optimization of mental health support services provision with an emphasis on people who use drugs (incl. OST clients and NPS users), including war refugees from Ukraine, in different backgrounds as mentioned above.

Objectives and key tasks of the national consultants:

EHRA is looking for national analytics in four countries: Poland, Moldova, Czech Republic and Estonia (one for each country), to conduct a national mapping of existing system of the mental health care and an assessment of existing and potential structural, legal, language, stigma-related and other barriers hampering the access of people using drugs (incl. OST clients and NPS users) residing in a country and war refugees from Ukraine to mental health services, in emergency situations related to COVID pandemic and war crisis as well as identify existing best practices/innovations in provision of mental health services to indicated target populations.

These national consultants are expected to perform the following objectives, in accordance with the timeframe below:

  1. Conduct mapping and assessment, individually for each country, based on a methodology developed by a Lead Consultant working with EHRA.

Mapping of the mental health care existing system and management for each of the selected countries should describe available current possibilities to receive mental health services from a patient’s perspective (patient’s pathway at different levels of services’ provision – starting from community level up to specialised services) for the following categories:

  • system of mental health services for a regular population in a given country, serving as an introduction and providing background to further provisions;
  • people using drugs, including such sub-groups as OST clients and NPS users;
  • refugees, incl. war refugees/temporarily displaced person from Ukraine, with limited access to regular health care.

Limitations or changes in access to mental health services system which had been introduced in emergency situations as a result of COVID pandemic restrictions should be mentioned and explored in this section.

Methods of data collection for the mapping may include:

  • desk review of all relevant publications, legal documents and other materials being publicly available, including web-sites of relevant governmental institutions.
  • interviews with the key informants (if needed).

Assessment of barriers/innovations should explore:

  • existing and potential structural, legal, language, stigma-related and other barriers hampering access to mental health services of the mentioned key populations;
  • existing and potential barriers hampering the access to mental health services for war refugees and people on a temporary stay due to emergency situations seeking relevant MH services in the specified countries;
  • existing best practices/innovations in MH provision which have proven its effectiveness and responsiveness to the needs of the mentioned key populations and (war) refugees.

Mentorship support would be provided to national consultants during the implementation stage by a Lead Consultant.

Prior to conducting mapping and assessment at the national level, and, as a preparation for further implementation, national consultants are expected to:

  1. Participate in Multidisciplinary Expert Meeting, conducted on August 30-31, 2022, in Istanbul, Turkey, by taking part in consultations on identifying barriers and challenges in accessing mental health care and support services for people who use drugs, people who use new psychoactive substances, and migrants and refugees.
  2. Take part in Training session on September 1, 2022 where assessment methodology and its implementation process will be presented by a Lead Consultant. The Training will be held concurrently with Multidisciplinary Expert Meeting, at the same location.

Expenses related to consultants’ participation in Multidisciplinary Expert Meeting and training
(travel, accommodation, etc.) will be covered by EHRA separately.

Deliverable:

Findings on mapping of services and existing barriers as well as any best practices existing in a country and recommendations on optimization of mental health services provision to people using drugs (incl. OST clients, NPS users) involving war refugees from Ukraine, in emergency situations connected to COVID and war crisis, should be presented in a format of a National Report.

National Report should include an outline of mental health care system, assessment of barriers, existing best practices and recommendations on optimization of mental health services provision.

The language of the resulted documents should be English/Russian.

Timeframe:

  1. August 30-31, September 1, 2022 – participate in Multidisciplinary Expert Meeting and a training session on assessment methodology and its implementation process.
  2. By September 30, 2022 – submit draft of the National Report, including outline of mental health care system, assessment of barriers, existing best practices and recommendations, for discussion and feedback from EHRA.
  3. By October 7, 2022 – receive feedback from a Lead Consultant/EHRA staff on the National Report .
  4. By October 20, 2022 – complete and submit the final version of the National Report, including an outline of mental health care system, assessment of barriers, existing best practices and recommendations on optimization of mental health services provision.

Cost of services

The cost of services will be calculated on the basis of the consultant’s fixed number of working days (18) and his or her confirmed daily rate.

In addition, EHRA will cover travel, accommodation and other relevant costs during Expert Meeting/training.

Evaluation criteria / requirements for candidates:

 Submitted applications will be evaluated by the evaluation panel of the Eurasian Harm Reduction Association.

A two-stage procedure will be utilized in evaluating the proposals:

  • evaluation of the previous experience (portfolio) via technical criteria – 80% in total evaluation.
  • comparison of the costs (best value for money) – 20% in total evaluation. The EHRA will evaluate the proposal regarding the best value for money (price in euros and other factors are taken into account).

Cost evaluation is only undertaken for technical submissions that score a minimum 90 points out of a maximum of 100 as a requirement to pass the technical evaluation. A proposal which fails to achieve the minimum technical threshold will not be considered further.

Consultants with proven work experience in the topics of mental health and key populations (people who use drugs, OST clients and NPS users) would be given a priority.

Criteria Weighting
Good understanding of the mental health care existing system and ability to present it from a patient’s perspective (patient’s pathway at different levels of services’ provision). Good understanding of existing/potential structural, legal, language, stigma-related and other barriers hampering the access to mental health services. Access to relevant sources of information required to complete the task. 35 points
Knowledge of specifics related to people using drugs (incl. OST clients and NPS users) Access to relevant sources of information required to complete the task. 25 points
Knowledge of specifics related to emergency situations connected to COVID and war crisis, including war refugees/people on a temporary stay from Ukraine. Access to relevant sources of information required to complete the task. 15 points
Experience of development of similar publications and a strong record of adherence to evidence-based approaches. 25 points
Total 100 points

This announcement shall not be construed as a contract or a commitment of any kind. This request for proposals in no way obligates EHRA to award a contract, nor does it commit EHRA to pay any cost incurred in the preparation and submission of the proposals.

The above-mentioned parameters should be clearly explained in a Letter of Interest and CV submitted by a prospective consultant.

To be eligible as a EHRA consultant, any organization or individual must comply with the Eurasian Harm Reduction Association Code of Ethics which you can find at the following link: https://old.harmreductioneurasia.org/ehra-code-of-ethics/

Additionally, the consultants should have:

  • No conflict of interest (should be declared in the Letter of Interest);
  • Fluency in English and/or language/-s of the countries selected.

How to apply

Applicants must submit the following documents:

– CV,

– Letter of Interest. The CV and application should clearly reflect the competency of the candidate necessary to complete this task and include a cost per day in EUR.

Please submit your proposal to the info@harmreductioneurasia.org

In the subject line of your e-mail please indicate the RFP number and your name.  Otherwise, the application will not be considered.

RFP: External consultants to conduct the assessment of the sustainability of opioid agonist therapy (OAT) in the context of the transition from the Global Fund support to national funding in Republic of Albania and Kyrgyz Republic

Posted on by Igor Gordon

REQUEST FOR PROPOSALS (RFP) 

RFP Number EHRA-06-22
RFP Title External consultants to conduct the assessment of the sustainability of opioid agonist therapy (OAT) in the context of the transition from the Global Fund support to national funding in Republic of Albania and Kyrgyz Republic
RFP Closing Date and time: 24:00 EET 15 July 2022 г.
Proposal Submission Address: info@harmreductioneurasia.org

Background

Being a partner of the Alliance for Public Health, the All-Ukrainian Network of PLWH 100% Life and other regional and national organizations in the implementation of the Global Fund funded regional HIV project “Sustainability of services for key populations in Eastern Europe and Central Asia”, Eurasian Harm Reduction Association (EHRA) is aimed at the improving the sustainability of HIV programs in EECA countries.

To contribute to this objective, EHRA is planning to conduct in a number of EECA countries the assessment of the sustainability of opioid agonist therapy (OAT) in the context of the transition from the Global Fund support to national funding.

In 2019 – 2020 the Eurasian Harm Reduction Association (EHRA) has developed and piloted the methodological approach and tools for countries to assess the sustainability of opioid agonist therapy (OAT) programs in the context of transition from Global Fund’s, or other donor, support. This assessment covers the current situation, progress achieved, risks, and opportunities for sustainability with a focus on programmatic aspects of OAT.

EHRA is looking for the national level consultants to conduct the assessment of the sustainability of OAT programs in the context of transition using the EHRA developed assessment framework and methodology in Republic of Albania and Kyrgyz Republic.

Tasks for the consultant

The consultant is expected to conduct the national assessment process in accordance with an Assessment Guide “Measuring the sustainability of opioid agonist therapy (OAT)”. The assessment process should include the next stages:

  1. Preparation stage

At this stage consultant is expected to familiarize themselves with the reports on the results of the assessments, conducted in other countries, as well as to conduct the planning and revision\adaptation of the OAT Sustainability Assessment Framework and methodology to the national context. To do that it the consultant will need to establish and engage an advisory group composed of 4-7 national experts representing different sectors and bringing a combination of expertise in the issue areas (please see chapter 2.1. of the Assessment Guide for more details).

In particular, the revision and adjustment of the tools provided in the relevant sections of the EHRA Assessment Guide are recommended, including:

  • Outline of the report (Annex 3 of the Assessment Guide);
  • Instruments for structuring the collected information from the literature review and interviews (and focus groups, if any) (see the separate file for Annex 4 with the instructions and instruments for each of the indicators); and,
  • Interview and focus group guides (see separate files for Annex 5 and Annex 6 accordingly).

Adjustment of the first two instruments – the outline and the instruments for structuring information – is recommended to be undertaken first. The changes in the interview guide should follow the desk review (see Section 2.2.1. of the Assessment Guide) once conducted and missing information is identified.

  1. Assessment stage

To conduct a thorough and comprehensive assessment, the following steps must be undertaken:

  • Throughout the data collection process, to assess each indicator for each sustainability issue area using the tables provided in the annexes to the Assessment Guide (see Annex 4 of the Assessment Guide) and in accordance with the outline of the report (Annex 3 of the Assessment Guide);
  • To conduct the collection of quantitative and qualitative data through a desk review (see the Section 2.2.1 of the Assessment Guide);
  • To conduct the collection of quantitative and qualitative information through interviews with selected key informants (see Section 2.2.2. of the Assessment Guide) and focus group discussions (see Annexes 5 and 6 of the Assessment Guide); and,
  • To analyze the received data and prepare it for the inclusion into the report.

Guidance on how to complete each of the above key steps is provided in relevant sections of the EHRA Assessment Guide “Measuring the sustainability of opioid agonist therapy (OAT)”.

In accordance with the OAT sustainability framework, the focus of all of these steps should be around the next three issue areas of sustainability: Policy & Governance, Finances & Resources and Services.

  1. Development of the report

Once the assessment has been conducted, the consultant is expected to compile the data and draft the report. Conducting data verification will be required with the suppport of the Advisory Group – more guidance on that could be found in the Assessment Guide.

A report outline is provided in Annex 3 to the Assessment Guide. The report should include contextual sections, findings and conclusions for each of the issue areas as well as general conclusions and recommendations to government institutions, practitioners, civil society, technical partners and donors.

Deliverables

The report on the results of the assessment of the OAT sustainability in the context of the Global Fund transition in one of the next countries – Albania, Kyrgyzstan – in accordance with the preliminary agreed outline. The report should include the annexes with the information on the detailed methodology, the list of respondents and an overview of measurement scoring of sustainability. Other annexes could be included as well if relevant.

The language of the resulted documents should be English or Russian.

Timeframe

  • The Preparation stage should be completed by 15.08.2022. The report outline, instruments for structuring information and interview guide should be agreed with the EHRA in case they are changed\adjusted. List of the advisory group members should be agreed with EHRA as well by that date.
  • The Assessment stage should be completed by 30.09.2022.
  • The draft report should be provided to the EHRA colleagues for the review and feedback by 31.10.2022.
  • The final report should be submitted by 01.12.2022.

Payment

The final cost of the contract will be calculated based on the number of working days indicated by the consultant in their application required to complete each stage of the assessment process described in this RFP, as well as the daily rate (in Euros) confirmed and agreed with EHRA. The daily rate must include all taxes to be paid by consultant themselves.

Evaluation criteria / requirements for candidates:

Submitted applications will be evaluated by the evaluation panel of the Eurasian Harm Reduction Association. A two-stage procedure will be utilized in evaluating the proposals:

  • evaluation of the previous experience (portfolio) via technical criteria – 80% in total evaluation (please find the criteria in the table below)
  • comparison of the costs (best value for money) – 20% in total evaluation. The EHRA will evaluate the proposal regarding the best value for money (price in euros and other factors are taken into account).

Cost evaluation is only undertaken for technical submissions that score a minimum 80 points out of a maximum of 100 as a requirement to pass the technical evaluation. A proposal which fails to achieve the minimum technical threshold will not be considered further.

Criteria: Points
High level of knowledge on OAT situation in the country of the assessment, including programmatic, organizational, financial and political aspects (to follow from the Letter of Interest); 25
Good knowledge and understanding of the processes taking place in the country in the context of the transition from the Global Fund’s support and ensuring the sustainability of HIV and OAT related services. The personal participation of an expert in such processes at the national or regional levels is welcome (should follow from the Letter of Interest); 25
Relevant experience in conducting this kind of analytical work, including collecting and analyzing qualitative and quantitative data, preparing reports on the results of assessments and recommendations (should follow from the Letter of Interest); 25
Availability of professional contacts with experts dealing with OAT in the country, as well as clients of OAT programs, the ability to establish communication with experts key to this assessment (should follow from the Letter of Interest); 25
Maximum possible number of points 100

Mandatory requirement for the candidates: excellent knowledge of written and spoken English and Russian (for the candidates to conduct the assessment in Kyrgyzstan), good knowledge of written and spoken English (for the candidates to conduct the assessment in Albania) and excellent knowledge of the native language of the country to conduct the assessment for any candidates.

This announcement shall not be construed as a contract or a commitment of any kind. This request for proposals in no way obligates EHRA to award a contract, nor does it commit EHRA to pay any cost incurred in the preparation and submission of the proposals.

Based on the evaluation results, the evaluation panel may decide to support several consultants. In this case, the evaluation panel will contact the selected consultants for negotiations.

How to apply

To be eligible as a EHRA consultant, any organization or individual must comply with the Eurasian Harm Reduction Association Code of Ethics which you can find at the following link: https://old.harmreductioneurasia.org/ehra-code-of-ethics/ Also, the applicant should support the position of the EHRA on the issue of Russian aggression against Ukraine https://old.harmreductioneurasia.org/eurasian-harm-reduction-association-condemns-the-russian-war-against-ukraine/

Applicants must submit the following documents:

  • CV,
  • Letter of Interest.

The CV and application must reflect the candidate’s competencies required to complete this task. The Letter of Interest should also include the estimated number of working days required to complete each stage of the assessment process and the daily rate in EUR.

Please submit your proposal to the info@harmreductioneurasia.org

In the subject line of your e-mail please indicate the RFP number and your name.  Otherwise, the application will not be considered.

SIGN UP FOR FREE ONLINE COURSE «Digital Help: Services For Key Populations»

Posted on by Igor Gordon

Sign up for the course HERE before June 30.

Who is this course[1] for and why?

This online course is dedicated for NGOs and public health institutions providing digital or remote services for key populations, as well as for organizations that are just planning to introduce such services. The purpose of the course is to build capacities of outreach workers, social workers, psychologists, and other specialists who are involved in provision of online/remote services, and managers of those programs, for better quality of the services.

This course has been designed to help organizations in providing direct online help for key populations. During the Covid 19 pandemic digital tools turned out to be important means of reaching members of vulnerable groups. The main aim of the course is to provide participants with the basic knowledge on the core elements of providing digital services for key populations.

There is no one tool that fits all needs. There are many specialized tools, and they are constantly being developed, improved, or fixed. A tool used by one organization may not fit the requirements of others. Therefore, the main objective of this course is to show how to properly select digital tools and evaluate their usefulness.

Before details of tool selection, we will show how using Internet based interventions can be an effective approach to evidence-based work with key groups and individuals. We will then look at another important aspect, computer mediated communication. We will also tackle the issue of confidentiality, privacy, and data storage safety, as well as ethics. The Internet can be a wonderful tool, but online safety is a key issue when providing online services.

What topics will be covered?

  • Online communication – specifics of computer mediated communication, rules of netiquette, language in digital services.
  • Planning digital services based on understanding of the target audience using Persona tool
  • Understanding of possible ways of using available digital tools.
  • Online counselling and therapy – framework for practice, structure of effective client session, practicalities of developing online relationship.
  • Secure digital services – privacy, confidentiality, and security guidelines, secure software, and hardware, encrypting sensitive data, tips to protect your online privacy and security.
  • Ethics and dilemmas of running online services and online services as a source of strain and the work-life in balance.

Learning outcomes

By the end of the course, you will be able to:

  • Use online communication effectively for counselling and therapy.
  • Describe what a Persona is and identify why and when to use it.
  • Construct a Persona.
  • Recognize the strengths and weaknesses of various tool categories.
  • Compare and contrast digital tools.
  • Adopt the use of counselling skills in an online context.
  • Protect your online privacy and security.
  • Be aware of ethical issues and dilemmas of running on-line services

How will the course be organised?

The program of the course consists of six modules with learning content, self-check tests, additional tips, and practical exercises. For each module, the lesson text has been prepared for reading online and in PDF format for downloading it. We have also included additional materials such as: questionnaires and surveys, videos, and links to external sources on the Internet.

During the course, we plan four online video meetings with a group of all training participants. During these meetings you will be able to get to know your fellow students better, share your experiences, discuss with everyone important topics and ethical dilemmas you may encounter when working online in connection with the provision of online services, and receive advice from the trainers on the course and feedback on the completed assignments.

The course is available in Russian or English.

When will the course take place?

The full course will take one month to complete, in which you will need to allocate 22 hours of your time to learning. You can choose in which month you want to start training, from July till November.

Certificate

To receive certificate of completion, each participant must complete 80% of all tasks on the platform, take part in the four video calls, complete the final assignment.

You can register for the course HERE before June 30.

We will notify you personally about your enrolment and the start date by e-mail before 27th June.

If you have any questions, please contact Igor Gordon by igor@harmreductioneurasia.org

[1] The course was developed by the Global Public Health Network in partnership with the Eurasian Harm Reduction Association (EHRA) with participation of ECOM – Eurasian Coalition on Health, Rights, Gender and Sexual Diversity and the Eurasian Women’s Network on AIDS (EWNA) within the framework of the Eurasian Regional Consortium’s project ‘Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services’ funded by the Robert Carr Civil Society Networks (RCF).

[1] The course was developed by the Global Public Health Network in partnership with the Eurasian Harm Reduction Association (EHRA) with participation of ECOM – Eurasian Coalition on Health, Rights, Gender and Sexual Diversity and the Eurasian Women’s Network on AIDS (EWNA) within the framework of the Eurasian Regional Consortium’s project ‘Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services’ funded by the Robert Carr Civil Society Networks (RCF).

RFP EXTENDED: trainers to run an online course on delivering digital services to key populations

Posted on by Igor Gordon

We are looking for trainers to run an online course on delivering digital services to key populations

RFP Number EHRA-05-19
RFP Title Trainer online course on digital services
RFP Closing Date and time: 24:00 EET on June 19, 2022
Proposal Submission Address: info@harmreductioneurasia.org

Background

Eurasian Harm Reduction Association (EHRA) is a non-for-profit public membership-based organization uniting harm reduction activists and organisations from Central and Eastern Europe and Central Asia (CEECA) with its mission to actively unite and support communities and civil societies to ensure the rights and freedoms, health, and well-being of people who use psychoactive substances in the CEECA region. This call for proposals is organized within the project “Sustainability of Services for Key Populations in Eastern Europe and Central Asia”.

In 2021, in collaboration with the Global Public Health Network, EHRA has developed an online course that provides the basic knowledge and skills needed by community workers, social workers, psychologists and other professionals who are already involved in or are just planning to launch digital and remote services for key populations.

The course consists of four modules with learning content, self-tests, additional tips and practical exercises. The course also contains additional materials including questionnaires and surveys, videos and links to external sources.

The course is designed in a way that 80% of the material is for self-study, and the rest 20% with supervision of trainers.

The course is available in Russian and English and can be found on the LearnWorlds platform – https://ehra.learnworlds.com/course/digi.

The consultants selected under this request for proposals will be financed from two different projects. The work of a trainer to deliver a course for social workers, outreach workers, psychologists and other professionals providing counselling to people who use drugs will be funded from the multi-country project ‘Sustainability of Services for Key Populations in Eastern Europe and Central Asia’ funded by the Global Fund to Fight HIV, Tuberculosis and Malaria. The work of trainers to deliver a course on online services for other key populations, including gay men and other men who have sex with men, sex workers, transgender people, and women and young people living with HIV will be funded by the Eurasian Regional Consortium project supported by the Robert Carr civil society Networks Fund (RCF).

Aim of the consultancy: 

As part of this request for proposals, we are looking for qualified trainers who will be able to independently deliver an online course for 5 different groups in Russian or English. All pre-selected trainers will receive training for trainers to work effectively with the course.

Objectives of the consultancy:

  1. with EHRA support, familiarise with the course content and how to manage the LearnWorlds platform. EHRA will provide instructions on course management, access to the LearnWorlds platform, and technical support to trainers.
  2. Conduct online trainings for up to 6 groups of participants. In each training, the trainer will be required to keep high level of attention and interest of the course participants (up to 30 people) while going through 5 training modules and 4 online sessions in each training session, controlling giving feedback on test assignments.
  3. Provide participants with counselling and mentoring support after completion the course (no more than 2 hours of support for participants on request).
  4. Provide a progress report, including recommendations for further technical support to specialists who provide online services to key groups. 

Proposed timeline: All trainings must be completed by 31 November 2022. A detailed training plan will be agreed separately with trainers.

Evaluation Criteria

Submitted applications will be evaluated by the evaluation panel of the Eurasian Harm Reduction Association.

A two-stage procedure will be utilized in evaluating the proposals:

  • evaluation of the previous experience (portfolio) via technical criteria – 80% in total evaluation;
  • comparison of the costs (best value for money) – 20% in total evaluation.

Cost evaluation is only undertaken for technical submissions that score a minimum 80 points out of a maximum of 100 as a requirement to pass the technical evaluation. A proposal which fails to achieve the minimum technical threshold will not be considered further.

 To assess submitted applications, the following technical criteria will be used (80%) (maximum possible number of points is 100):

Evaluation criteria:

 

 Points
Experience of working as trainer (including experience of delivering online training) 40

 
Experience in working with key populations 30

 
Relevant education (psychology, social work, pedagogy) 30

 
 

Maximum possible number of points

  

100

Cost proposal (20%): EHRA will allocate same importance to the provided portfolio and recorded experience as to the cost of the services. The cost proposal will be evaluated in terms of best value-for money to EHRA in EUR, price and other factors considered

Condition

This announcement shall not be construed as a contract or a commitment of any kind. This request for proposals in no way obligates EHRA to award a contract, nor does it commit EHRA to pay any cost incurred in the preparation and submission of the proposals.

How to apply

To be eligible as a EHRA consultant, any organization or individual must comply with:

Applicants must submit the following documents:

  1. CV
  2. Cover letter

The CV and Letter of Interest should clearly reflect the competency of the candidate and trainer’s experience (including delivery of online trainings) necessary to complete this task, as well as include daily rate in US dollars.

Please submit your proposal to the info@harmreductioneurasia.org. In the subject line of your e-mail please indicate: EHRA-05-19 and your name.  Otherwise, the application will not be considered. 

General terms

Interested consultants should pay attention to the following conditions:

  • EHRA will sign an agreement with the winner of the competitive selection. The contract will define a detailed work plan and payment terms.
  • 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.
  • The winner must confirm his/her daily rate before signing of the agreement.
  • Results will be announced by June 23, 2022. Each candidate will be contacted individually.
  • Any questions regarding the participation should be sent to igor@harmreductioneurasia.org till June 17, 2022.

EXTENDED! REQUEST FOR PROPOSALS: consultant to develop practical compendium of methods for community-led monitoring

Posted on by Igor Gordon
RFP Number EHRA-05-18
RFP Title Consultancy CLM practical compendium
RFP Closing Date and time: 24:00 EET on June 12, 2022
Proposal Submission Address: info@harmreductioneurasia.org

Background

Eurasian Harm Reduction Association (EHRA) is a non-for-profit public membership-based organization uniting harm reduction activists and organisations from Central and Eastern Europe and Central Asia (CEECA) with its mission to actively unite and support communities and civil societies to ensure the rights and freedoms, health, and well-being of people who use psychoactive substances in the CEECA region. This call for proposals is organized within the project “Sustainability of Services for Key Populations in Eastern Europe and Central Asia”.

Community-led monitoring is becoming increasingly demanding among both key population community groups and donors as an approach and mechanism in identifying and addressing gaps in HIV response in the CECCA region.

However, community groups often abstain to get involved in CLM, thinking it costly, complicated, and has limited advocacy effect. Many community groups face challenges to choose correct monitoring methods, compatible with organization’s human, financial and technical resources.

In December 2021, EHRA in collaboration with UNAIDS and GF carried out a webinar (link: https://eecaplatform.org/en/webinar-on-clm/), where community and civil society activists were provided with information about:

  • international approaches to CLM by UNAIDS and the Global Fund,[1]
  • existing experience of conducting CLM and follow-up advocacy by different community groups in the CEECA region (gender audit by EWNA, community satisfaction by EHRA, „secret client“ by ECOM).[2]
  • addressed key principles and approaches when selecting CLM methods and role of CLM in community-driven advocacy, illustrated with practical examples.

Other CLM resources include:

  • CLM Resource Hub, powered by UNAIDS,
  • Community–Led Monitoring Tools developed by PEPFAR,
  • Technical Guidance: Principles and process in establishing CLM of HIV services, developed by UNAIDS,
  • A community toolkit developed by ITPC.

Aim of the consultancy:

With this RFP we are looking for a qualified external consultant who will help us to develop practical compendium of CLM methods. This document should easily explain community groups different CLM methods and how logically select appropriate one, to identify gaps or address stated advocacy asks. The guidance should also show in a simple way, a clear link between the chosen methods and required human, financial and technical resources needed to carry out the monitoring.

 

Objectives of the consultancy:

  1. Develop a practical compendium of CLM methods. Should be completed before 10th July 2022.
    • Develop preliminary outline of the compendium, in consultation with EHRA.
    • Draft compendium of CLM methods which contains structured catalogue of different CLM methods with clear and simple explanation of each method. The catalogue should also include section with complete list of possible issues that CLM could address; examples of required financial, technical, and human resources for each CLM method; clear explanation and criteria of what is the difference between CLM and other research and monitoring methods; illustrative examples of CLM use. Volume of the publication should not exceed  30 A4 pages, Times New Roman 12, excluding infographics and illustrations. The document can be drafted in ENGLISH or RUSSIAN languages.
    • The document should be written in a simple, clear language, understandable to people without special education and without use of specific sociological professional terminology. This tool should not duplicate all previous efforts made by the
    • Finalize the guidance, after two rounds of feedback from EHRA.
  1. Participate in development of a webinar and content for online tool for community-based organizations. The webinars will be focused on CLM methods described in the tool. All webinars will be conducted tentatively in August 2022.

 

Proposed timeline:

All activities should be completed before 31st August, 2022.

 

Evaluation Criteria

Submitted applications will be evaluated by the evaluation panel of the Eurasian Harm Reduction Association.

A two-stage procedure will be utilized in evaluating the proposals:

  • evaluation of the previous experience (portfolio) via technical criteria – 80% in total evaluation;
  • comparison of the costs (best value for money) – 20% in total evaluation.

Cost evaluation is only undertaken for technical submissions that score a minimum 80 points out of a maximum of 100 as a requirement to pass the technical evaluation. A proposal which fails to achieve the minimum technical threshold will not be considered further.

 To assess submitted applications, the following technical criteria will be used (80%) (maximum possible number of points is 100):

Evaluation criteria:

 

 Points
Knowledge of research methodologies and experience in conducting research 40

 
Experience in working with key populations 20

 
Experience in developing tools, writing technical reports, guidance 20

 
Relevant education 20
 

Maximum possible number of points

  

100

 

Cost proposal (20%): EHRA will allocate same importance to the provided portfolio and recorded experience as to the cost of the services. The cost proposal will be evaluated in terms of best value-for money to EHRA in EUR, price and other factors considered.

Condition

This announcement shall not be construed as a contract or a commitment of any kind. This request for proposals in no way obligates EHRA to award a contract, nor does it commit EHRA to pay any cost incurred in the preparation and submission of the proposals.

How to apply

To be eligible as a EHRA consultant, any organization or individual must comply with:

Applicants must submit the following documents:

  1. CV
  2. Cover letter
  3. Examples of relevant publications

The CV and Letter of Interest should clearly reflect the competency of the candidate necessary to complete this task, as well as include the proposed number of working days for each objective, cost and timing of their implementation. Please, also add to your Letter of Interest short description of your approach in developing the guidance and very preliminary vision of the guidance content structure (150 words max).

Please submit your proposal to the info@harmreductioneurasia.org. In the subject line of your e-mail please indicate the RFP number (EHRA-05-18) and your name.  Otherwise, the application will not be considered.

General terms

Interested consultants should pay attention to the following conditions:

  • EHRA will sign an agreement with the winner of the competitive selection. The contract will define a detailed work plan and payment terms.
  • 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.
  • The winner must confirm his/her daily rate before signing of the agreement.
  • Results will be announced by June 7,2022. Each candidate will be contacted individually.
  • Any questions regarding the participation should be sent to igor@harmreductioneurasia.org till June 3, 2022.

[1] a. HOW TO IMPLEMENT COMMUNITY-LED MONITORING. A Community Toolkit. URL: https://eecaplatform.org/wp-content/uploads/2021/12/1205_itpc_clm_design_fullreport06_compressed.pdf

  1. Community-led Monitoring for HIV, TB and Malaria programs and to address the impacts of COVID-19. URL: https://eecaplatform.org/wp-content/uploads/2021/12/clm_ehra-webinar.07122021.pdf
  2. UNAIDS Perspectives and Support for CLM, by Dominic Kemps. URl: https://eecaplatform.org/wp-content/uploads/2021/12/clm-presentation-for-eurasian-harm-reduction-assoc-webinar-1221.pdf

[2] a. ЧЕК-ЛИСТ ПОДГОТОВКИ К ИССЛЕДОВАНИЮ. Сексуальное и репродуктивное здоровье и права

женщин, живущих с ВИЧ. URL: https://eecaplatform.org/wp-content/uploads/2021/12/chek-list_ezhss.pdf

  1. “Mystery Client” methodology, ECOM. URL: https://eecaplatform.org/wp-content/uploads/2021/12/ecom_clm.pdf
  2. Community led survey of client satisfaction with opioid maintenance therapy services among participants in Kyiv and the Kyiv Oblast region, Ukraine, by Maria Plotko. URL: https://eecaplatform.org/wp-content/uploads/2021/12/ehra_omt_plotko.pdf

RFP extended: Small grants to support local actions on 26 June 2022 as part of the “Support. Don’t Punish!” campaign in the CEECA region

Posted on by Igor Gordon

REQUEST FOR PROPOSALS (RFP)

Small grants to support local actions on 26 June 2022 as part of the “Support, Don’t Punish!” campaign in the CEECA region

RFP Number EHRA-05-17
RFP Title Small grants SDP2022
RFP Closing Date and time: 23:59 EET on May 22, 2022
Proposal Submission Address: info@harmreductioneurasia.org

BACKGROUND

Eurasian Harm Reduction Association (EHRA) would like to inform initiative groups and organizations of the community of people who use psychoactive substances, as well as organizations working in drug policy and harm reduction field in CEECA region, about the possibility to receive up to 500 USD in form of small grant for local actions and events on Global Day of Action, June 26 in a frame of “Support, Don’t Punish” campaign.

The Eurasian Harm Reduction Association has been actively supporting the global initiative and activities of the campaign “Support, Don’t Punish”, which celebrates its 10th anniversary this year. More information about the campaign can be found at https://supportdontpunish.org/join/. A report of the 2021 campaign events funded by EHRA can be found –>HERE <–

This year is no exception. We are joining the broader coalition of campaigners to support drug policy reform, decriminalisation and community involvement in advocacy. EHRA as a part of the International Harm Reduction Consortium project “Ending Inequalities for People who Use Drugs: Strengthening Harm Reduction to Elevate Rights, Health and Capacity” will provide small grants to CBOs and CSOs to deliver local actions and events on June 26, organised by harm reduction activists and the community of people who use drugs, who on the ground are resolutely opposing the harmful “war on drugs”.

 

IMPLEMENTATION TIME: June 2022

Language of proposal: Russian or English

Application submission deadline: 23:59 EET on May 22, 2022

 

REQUIREMENTS FOR APPLICANTS

  • Only non-governmental and non-profit organisations registered as legal entities in one of the 29 countries of the Central and Eastern Europe and Central Asia region can apply. Initiative groups can also apply, but their fiscal agent must be an NGO or non-profit organisation.
  • Work with / represent / provide services to / advocate for the needs of people who use drugs.

The total budget for sub-grants is $2 000. 4 groups/organizations with a highest score (out of 100 points) and based in 4 different countries will be selected to receive the funding. Maximum grant amount is 500 $.

 

EVALUATION CRITERIA

Submitted applications will be evaluated by an evaluation panel of the Eurasian Harm Reduction Association.

Evaluation criteria: Points
Clear and specific description of stated problem.

The stated problem is directly connected with drug policy reform, decriminalisation and community advocacy.

 30
The proposed activities should be feasible. 20
The anticipated results should be realistic, commensurate with the proposed format and budget. 20
Realistic and justified budget 20
Applicant is member of EHRA 10
Maximum possible number of points 100

How to apply

To be eligible as EHRA sub-grantee, any organization or initiative group must comply with

 Applicants must submit the following documents:

– Application form <– download 

– Organizational registration document

– Memorandum of cooperation (in case of working through a financial agent).

Please submit your proposal to the info@harmreductioneurasia.org.

In the subject line of your e-mail please indicate: EHRA-05-17 “Small grants SDP2022”_ and name of your organization/ initiative group.  Otherwise, the application will not be considered.

 

General terms and conditions

This announcement and its attachments shall not be construed as a contract or a commitment of any kind. This request for proposals in no way obligates EHRA to award a contract, nor does it commit EHRA to pay any cost incurred in the preparation and submission of the proposals.

Interested applicants should pay attention to the following conditions:

  • EHRA will sign an agreement with 4 winners of the competitive selection. The contracts will define a detailed work plan, budget and payment terms.
  • 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.
  • Results will be announced by 20th May 2022. Each applicant will be contacted individually.
  • Any questions regarding the participation should be sent to igor@harmreductioneurasia.org till May 13, 2022.

Eurasian Harm Reduction Association’s position on the Russian military aggression in Ukraine

Posted on by Igor Gordon

Eurasian Harm Reduction Association condemns the Russian war against Ukraine

The values of the Eurasian Harm Reduction Association (EHRA), our mission, and all our work are aimed at ensuring the people’s rights and freedoms, health, and well-being.

We consider the actions of the Russian Federation on the territory of Ukraine as an act of genocide against the people of Ukraine and a grave violation of the international humanitarian and human rights law. We condemn and oppose Russia’s act of aggression and incursion into the sovereign state of Ukraine in violation of international law.

We make every effort to support Ukrainians, first of all, those from among the representatives of key populations affected by HIV, TB, including people who use drugs, who became a victim of this war and genocide.

In regard to the above-mentioned, EHRA will stop any partnership with organizations or individuals who do not support the position of the EHRA on the issue of Russian aggression against Ukraine. By default, the position represents the opinion of all EHRA members.

Expert Group Meeting of the Eurasian Harm Reduction Association

Posted on by Igor Gordon

Moving Together Towards Quality Harm Reduction[1]

5-7 October 2021

Meeting report

Contents

Rational and background of the meeting. 2

Meeting goals and objectives. 3

Summary of highlights and key themes discussed during the meeting. 4

Immediate next steps in national and regional advocacy. 7

Rational and background of the meeting

Harm reduction as a concept appeared in 1980s as a solution to health problem – the spread of HIV/AIDS among injecting drug users. Since its pioneer days, the key success factor for effectiveness of harm reduction interventions is the adherence to four fundamental principles – (1) respecting the human rights of people who use drugs, (2) commitment to evidence, (3) commitment to social justice and collaborating with community of people who use drugs, (4) free from stigma and discrimination.

A definition provided by the Harm Reduction International is consistent with EHRA understanding of harm reduction. “Harm reduction is policies, programs, and practices aimed at minimizing the negative effects of current policies on the health, social opportunities, and human rights of people who use drugs. Harm reduction is based on justice and human rights aimed at positive changes and the provision of social and medical assistance to people without condemnation, coercion, discrimination, or requiring them to stop using psychoactive substances as a prerequisite for support”[2].

Harm reduction as a comprehensive package of interventions[3] for the prevention, treatment, and care of HIV among people who inject drugs[4] has been endorsed widely, by WHO, UNAIDS, UNODC, the UN General Assembly, the Economic and Social Council, the UN Commission on Narcotic Drugs, the UNAIDS Programme Coordinating Board, the Global Fund and PEPFAR.

Over the years, harm reduction has evolved, new interventions have been added, to meet the needs of people who use drugs and public health challenges.

To date, there are many modalities of harm reduction approaches, however, not all of them adhere to the fundamental principles. In practice, quite vague interpretation of harm reduction concept negatively affects the quality of the programmes, causing lower enrolment rates and efficiency of interventions.

At the moment, as the data shows access to full-scope quality harm reduction services in CEECA countries is limited. In many CEECA countries, existing harm reduction interventions do not include distribution of naloxone, drug checking, access to sexual and reproductive health services, and/or access to social service programs. As a result, harm reduction programs may not have the ability to reduce overdose mortality; protect against HIV and other blood-borne infections; ensure access to HIV, hepatitis B and C, tuberculosis, and sexually transmitted infections (STI) treatment; and/or provide social support and social integration for people who use drugs. The reason for such a significant aberration in provision of harm reduction services lies in criminalization of drug use which creates barriers for effective service provision and significantly influences lack of political will of national and municipal authorities to fund comprehensive harm reduction services. Its more politically and publicly acceptable to finance and deliver harm reduction interventions as blood-borne diseases prevention among vulnerable populations instead of funding and developing programmes aimed at saving the lives, health and social welfare of people who use drugs. If the states would really want to end HIV and preserve public health as it stated in many government strategies harm reduction programs would look differently.

The new Global AIDS Strategy 2021-2026[5] emphasizes the urgent need to change the laws, remove legal barriers, eliminate stigma and discrimination. Thus, harm reduction service providers should include advocacy and change of policies and practices in their work, and communities should engage in monitoring and evaluation of provided services and actively participate in the development of programs and policies[6].

EHRA seeks to ensure that countries in the CEECA region have access to quality and effective harm reduction services based on the needs of people who use psychoactive substances that also consider any new changes in the drug scene. It is important for us that different groups of people who use psychoactive substances have access to harm reduction, including women, youth and adolescents, people with physical or mental health issues, and people living with HIV, viral hepatitis, and tuberculosis. We consider harm reduction services as an integral part of ensuring universal health coverage for people who use psychoactive substances; this population often experiences the most severe forms of discrimination and is the most vulnerable in terms of socio-economic status.

Expert group meeting  was organized to meet EHRA’s strategic objective 2.1[7] from EHRA Strategy 2020-2024: „Contribute to improving the quality and comprehensiveness of existing harm reduction services in the countries of the CEECA region” specifically to support development of a simple system of self-assessment and peer review by professionals and technical assistance to improve the quality of harm reduction programs is developed by EHRA through expert practitioners based on international standards and recommendations.

 

Meeting goals and objectives

Why we need this:

During the transition from international to state funding, the quality of harm reduction

programs is lost with cutting unit costs. The role of EHRA as a professional network is to

define criteria of harm reduction quality and to agree on joint advocacy and capacity

building plan for the network to improve the quality and comprehensiveness of existing

harm reduction services in the countries of the CEECA region.

The EHRA Secretariat initiated a meeting to identify what EHRA, as a professional harm reduction association in the region should do about the deteriorating quality of harm reduction services in CEECA. 20 EHRA member organizations from 14 CEECA countries with vast expertise of harm reduction service provision were invited to the meeting.

Outcomes of the meeting:

– A clear understanding of the harm reduction goals and definition of quality criteria

(EHRA position paper)

– EHRA approaches to ensure quality and support national advocacy

– Establishment of EHRA expert group on harm reduction quality in the region with

regular annual meetings

 

Meeting outline

  • Overview of current state of harm reduction in CEECA
  • Discussion on the key challenges in ensuring quality of harm reduction from position of service provider, clients and donors/state
  • Exploring methods and evidence based best practices in service quality assurance
  • Building consensus on the key approaches to setting targets and measuring the quality of harm reduction services.
  • Map out EHRA’s immediate next steps and in national and regional advocacy on ensuring quality of harm reduction in CEECA

The meeting sought to focus on finding expert consensus, taking into account differences in the state of harm reduction in countries, variations in modes of provision, specifics linked to sources of funding, best practices in insuring delivery of quality services, international guiding documents and recommendations, on the following issues:

 

  • What is the goal of harm reduction services?
  • What are the components of harm reduction?
  • Whcih criteria show that service is of high quality?
  • What are the key criteria to measure harm reduction quality?

Summary of highlights and key themes discussed during the meeting

After comprehensive overview of current state of harm reduction in CEECA, and discussing country specifics shared by experts, the four issues has been identified to be addressed urgently:

  • reduction of harm reduction to HIV prevention and the need to include the broad range of health and social services and/or referral system,
  • need to involve mental health into the concept of harm reduction,
  • lack of services for young people and gender sensitive services,
  • lack of services for the users of new psychoactive substances and overall rigidity of services.

Participants have confirmed that a definition of harm reduction currently used by EHRA  is up to date and must be used for designing any harm reduction intervention.  

Participants one more time stressed that services should be considered holistically and should protect person’s life and dignity at their core. Interventions should be designed to reduce legal, health (incl. psychological, mental, HIV, HCV, TB, Covid) and social harms or risks associated with drug use; and to guarantee access to medical and social care for the most in need (complex of medical + social services for person and family for different groups: women, young people, imprisoned ones, polydrug users).

Experts agreed that in addition to a comprehensive package of 9 interventions for the prevention, treatment and care of HIV among people who inject drugs, that has been endorsed widely, by WHO, UNAIDS, UNODC, the UN General Assembly, the Economic and Social Council, the UN Commission on Narcotic Drugs, the UNAIDS Programme Coordinating Board, the Global Fund and PEPFAR, quality harm reduction should include various additional possibilities and components:

The comprehensive HIV package Additional components that should be included
Needle and syringe programmes Stimulant substitution treatment
Opioid substitution therapy and other evidence-based drug dependence treatment Primary medical care (e.g. treatment of wounds, abscesses)
HIV testing and counselling Peer-work and outreach
Antiretroviral therapy Digital/online outreach;
Prevention and treatment of sexually transmitted infections Mental health support, including peers with double diagnosis (for example, drug dependence and bipolar)
Condom programmes for people who inject drugs and their sexual partners Integrated treatment of HIV, Hepatitis C, NSP and OST services

 
Targeted information, education and communication for people who inject drugs and their sexual partners Everyday housekeeping services (e.g. washing machines, shower, food, etc.)
Prevention, vaccination, diagnosis and treatment for viral hepatitis Shelters for women who use drugs victims of violence
Prevention, diagnosis and treatment of tuberculosis. Overdose prevention interventions (both for opioid and stimulant users)

 
Social care, case management (incl. development of clients social skills, assistance with employment)
Legal consultations/paralegal help
Drop-in centers / safe spaces to relax, spend time
Safe consumption rooms (not only for injectable drugs)
Drug checking
Gender sensitive services for women who use drugs

Expert group agreed, that a good quality harm reduction program should meet the following criteria, it should be:

  • trustful;
  • culture appropriate;
  • accessible 24/7 or at least on a regular basis;
  • sustainable in terms of stable team and working hours;
  • flexible;
  • intersectional, responding to the needs of different communities;
  • client oriented;
  • measurable;
  • accessed without barriers;
  • safe (comfortable, anonymous).

To assess the quality of existing programs there should be:

  • space and tools to provide feedback (e.g. to measure client’s satisfaction);
  • supervision, intervision for staff, performance appraisal;
  • community involvement in decision making;
  • optimization of data collection and sufficient budget for research.

The main role of Eurasian Harm Reduction Association should be ensuring quality of harm reduction services in the region – advocacy and technical support for the members, mentoring, platform for sharing the best practices, collecting related material and information, cooperation with international bodies.

 

Immediate next steps in national and regional advocacy

Participants mapped out EHRA’s immediate next steps and required national and regional advocacy efforts to ensure quality of harm reduction in CEECA. EHRA Expert group on harm reduction quality will be involved in each step of the development of:

* EHRA position on quality of harm reduction services. The position should be developed internally, widely discussed among EHRA members and adopted to strengthen advocacy for access to high-quality, evidence-based, gender-transformative, non-discriminatory harm reduction services in freedom and in closed settings that have proven to be effective and are based on people’s needs and human rights. Before the approval draft position will be presented to the Steering Committee, discussed with the Expert group as well as members of the Association and reviewed by Advisory board.

* Components, arguments, criteria (CAC). Development of the set of evidence-based advocacy arguments organized in on-line platform describing Components, Arguments, Criteria (CAC) for improvement of quality of harm reduction programs in CEECA, considering COVID-19 learnings from national and regional advocacy for quality harm reduction services. Arguments need to contain links on scientific evidence and international recommendations. Developed set of CAC need to include answers on the following questions:

  • What kind of components quality harm reduction program should include to fulfill its goals?
  • Arguments with links to scientific data supporting inclusion of each of the components
  • Criteria that should be used to access the quality of existing services

* Collection of the set of best practices and practical examples of harm reduction programs effectively implementing each of the CAC components in CECCA region.

  • Self-assessment system (toolbox) to assess the quality of harm reduction programs and services.

* Advocacy with WHO, UNAIDS, UNODC, Global Fund to ensure that the quality of services is reflected in their documents.

[1]This meeting was organized Eurasian harm reduction association (EHRA) in the framework of in the project of Eurasian Regional Consortium “Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services” supported by the Robert Carr Fund for civil society networks.

[2] https://old.harmreductioneurasia.org/wp-content/uploads/2020/05/EHRA-Strategy-2020-2024-ENG.pdf

[3] https://www.who.int/publications/i/item/978924150437

[4] https://apps.who.int/iris/bitstream/handle/10665/208825/9789241549684_eng.pdf?sequence=1&isAllowed=y

[5] https://www.unaids.org/en/Global-AIDS-Strategy-2021-2026

[6] “Decision-makers cannot hope to develop and implement new strategies for quality without properly engaging health-service providers, communities, and service users”. https://apps.who.int/iris/bitstream/handle/10665/43470/9241563249_eng.pdf?sequence=1&isAllowed=y

[7] https://old.harmreductioneurasia.org/wp-content/uploads/2020/05/EHRA-Strategy-2020-2024-ENG.pdf