Author: Igor Gordon

Eurasian Harm Reduction Association Code of Ethics

Posted on by Igor Gordon

The Eurasian Harm Reduction Association (EHRA) Code of Ethics (the Code) is a set of fundamental principles, standards and policies to govern decisions and behaviour at EHRA. The Code clarifies an organization’s mission, values and principles, linking them with defined standards of professional conduct, as well as gives specific guidance for handling issues like compliance, integrity, anti-fraud, non-discrimination, anti-harassment policy and Conflict of interest.

The Code is intended primarily for EHRA’s employees and members, and together with the EHRA Code of Conduct the Code is a main guide and reference for employees and governing bodies to support day-to-day decision making. The Code also serves as statement of organizational values internally for EHRA members, as well as for partners with whom EHRA has contractual and partnership relations. The Code shows EHRA commitments for external stakeholders such as advocacy allies, potential EHRA donors, UN agencies, other national and international organizations.

EHRA requires governing bodies, members and employees to observe high standards of business and personal ethics in the conduct of their duties and responsibilities. As employees and representatives of the EHRA, we must practice honesty and integrity in fulfilling our responsibilities and comply with all applicable laws and regulations.

The Code is made up of 4 policies:

  1. Compliance, Integrity and Antifraud policy
  2. Conflict of Interest policy
  3. Non-discrimination, Anti-Harassment Policy and Complaint Procedure
  4. Whistleblowing policy

The Code was formulated and adopted by EHRA Steering Committee and included input from EHRA members.  The Code should be revised depending on needs, but not less than once in 5 years. All revisions and amendments should be approved by the Steering Committee. 

FULL TEXT OF THE EHRA CODE OF ETHICS

 

Vacancy announcement: Communications and Public Relations Officer (call open until February 26, 2021)

Posted on by Igor Gordon

EXPECTED START DATE: ASAP

JOB TYPE: permanent, full time

JOB LOCATION: Vilnius, Lithuania

COMPENSATION:  Minimum gross salary is 1700 euro and up depending on qualifications and experience

OVERALL RESPONSIBILITY

  • Oversee and implement the organization’s communication.
  • Employ effective communications to support EHRA’s mission delivery and increase the effectiveness of EHRA’s advocacy and technical support.
  • Lead the implementation of a comprehensive communication plan to support EHRA’s strategic objectives, program delivery, branding and organizational development.
  • Coordinate EHRA’s key messaging/communications products and communications channels (website, listserv, social media etc.).
  • Develop and maintain relations with media to ensure EHRA’s presence in media and coverage of key harm reduction and human rights issues.

QUALIFICATIONS FOR POSITION

  • Degree in Communications, Marketing or or a related field.
  • Experience of media content development (written article, video product, PR products);
  • Experience and skills in organizing regional or national media/public awareness or issue-based campaign through different media.
  • Strong verbal and written communication skills including media relations, briefings, meeting facilitation and presentations.
  • Working experience in a similar position in international environment.
  • English and Russian language speaking and writing skills.
  • Ability to multitask.
  • Flexibility, adaptability and a commitment to work within an international team.
  • Excellent computer skills, PowerPoint (video production and editing is an asset).
  • Understanding of the non-profit/NGO world.
  • Tolerance and comfort working with diverse communities (people who use drugs, sex workers, men who have sex with men, etc.).

Interested candidates should provide:

  • updated CV outlining specific relevant experience and two references.
  • at least three examples of work in communications, PR or marketing OR job portfolio.
  • a short cover letter indicating suitability for the position.

Documents should be sent to: igor@harmreductioneurasia.org until February 26, 2021.

Download full job description HERE

Interviews will be done on a rolling basis.

Only shortlisted applicants will be contacted.

 

EXTENDED: Tender for consultancy to conduct mapping of budget advocacy effort and impact in EECA region for the past 3 years

Posted on by Igor Gordon

the new deadline for submission is before 24:00 EET on February, 17, 2021

Within the regional analysis and dialogue “Taking stock of budget advocacy efforts to date in EECA region”, the Eurasian Harm Reduction Association (EHRA) announces an open call for a consultant to conduct the mapping of budget advocacy activities and its impact on sustainability and funding of HIV services for key populations, for the past 3years in Eastern Europe and Central Asia region.

Objectives of the consultancy

The objective of the consultancy is to map budget advocacy effort and projects funded by different international donors and its impact on sustainability and funding of HIV services for key populations, for the past 3 years in 8 EECA countries (Bulgaria, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Montenegro, Northern Macedonia, Ukraine).

The mapping will include:

  • analysis of scope, funding and geography of budget advocacy projects implemented in the region;
  • defining roles of different civil society organisations, community groups, patients’ organisations, transperancy and open budget partners, parliament members and other officials;
  • identifying different components of budget advocacy implemented in countries;
  • documenting results that have been achieved, how they were measured and how they were compared to the initially set goals and targets;
  • analysis of what budget advocacy interventions have been most successful in leading to the documented outcomes;
  • analysis of factors such as specific advocacy approaches, partnerships, processes of health reforms or introduction of e-governance, transparent procurement, etc., which led to results in budget advocacy and ensured transition of HIV response services for key populations to domestic funding.

Focus of the mapping should be made on the efforts and projects dedicated to advocacy for sustainable funding of specific HIV prevention, testing and treatment services for such key affected populations as people using drugs, sex workers, men having sex with men, trans* people, people living with HIV and inmates.

The outcome dimensions of the projects and effort need to be taken into account while mapping:

  • budget related outcomes: specific budget approved, released or allocated;
  • outcomes for health finance systems, mechanisms of procurement and funding of services;
  • impact on capacity of CSOs in budget negotiation skills, shifting focus on the budget advocacy.

For the regional analysis the data from already published national reports and project reports could be used. The recently published report on the results of budget advocacy in Kyrgyzstan in the period from 2016-2019 could be a good example of such documents.

Tasks of the consultant:

  1. To develop the outline of the mapping and questioner for semi structured interviews with informants. EHRA will provide list of the key informants which could be extended by the consultant.
  2. To collect and analyze available publications and other secondary data.
  3. To conduct up to 20 interviews with key informants.
  4. To draft the mapping report which includes 8 country case studies and regional overview.
  5. To present report for discussion during the expert group meeting in April 2021.
  6. To finalize the report based on expert group recommendations.

Expected results of the consultancy:

  • Report on mapping of budget advocacy efforts and analysis of outcomes in EECA region in the past 3 years. Report should include 8 country case studies/mapping results analysis and regional overview;
  • Suggested recommendations for donors on priorities for investments in budget advocacy of services for key populations in EECA based on mapping and new economic and public health challenges impacting budget advocacy efforts in EECA region.

Knowledge of spoken Russian and English for conduction of interviews with budget advocacy projects implementors across the region is essential. The mapping developed within the consultancy can be submitted to EHRA in Russian or English (per consultant’s preference).

Find more information about project, objectives, timeline and evaluation criteria HERE

How to apply

Applicants must submit their CV, application (letter of interest) and relevant materials with experience proof in free form to anna@harmreductioneurasia.org, the subject of the letter is “EECA budget advocacy mapping”, the deadline for submission is before 24:00 EET on February, 17, 2021. The CV and application 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 stage, cost and timing of their implementation and confirmation of fluency in Russian and English to implement the task.

Harm reduction service delivery to people who use drugs during a public health emergency

Posted on by Igor Gordon

Harm reduction service delivery to people who use drugs during a public health emergency: Examples from the COVID-19 pandemic in selected countries

Virtually every country of the world has been faced with the COVID-19 pandemic. As learning developed as to how to combat transmission of the virus, countries increasingly resorted to national ‘lockdowns’ during the first wave of the pandemic from around March to June 2020. After coming out of the first wave of COVID-19, countries have used local, regional and national ‘lockdowns’ to once again prevent further transmission during the second wave and similar approaches are expected in the future in the event of further waves of the pandemic hitting countries until every country can vaccinate a high proportion of their population. For those people who are highly drug dependent, with a resulting compromised immune system, COVID-19 presents a serious threat to life regardless of age. Governments, non-governmental (NGOs) and communitybased organisations (CBOs) working to support people who use drugs, and other vulnerable and marginalised people in society, have had to react rapidly to the massive increase in COVID-19 transmission across countries and continents. The ten case studies presented here provide a snapshot of the responses of specific organisations and communities who work with people who use drugs and some other marginalised groups around the world, including Afghanistan, Australia, the Czech Republic, Kenya, Poland, Russia, Spain, Switzerland, Ukraine and the United Kingdom.

Extended: We are looking for consultants to conduct the assessment of the fulfillment of HIV related sustainability commitments given by the national governments in the context of country transition from the Global Fund’s support to national funding

Posted on by Igor Gordon

We are looking for the consultants to conduct the assessment of the fulfillment of HIV related sustainability commitments given by the national governments in the context of country transition from the Global Fund’s support to national funding in the following countries: Bosnia and Herzegovina, Georgia, Montenegro, North Macedonia and Serbia

Background

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

To contribute to this objective, EHRA is planning to conduct the assessment of the fulfillment of HIV related sustainability commitments given by the governments of 5 EECA countries in the context of their transition from the Global Fund‘s support to national funding. It is expected that based on the results of such assessment the key civil society regional and national partners working in those selected countries, will be able to adjust their advocacy efforts and actions to improve the financial sustainability and allocative efficiency of HIV national programs.

For that purposes in 2020 EHRA has developed a methodology and tools to conduct such assessment on a periodic basis.

EHRA is looking for 5 national consultants (1 per each country) to help with conducting such assessments in Bosnia and Herzegovina, Georgia, Montenegro, North Macedonia, and Serbia.

In Bosnia and Herzegovina and North Macedonia, the assessments will be conducted retrospectively, taking into account that the implementation of the last Global Fund HIV grants ended in these countries in 2016 and late 2017 respectively.

 Key tasks to be conducted by the consultants

 The consultants are expected to conduct in each of 5 countries the national assessment process in accordance with the Assessment Guide “Benchmarking Sustainability of the HIV Response in the Context of Transition from Donor Funding” to be provided by EHRA. The assessment process should include the next stages:

  1. Scoping: Identify and collect a set of strategic and programmatic documents, including national laws and regulations relevant to the transition process through desk review and interviews with key stakeholders.
  2. Conduct a review of those documents with the purpose to identify the government’s commitments with regards to transition; formulate and group commitments per the guidance provided by EHRA. The consultant should also identify where public/government’s commitments are deficient to properly address transition challenges or to be monitored.
  3. Coordinate and work with the national reference group to be composed of community representatives and national experts and engage them in (i) selecting priority commitments for the monitoring; (ii) define formulation of commitments if those are not sufficiently elaborated in public documents; and (iii) elaborate additional commitments if considered absolutely necessary for transition process monitoring.
  4. Collect data through desk research and/or key informant interviews aimed to measure progress for the selected set of commitments.
  5. Input selected indicators into the Transition Monitoring Tool to calculate the score; and,
  6. Write an analytical report to summarize the findings.

A Sample Outline of the National Report is provided in Annex 5 to the Assessment Guide. The report should include contextual sections, findings, and conclusions for each of the assessed commitments as well as general conclusions and recommendations for key national stakeholders.

 Deliverables:

1.A. Repository and mapping of documents relevant to the transition process (placeholders) and containing the government’s obligations with regards to transition (intentional or officially approved).

1.B. Repository of commitments, which the country (relevant public/governmental agencies) has committed to implement in support of transition of HIV response.

  1. Filled in Transition Monitoring Tool.
  2. Analytical Report on the results of the assessment of the fulfillment of HIV related sustainability commitments given by the national government in the context of the country transition from the Global Fund’s support to national funding.

The language of the resulted documents should be English.

The total contract cost for the work of one consultant under this ToR should not exceed 3,000 USD (including all taxes). 

Full ToR please find here

How to apply

The individual consultants are invited to submit their CV and the Letter of Interest by e-mail referenced under title “Consultant to conduct the assessment of transition related commitments in [name of the country you are interested to conduct the assessment in]” to ivan@harmreductioneurasia.org by COB 22 of January 2021 24:00 EET.

New words in 2020

Posted on by Igor Gordon

Looking back over the past year, the Eurasian Harm Reduction Association has found that several words have become solidly integrated into everyday use.

We have learnt a lot this year and we have a lot to look forward to in the New Year, 2021. You can call us eternal optimists, but we believe that we will make it through the difficulties, safe and strong! May we all have a strong spirit and new achievements!

This year we really want to greet everyone personally and wish something unique and unusual. We have hidden our wishes in a gift, and it takes only one click to receive it!

Online Training: “Access to comprehensive care for women who use drugs in case of violence”

Posted on by Igor Gordon

In November 2020, EHRA launched the ‘Access to comprehensive care for women using drugs in case of violence’ project aimed at increasing access to legal, psychosocial (including psychiatric) services and shelters for women who use drugs in case of violence.

The project is implemented in collaboration with the Alliance for Public Health as part of the Multi-country Project “Sustainability of Services for Key Populations in Eastern Europe and Central Asia” (aka #SoS_project) and funded through the COVID-19 Response Mechanism (C19RM) of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

On 10, 11 and 14 December 2020, the project held an online training on ‘Organising Care for Women who Use Drugs and are Victims of Gender-Based Violence’.

The training programme included the following topics:

Women who use drugs and women from other social groups in situations of gender-based violence, domestic violence, intimate partner violence. Needs, problems, existing services.
Gaps in government services and NGO services for women who use drugs.
Provision of services for women who use drugs in situations of violence by organizations and harm reduction organizations.
Build partnerships with organizations working to provide services to women in situations of violence. Fragmented analysis of potential partners.
Safety issues for women who use drugs and female staff members assisting in situations of gender based violence/ intimate partner violence.
Thirty-seven participants registered for the training. During the three days the maximum number of participants was 18, and the minimum number was 10. Participants were from the following countries: Georgia, Netherlands, Kazakhstan, Kyrgyzstan, Moldova, Serbia, Slovakia, Russia, Ukraine.

The experience of the participants in working with issues of women who use drugs and survivors of violence varied greatly: from impressive (e.g. Harm Reduction Network, Kyrgyzstan) to almost zero (e.g. ReGeneration, Serbia).

The next step in the project is to work with partner organizations through grants in 5 countries – Serbia, Macedonia, Kazakhstan, Russia and Ukraine. Activities in the countries will be as follows:

Documenting cases of violations of the rights of women who use drugs in case of violence; documenting their situation with access to psychosocial and legal services and shelters, crisis centres.
Advocacy, both at the level of decision makers and at the level of individual shelters, to change the rules and practices of shelters to accommodate women who use drugs in case of violence.
Train shelter staff to work with women who use drugs and collaborate with harm reduction programs.
Improve the quality of shelter services for women who use drugs and survivors of violence.
Also, recommendations on the provision of comprehensive services for women who use drugs and survivors of violence, including shelters/crisis centres, psychosocial and legal services, have already been initiated and will be developed in 2021 as part of the project.

We hope that the recommendations will be useful to country partners as well as to other organizations and groups seeking to improve access to comprehensive support for women who in case of violence.

Ensuring sustainability of services for key populations in the EECA region: initial expert meeting to take stock of budget advocacy efforts was organized 9-11th of December 2020

Posted on by Igor Gordon

At 9–11th of December 2020 budget advocacy, sustainability and transparency regional and national experts gathered online to take stock of what has been achieved over the past few years – taking into account the realities of the transition of HIV responses for key populations from donor support to national funding, limited donor resources for the Eastern Europe and Central Asia (EECA) region, and new economic and public health challenges including the COVID-19 pandemic. The dialogue aims to explore whether and how to budget advocacy efforts have impacted state budget funding for HIV services for key populations in the region, what critical elements of budget advocacy have made a difference, and what donors should take next steps to support further efforts by CSOs in budget advocacy for key population HIV services to be fully covered by national budgets in the region. The crises caused by the COVID-19 pandemic have significantly altered situations and contexts and added new urgency to the need to understand how to influence budget decisions effectively. There are huge risks associated with adjustments and replanning of all public health funding that many countries are doing in response to the crises because these changes could lead to lack of funding for HIV responses among key populations.
This meeting is part of the broader regional dialogue and analysis organized by the Eurasian Harm Reduction Association (EHRA) in partnership with Open Society Foundations; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the Eurasian Coalition on Health, Rights, Gender and Sexual Diversity (ECOM) and supported by the Robert Carr Fund for civil society networks.
This rare gathering of experts is part of ongoing efforts in the region to safeguard and improve people’s health and rights vulnerable to and living with HIV and other stigmatized conditions. Sustainability of services is the ultimate goal, with the transition from external to domestic funding being the process through which countries move as donor support decreases and then stops.
International donors have been withdrawing from support for HIV and other health programs in EECA for several years. Many countries no longer receive or are eligible for, funding from the Global Fund to Fight HIV, Tuberculosis and Malaria (Global Fund). Among other significant funders over the years, the UK Department for International Development (DFID) ended its support in the region several years ago, the US President’s Emergency Plan for AIDS Relief (PEPFAR) provides only small amounts of funding in a few countries, and the Dutch Ministry of Foreign Affairs, the German Agency for International Cooperation (GIZ) and the French 5% Initiative no longer consider the region a priority. Most of these funders provided critical financial and technical support for HIV prevention and other services for key populations, including people who inject drugs, men who have sex with men (MSM) and sex workers. The programs usually cannot survive international donor withdrawals unless they have access to domestic funding, especially from the public sector.

Budget advocacy work and transition experiences across EECA have varied in terms of overall success and the actions taken by civil society advocates, governments and donors to plan for and respond to donor withdrawals. The three-day initial meeting of the dialogue, which was held online and had more than 40 participants each day, included several comprehensive presentations of transition-related activities regionally and at the national level. The five-country examples from Kazakhstan, Kyrgyzstan, Ukraine, Moldova and North Macedonia highlighted different activities and methods used to secure the sustainability of funding for HIV response services specifically for key population – before, during and after transition processes. They served as the basis for group discussions about opportunities and challenges for this type of work across the region. The online meeting concluded with participants proposing suggestions and recommendations for priority actions to promote and ensure investment in health and social services for key populations in EECA.
During January – March 2021 the regional analysis and dialogue “Taking stock of budget advocacy efforts to date in EECA region” will continue with Budget advocacy effort and impact mapping for the past three years in the EECA region and Consultation to develop recommendations for regional partners on investment into sustainability of HIV- services for key affected populations, which is planned to organize in March 2021.
The key lessons learned on a national and regional level, methodical tools for analysis and preliminary recommendations from the initial meeting could be found in the detailed report (download the meeting report)

The submission to the Committee on Economic, Social and Cultural Rights (CESCR) ahead of Lithuania’s Periodic Review

Posted on by Igor Gordon

The submission to the Committee on Economic, Social and Cultural Rights ahead of Lithuania’s Periodic Review was submitted on behalf of the Eurasian Harm Reduction Association (EHRA), Harm Reduction International (HRI), the Association of Women Affected by HIV/AIDS and Their Family Members “Demetra”, Coalition “I Can Live”, Support Foundation “Rigra” and youth-led NGO “Young Wave”.

Focusing on the right to health, this submission is highlighting the failure of the Government of Lithuania to implement the State program on drugs, tobacco and alcohol control for 2018–2028 in line with its obligations under the International Covenant on Economic, Social, and Cultural Rights (ICESCR), with particular attention to:

  • Repressive drug policy as a barrier to achieving the realization of the highest attainable standard of physical and mental health for people who use drugs in Lithuania
  • Access to health services for people who use drugs in prison
  • Lack of health care, harm reduction and psychological support services in the community (outside prisons) for people who use drugs.

Questions for the list of issues

In view of the mentioned above, we recommend that the Committee considers including the following questions in the List of Issues that will be presented to Lithuania:

  1. Please indicate the steps taken to review and change legislation criminalizing personal drug use and assess the impact of repressive regulation on prison overcrowding.
  2. Please provide information on how does the government plan to introduce new harm reduction interventions and increase the accessibility of currently available harm reduction services in prison.
  3. Please provide information on how does the government plan to ensure sustainability of funding, availability and (expansion of the coverage of) the following services for people who use drugs:

a) Introduction of community HIV testing;

b) Scale up of antiretroviral therapy

c) Scale up of opioids substitution therapy

d) Expansion of low-threshold services,

e)Distribution of Naloxone

f) Implementation of harm reduction services in the penitentiary system

Please see submission here

In progress: Drug consumption rooms in Croatia

Posted on by Igor Gordon

FLIGHT

Life Quality Improvement Organization “FLIGHT” or just “FLIGHT” (in Croatian: LET) was registered in early 2003 and has been implementing needle exchange programs since its beginning. Besides direct work with people who use drugs, FLIGHT was always focused on promoting the effectiveness of harm reduction programs, conducting research, developing publications, working at EU level at number of networks, including the EU Civil society Forum. FLIGHT is the only organization providing programs for sex workers, twice per week at night hours in the center of Zagreb.

Organization has 4 staff members, including two social workers and two outreach workers, and has been implementing so called mobile outreach (with two vehicles) and has established 22 sites where users can come and exchange their used needles and syringes with the new ones, as well as ZAGREB ZOVI- where we deliver syringes to the users that live outside of those 22 sites.

Could you please share, why you decided to focus on drug consumption rooms as harm reduction service in Croatia?

Drug consumption rooms were included as a possibility or one of the measures in the National guidelines on harm reduction. So, we thought that now was a great moment to work and develop more detailed information on it, because governmental bodies are planning a review of the guidelines. And it would be great if drug consumption rooms are better explained in the guidelines.

During the project, you conducted a needs assessment among PWUD in Croatia. Could you please share the main results from this assessment? How people are reacting to the suggestion to start opening DCRs in Croatia?

We collected responses from 120 people who use drugs from 5 cities. Most of them are in favour of safe injecting rooms. During needs assessment, 80% of them answered that DCRs are needed. What is more, they would like additional services to be provided in DCRs, such as: opportunity to get a coffee or soup. Also, it would be useful to have an access to psychosocial counselling. The only issue, that might occur with opening the site is the local neighbourhood and its residents, who wouldn’t be happy about DCR.

1

Another activity which was implemented by you – development of the policy paper on safe consumption rooms. Could you please share what this policy paper includes and for whom it’s developed?

This policy paper provides answers if DCRs should be opened in Croatia and what are the main obstacles. It includes a theoretical basis about injection rooms, data on injection rooms in Europe, analysis of legislation, and recommendations for further work. It will be used for the development of new Guidelines on harm reduction in Croatia. The policy paper will be presented to representatives of national and local authorities to raise the issue of DCRs opening.

Are there any legal barriers to open DCRs in Croatia? If yes, could you briefly share what they are, and are there any possibilities to overcome it.

According to the existing criminal legislation in the Republic of Croatia, it is not possible to implement a harm reduction program that includes the establishment and operation of drug injection. Criminal Code, Article 191 criminalizes venues that enable consumers to use drugs. We were working together with a lawyer in producing the analysis and came to conclusion that there are two options: 1) an Ireland model- they made a lex specialis on DCR in 2017 or 2) change the Criminal code (Article No. 191)- where the questionable issue in providing the venue for injecting is raised. In that specific article all types of assisting in injecting drugs are mentioned and some would argue that even existing needle and exchange programs are illegal, there has been a national consensus since 1996 that giving new equipment to users wouldn’t be seen as assisting in drug use. There are adjusting national documents such as strategy on drug abuse and HIV prevention that mention harm reduction in a positive manner. But the issue of “venue” remains problematic.

What do you think should be the next steps in starting/ promoting safe consumption rooms in Croatia? And what should be civil society’s role in all this?

We need to continue to lobby and raise awareness on the positive aspects of the DCRs. NGOs that implement harm reduction programs are very important in raising awareness and educating other stakeholders.

We have updated the website www.smanjenje-stete.com as well as our main website www.udruga-let.hr and will continue to promote the need for DCRs. Policy paper and leaflets will be available for raising awareness and I will be speaking at the national conference and presenting the work we have done with support from the Robert Carr Foundation and EHRA.

We have now access to international documents provided by our international speaker at the conference and desk review we did.As each developmental project it might take time to open a DCR but at least we have a good starting point:

  1. Users are eager and would like this kind of service
  2. Analysis was provided and will be included in the National guidelines on harm reduction
  3. Capacities of FLIGHT and BENEFIT organizations have been developed and
  4. We are talking and promoting harm reduction and its efficiency.