Harm reduction is stated as a priority
National placeholders:
- Policies and legislation: drug policy etc.;
- National strategies: EU Association Agreement etc.;
- Sectoral strategies: Transition Plan, health sector strategy, etc.;
- Disease-specific strategies: HIV national action plan etc.
- Programs: National healthcare program, national AIDS program, etc.;
- Others: Clinical guidelines and protocols.
- Lack of democracy and transparency;
- Corruption;
- Lack of influence;
- Lack of awareness among the public agencies;
- Limited capacities and capabilities of CSOs to influence and engage with those processes.
- Key decision-makers declare their readiness to support harm reduction (President, MPs, Cabinet of Ministers, Ministry of Health, media, influential individuals);
- Global Fund;
- Transition process approaching;
- Donors;
- Creditors (IMF, World Bank);
- Country Coordination Mechanism;
- “Supporters” in government agencies;
- Working with media;
- Networking/partnerships;
- EC/EU integration;
- Public health concerns (e.g. HIV epidemics)
- International “best practice” examples;
- Communities with access to a number of working groups with the government Partnership with CSOs working on public budget and monitoring issues (or other relevant CSOs);
- Mapping of power and means of influence;
- Mapping of interests and powers;
- Methods and tools to be used by the communities to conduct legal reviews, mapping and advocacy activities;
- “Horror stories” — cases of countries where the transition process has failed;
- A checklist for national placeholders should be developed, and we should analyze which one is the “best” placeholder to prioritize harm reduction.
Harm reduction is included in the public allocation plan (budget)
National placeholders:
- National action plans;
- Drug policy-related programs;
- Annual budget and multi-year prognosis;
- Standards of services and costing;
- Procurement regulations;
- Budget law (to understand the budget cycle, especially at central and local levels).
Stakeholders:
- Country Coordination Mechanism, Ministry of Health, Ministry of Finance;
- Parliamentary committees for health and budgets.
Lack of standards and mechanisms/limitations of existing standards;
- Some countries do not have standards;
- The standards do not address the needs of citizens.
Budget watchdogs;
- Anti-corruption networks.
Guidelines for good harm reduction service standards;
- Standards for accreditation of harm reduction services;
- Social contracting mechanisms;
- Examples from other standards and analysis of the risks for implementation; this process should include analysis of all related risks (e.g. if the standards are too strict, implementation might be a problem, etc.);
- Guidelines for fiscal strategy analysis;
- Guidelines for analysis of the budget guidelines, budget requests, and budget proposals, and engagement in these activities;
- Partnerships created to help harm reduction NGOs in this
process.
Funds allocated for harm reduction in the budget are approved by the government
National placeholders:
- Budget proposal.
Stakeholders:
- Ministry of Health, Ministry of Finance;
- Government;
- Parliamentary committees for health and budgets
No barriers identified
No facilitators identified
Tools and case studies on how to influence and engage in this process.
Funds allocated and approved for harm reduction in the budget are adopted by the parliament
National placeholders:
- Budget proposal.
Stakeholders:
- Parliamentary committees for health and budgets;
- Parliamentarians.
No barriers identified
No facilitators identified
Tools and case studies on how to influence and engage in this process.
Enhance the outcomes of budget expenditures
National placeholders:
- Enacted budget/amended budget;
- Law on public procurement;
- Annual public procurement plans;
- Documents developed during the implementation of public procurement procedures.
Stakeholders:
- All budget users responsible for the implementation of harm reduction programs;
- Principal Recipient of the Global Fund grant;
- Public procurement agencies.
No barriers identified
No facilitators identified
Tools for public procurement monitoring and analysis;
- Guides for public procurement processes at the country level;
- Methodology for community assessment of public procurements and the quality of and satisfaction with the goods/services procured.
Enhance the quality, availability, and cost-effectiveness of harm reduction programs and services
National placeholders:
- Budget execution reports;
- Transition plan;
- National HIV/AIDS plan.
Stakeholders:
- All budget users responsible for the implementation of harm reduction programs.
No barriers identified
No facilitators identified
- Tools for monitoring and evaluation of budget execution outcomes;
- Tools for engagement in this phase of the budget cycle.