Support. Don’t Punish. 2022

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.

Harm Reduction in Eurasia 2020 published in Russian

November 27, 2020, Vilnius

The Eurasian chapter of the Global State of Harm Reduction 2020 was presented and published today in Russian language.

This is the seventh edition of the Global State of Harm Reduction Report 2020, prepared by the Harm Reduction International, now in the year when public health took a leading position in the world news. COVID-19 and response measures introduced around the world continue to disrupt our lives. The report provides the most up-to-date information on existing programs, the situation with HIV, viral hepatitis and tuberculosis among people who use drugs, as well as analysis of harm reduction programs in the context of the COVID-19 epidemic. The parts of the report describing the situation in the Central, Eastern Europe and Central Asia region were gathered and summarized by the Eurasian Harm Reduction Association (EHRA).

A short summary of the report is presented to the public during an online discussion today. In total, the region is home to approximately 3 million people who inject drugs, 66% of whom are living in Russia and 77% in Russia and Ukraine together.

Syringe exchange programs operate in 27 of the 29 countries in the region, except Turkmenistan and Bulgaria. Unfortunately, the programs experience problems in many countries, particularly with sustainable funding, especially in transitioning from donor to domestic funding sources. The report shows challenges in unit cost, scope and quality of harm reduction services over the past two years.

Opioid Agonist Treatment (OAT) programs are implemented in 26 of the 29 countries in the region, except Russia, Uzbekistan and Turkmenistan. Unfortunately, we can state that most people who use drugs in the region live in countries where OAT programs are prohibited. In the transition of OAT programs from donor support to domestic funding, the biggest challenges are the availability and coverage, quality, and sustainability of program funding.

The key problem areas for harm reduction implementation in the CEECA region are as follows:

  • Criminalization
  • Decrease in funding
  • Lack of political support
  • Pressure on civil society

As a result, we see low coverage of harm reduction services and poor quality of programs.

The report provides detailed information on the situation with HIV, TB, hepatitis, and COVID-19 response programs for people who use drugs in the CEECA region. It provides an analysis of the programs, as well as challenges in accessing services.

The report provides an opportunity to learn about innovative harm reduction practices being implemented in the countries of the region. Substitution therapy for amphetamine users, kits for smoking and oral use, drug checking, safe consumption rooms, harm reduction for women who use drugs and for new psychoactive substance users, as well as for those who use drugs in Chemsex practices (LGBTQI, sex workers) are all being actively implemented in the region by the community- and harm reduction organizations.

EHRA sincerely thanks its colleagues who helped us prepare this report through individual interviews and verification of data from countries and the region.

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How to exhibit about harm reduction at music festival

Harm reduction at music festivals – it is not a new practice for Europe. However, here, in CEECA region, we are just making first steps towards implementation of such practices in condition of criminalization of drug possession and distribution. This year at one of the small festivals in Lithuania, our team joined the initiative and now we are ready to share a few impressions. “Say know” instead of “say no” to drugs was our motto during the YAGA festival, which took place on August 6-10 in Lithuania.

The participants of the festival, regardless of whether they use psychoactive substances or not, were very interested in any information on how to protect themselves and others in different situations related to the consumption and different sexual practices.  What do we need to know to reduce the risk or harm from substance use?

– You need to know what you use. With legal substances, the quality of the product has been tested and licensed by the government. In the case of illegal substances, you can not trust what drug dealers say. Drug testing is a key approach to harm reduction. It would be ideal to analyze the content of different substances in a drug, but so far only a couple of countries in Europe have offered such testing . In the context of the festival, it is possible to carry out reagent tests, when a person can test by himself or herself whether the substance declared by the seller is in a tablet or powder, some tests also make it possible to determine the purity of the substance. After taking several tests, a person will be able to find out if there are any other substances in the tablets.

– You need to know the health risks and consequences of using psychoactive substances in different ways and know remember reduction measures to prevent the risks. EHRA team at the exhibition of harm reduction tools showed visitors what items can help to reduce the health risks of smoking, oral, injected, or rectal use.

– You need to know how to prevent overdose or how to make human life safer in the event of an overdose. And while the use of naloxone is recommended for opioid drugs, there are no such simple overdose prevention methods for stimulants.  

What is important is that the team has agreed in advance with the festival organizers, local authorities, the police, and medical services on all harm reduction activities. Any talk about drugs, peer counseling, or a seminar on drugs initially frightens the organizers, as if the conversation itself was propaganda for use. In Lithuania, the Be safe lab project has been running for several years now at the most popular music festivals, in cooperation with the Drug, Tobacco, and alcohol control department and the Coalition “I can live”. Thanks to this project, festival participants have access to information about the harm caused by different substances, especially if they are mixed, and have an opportunity to receive professional medical (psychological and drug treatment) assistance in case of problems. Such partnership facilitated our activity at the festival.

Information about the safe combination of drugs, harm reduction measures for different ways of use, reducing the risk of overdose, and assistance with the unpleasant consequences of drug use (what is called a bad trip, when psychosis, paranoid conditions, etc.) – these topics mostly were in demand among festival participants. It was important that professional help and support in case of problems related to the use of this drug was available 24 hours a day, 7 days a week right at the festival. Our partners from Demetra during the festival provided the opportunity for those wishing to be tested for HIV, as well as free consultations on safe sex and receive condoms and lubricants.

One of popular spots in the festival camp was EHRA’s equipment exhibition “HARM REDUCTION TOOLS”. The wooden stand demonstrated different examples of the tools used to reduce harm was placed with short explanation – for what drug is it used and what health harm it could prevent. Different drug use equipment like smoking kits, snorting kits, booty bumping, tools for oral administration of drugs, injecting equipment, reagents for the drug checking were presented. 

In total, around 15-20 different tools from traditional needles and syringes, condoms and lubricants to overdose preventing medication such as nasal naloxone, other tools of safety such as tests for drug checking and gelatine capsules. During several hours per day one of the EHRA volunteers guided festival participants on what was presented on the stand as well as provided with additional explanation on harm reduction approaches and tools used all around the globe and in Lithuania.

The idea with harm reduction exhibition worked out well, a lot of people came to the stand, listened to the "lecturer", asked questions and took reagent tests and gelatine capsules. People said that they feel "enlightened" and that this project is very useful and important. Our colleagues from Demetra and Be Safe Lab also learned a lot and proposed to repeat this exhibition at future events.
Maria Plotko
Senior Program Officer, exhibition co-creator

Also this year EHRA team organized a seminar “Sex, Drugs and Harm Reduction” to tell festival visitors more about harm reduction, safe use of psychoactive substances and about protection in “chemsex”.

The last but, not least initiative was the distribution of reagent tests for those who wanted to check psychoactive substances. This action was important in term of local approach to the harm reduction as in Lithuania on-site drug checking is not allowed (criminalized).

Despite the late hour quite big group of people came to the workshop on Sex, Drugs and Harm reduction there was a problem with loud music and no lightning but people stayed anyway, surprisingly asked a lot of questions about naloxone
Maria Plotko
Senior Program Officer, exhibition co-creator

Harm reduction during music festivals and events, introduction of harm reduction tools for non-injection use into harm reduction programs, integration of substance testing in CEECA countries – all these tasks are faced by EHRA in advocacy. Based on the practical experience of consulting during the festival, the team will act more effectively in future activities.

It was a pleasure for the EHRA team and for me personally to hear from young people from around the world, Lithuania, Poland, Latvia, Estonia, Finland that our exhibition of harm reduction tools was useful. Many people, while looking at simple tools, immediately discussed how and where to buy gelatin capsules or substance tests. Health and safety are very important to everyone we talked to, and harm reduction programs are an opportunity to know and understand more about your safety and well-being. It is a pity that harm reduction organizations in the Eurasia region rarely have the full range of resources to help people who use drugs. Sometimes there is nothing else but a simple syringe, condom, and HIV information material. But the topic of quality and range of harm reduction services in our region is definitely much broader than our visit to one music festival with an exhibition and seminar.
Ganna Dovbakh
EHRA Executive Director

“Gathering Data on Human Rights Violations and Reaction Mechanisms”: Regional Workshop for activists and professionals from South East Europe countries

The Eurasian Harm Reduction Association (EHRA) will conduct a 2-day regional workshop for activists and professionals from South East Europe countries “Gathering data on human rights violations and reaction mechanisms” on March 18-19*, 2020, in Belgrade, Serbia.

Continue reading ““Gathering Data on Human Rights Violations and Reaction Mechanisms”: Regional Workshop for activists and professionals from South East Europe countries”

League of Practices: first results of Community-led monitoring of satisfaction with services in EECA region

On January 20-21, the Eurasian Regional Consortium* hosted in Vilnius the final reflective meeting based on the results of the Community-led monitoring conducted by the community in Ukraine, Russia and Kyrgyzstan within the framework of the project “Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services”.

Continue reading “League of Practices: first results of Community-led monitoring of satisfaction with services in EECA region”

Effective EHRA is critical to the joint struggle for rights and services for people who use drugs in the CEECA region: The Annual Meeting of the Steering Committee and the Advisory Board of the EHRA held in Tbilisi

In circumstances, when the states of Central and Eastern Europe and Central Asia (CEECA) fail to fulfill their commitments of transition to domestic funding, and, also, they toughen the repressiveness of drug policies, much depends on the effectiveness of regional advocacy.

Continue reading “Effective EHRA is critical to the joint struggle for rights and services for people who use drugs in the CEECA region: The Annual Meeting of the Steering Committee and the Advisory Board of the EHRA held in Tbilisi”

Time to Act! The 4th European Harm Reduction Conference

November 21, 2018

11.45 – 12.30

Panel discussion: Harm Reduction future: sustainability and impact

Moderator: Ganna Dovbakh and Wolfgang Phillipp

Naomi Burke-Shyne, HRI

Katya Lukicheva, OSI

Palani Narayanan, Global Fund

Susanna Ronconi, Forum Droghe, Italy

Marian Ursan, Carusel, Romania

12.30 – 12.45

“Chase the Virus, not People!”

Ganna Dovbakh, EHRA

16.00 – 17.30

Parallel session 7*: Bringing treatment to the community (HA REACT) 

Chair: Alexandra Gurinova

Co-organised by the European Joint Action on HIV and Co-infection Prevention and Harm Reduction (HA-REACT), HA-REACT addresses existing gaps in the prevention of HIV and other co-infections, especially tuberculosis and viral hepatitis, among people who inject drugs (PWID). It is a joint effort of 23 organisations in 18 EU Member States, and focuses on those countries where there are obvious gaps in effective and evidence-informed harm reduction interventions, or where such interventions are not being implemented at a sufficient level.

Gender approach in testing and other harm reduction interventions

• Alexandra Gurinova, Deutsche Aids Hilfe, Germany

• Olga Belyayeva, Eurasian Harem Reduction Association, Lithuania

Integrated care for people who use drugs – challenges and recommendations

• Kristel Kivimets, National Institute for Health Development, Estonia

Responding to HIV and overdose epidemics in Estonia

• Aljona Kurbatova, National Institute for Health Development, Estonia

Drug policy change through the lens of OST treatment implementation in Lithuania

• Morgana Daniele, Youth Rise, UK

November 22, 2018

11.00 – 12.30

Parallel session 12*: Transition and sustainable funding of harm reduction (OSF), part 1

Room: 2 – MIRCEA ELIADE
Chair: Ekaterina Lukicheva

This session aims to increase the understanding of progress and key success factors that lead to sustainability of HR programs in countries transitioning from Global Fund’s support of HIV response to national funding including the role civil society and community representatives plays in these processes.

Participants will:

  • Learn about the harm reduction financing changes and donor transition related processes taking place in SEE countries
  • Better understand key facilitators and factors that lead to their programmatic and financial sustainability
  • Learn from the experience of civil society and community representatives advocating for sustainability of HIV prevention services among key affected populations in their countries.

14.00 – 15.30

Parallel session 17*: How to leverage EU membership and accession for increasing sustainability and quality of harm reduction services at country level (OSI part 2).

Room 2 – MIRCEA ELIADE
Chair: Raminta Stuikyte

This sesison will discuss the challenges, lessons learnt and possible opportunities for NGOs in those EU member counties which lack of the political will to ensure the sustainability of harm reduction services at the expense of the state budget
Participants will:

  • Learn more about the political, technical, funding opportunities and instruments available for NGO in EU member and accession countries which could help to improve the sustainability of HR services they provide
  • Get an opportunity to discuss their situations, share their concerns and learn from each other’s experiences of advocating for the increase of the governmental funding for HR services

November 23, 2018

09.00 – 10.30

Parallel Session 26: Drug policy trends: alternative to coercive sanctions

Room: 1 – Aula
Chair: Ganna Dovbakh

This session aims to provide space for discussion on current drug policy trends in Europe, the impact of international drug policies on European national policies and practice and the ways of transferring European best practices to other regions.

Participants will:

  • Increase their understanding of the perspective of young people on the international and national drug policies;
  • Learn about the current state of advocacy for decriminalization, legalization and alternatives to coercive sanctions (ACS) in Europe;
  • Learn about pilot diversion from arrest programs in EU and barriers to their integration;
  • Share perspectives of EU best practices in drug policy that could be promoted outside of the EU.

Shrinking space for harm reduction and human rights in EU based on Hungarian situation

Peter Sarosi, Drugreporter, Hungary

Promotion of Alternatives to Coercive Sanctions (ACS) Programs in EECA

Dasha Matyushina, Eurasian Harm Reduction Association, Russia

Guidelines for law enforcement to improve public health outcomes for YPUD

Morgana Daniele, Youth Rise, UK

09.00 – 10.30

Parallel session 29 : Gendered consequences of repressive drug policies

Room: 4 – Simion Mehedinti
Chair: Eliza Kurcevič

The session aims to provide space for women who use drugs and specialists working with this group to share and discuss gender specific consequences of repressive drug policies and the availability and quality of existing services inclusion of the community in the global women’s movement.

Participants will:

  • Learn about recent studies of human rights violations of women who use drugs and the process of submitting complaints to UN bodies
  • Increase their knowledge of intersectional feminism and the inclusion of the community of women who use drugs in the global feminist movement
  • Learn about gender differences in substance use and the prevalence of HIV and HCV, and gender-sensitive services including services for women who use drugs who suffered from violence
  • Discuss how to protect and minimize risks among activists and human rights defenders

Gender differences among people who inject drugs (PWID) in Estonia

Maris Salekesin, National Institute for Health Development, Estonia

Human Rights of Women Who Use Drugs: Institutional Violence and Human Rights Abuse by OST Clinics’ Staff

Maria Plotko, Eurasian Harm Reduction Association, Lithuania

Harm Reduction Challenge: public nuisance vs public health

Aura Ruig, Metzineres, Spain

Protection of Harm Reduction and Community Activists from Pressure, Arbitrary Arrest and other Forms of Abuse by Authorities

Dasha Matyushina, Eurasian Harm Reduction Association, Russia

Harm reduction from perspective of feminism and history of the feminist movement

Fenya Fischler, Association for Women’s Rights in Development, UK

 

* – The list of the sessions, in which the representatives of EHRA’s team took part in their preparation