Trainings in Tajikistan, Kazakhstan and Georgia for peer workers about online consultations

Vielta Parkhomenko, EHRA consultant

In January, I applied for a consultancy to develop a cool manual on how to provide harm reduction consultations online based on a  peer-to-peer approach. I was happy for having such an opportunity and being selected.

There are really a lot of manuals about peer-to-peer consultation, so my task was not only to collect working methodologies and tools and “flavor” them with my own knowledge and experience but also to teach people with living/lived substance use experience on how to provide consultations within their communities, but virtually. I started work in February and then the full-scale invasion of my country, Ukraine, happened. It was 24th February. I was writing the manual from my phone on the bus while evacuating children to Ireland, writing on the train in the dark on the way to Poland, and that was a moment when I even more realized the importance of this manual and how it can help people. I didn’t know if I would have the strength to do something useful, but I decided to try, and it worked out in the end.

In February we started developing a training manual on online peer-to-peer consultations on the harm reduction topics. We know that there are many manuals and trainings on how to consultant based on a peer-to-peer principle, but now the relevance of online services is coming to the forefront. We, therefore, had the challenge of putting together workable methodologies and tools, creating a manual, and teaching people with living/ lived experience of substance use how to consult within their community specifically in an online format.

Clearly, the drug scene in the world has changed a lot over the past decades and continues to change. It used to be that peer consultations were mostly effective in places where substances were sold, and these were streets. Now, in many countries, substances are increasingly available in the online space where communication takes place.  This change has also been strongly influenced by the COVID-19 situation.

We understand how important it is to consider the needs and experiences of community members when developing training materials and programmes which are created for the groups of people who use psychoactive substances , so we finalized the manual after collecting comments and suggestions from peer consultants at the national trainings.

We have included 6 main sections in the manual:

  1. Basic information on online peer consultations
  2. How to provide peer support online?
  3. Resources you need for online peer consultations
  4. How can consultants build trust online?
  5. How to refer people to specialists?
  6. How can safety be ensured?

Once the draft of the manual was ready, we organized and conducted 3 national trainings in the countries that were selected through the open call – Tajikistan, Kazakhstan and Georgia.

The structure of the trainings was based on the SPT methodology (socio-psychological training). Different methods of presenting information were used in the training, because each method has both advantages and disadvantages, and different methods are suitable for different groups of participants (visual, audial, digital, and kinesthetic). A variety of group work methods were used: working in pairs, exercises aimed at developing leadership skills and general communication skills. The training itself was a success – the structure of the training was maintained, and a positive group dynamic was clearly visible.

Modification of the exercises for the individual structural parts of the training helped to regulate time and manage group dynamics. The training was aimed at different aspects of activity: development of cognitive sphere (perception, attention, memory, thinking, imagination, speech), assistance in adaptation to new conditions/social status, development of communicative sphere, emotional sphere (learning emotions, recognizing them, developing skills (how to display and redirect them constructively), ability development, ability to resist stress, increase of own self-esteem.

I would like to note the increase in the level of knowledge – the specifics of the training topic does not involve filling out training questionnaires, so the assessment was carried out through an analysis of expectations. Some knowledge was new to the activists, in particular online counseling techniques such as “emotional ventilation”.

Training were energetic and very intensive. Education led to the following results: improvement of knowledge, rethinking of existing experience, distribution of responsibilities, improvement of team and organizational interaction, getting knowledge and skills of project writing and resource search, ability to deal with critical situations, improvement of communication skills, gaining knowledge of organizational development opportunities.

Trainings is always a collaborative work in which the group does most of the work. The theoretical part was taken positively, participants asked many questions and gave concrete examples of what they had learned from the discussions and which of their expectations were met. People shared their personal stories, experiences of peer consulting, and exchanged cool tips and tricks. Different countries use different platforms for consulting and different experiences of both online and peer consulting.  Tools and techniques were discussed, as well as the needs of people coming every day to people in their community who can be trusted. Participants learned to see the differences between online and offline formats of consulting, consulting algorithms, psychological techniques, ethical principles, and self-care.  The topic of self-care was particularly relevant, as often consultants focus more on helping others. Participants had the opportunity to take an emotional burnout syndrome test and some of the results they shared were unexpected.

Trainings were very emotional. We laughed a lot and sometimes even cried. In each city, I received an unconditional support and new experiences.  In some countries, there were people for whom it was their first experience of participating in the training. Three times after the training, I received feedback from participants that they had received more than they expected, and that they were ready to implement online consulting in their countries. They really did not want this training to end. And when I returned home, I realized that my efforts had not been in vain. And when our manual will be published, I believe there will be many more countries where people can get professional online help from those who are easy to trust – peer consultants.

Kazakh meeting: Integration of WINGS tool in harm reduction programs and shelters for survivors of GBV

“And how do you decipher GBV? Gender justified (in Russian based and justified starts with the same letter) Violence? – asked a young man, looking into our room. Thus began a meeting about the availability of shelters and support services for women who use drugs in situations of violence and the implementation of the WINGS tool in Kazakhstan.

The meeting was attended by representatives of the community, shelter and rehabilitation center staff, police officers, psychologists, narcologists, as well as researchers helping to adapt WINGS and document its implementation in countries.

WINGS (Women Initiating New Goals for Safety) was developed by Dr. Louise Gilbert, Dr. Timothy Hunt, and Dr. Tina Jivatram-Negron of the Social Intervention Group at the Columbia University School of Social Work. When introduced in Kyrgyzstan, sex workers participating in the focus group in sauna in southern Kyrgyzstan in 2013 suggested the name Wings of Hope. So in the region the project spread under the name “Wings”. In addition to Kyrgyzstan, “Wings” work in Georgia, Ukraine and since 2022 in Kazakhstan. The cornerstone of the system is to develop a safety plan with the participant. Thanks to that, a woman knows where and whom to call in case of danger, or contact in case of violence, how to behave and what to do to reduce the risk of violence or to protect herself and her loved ones as much as possible if it cannot be avoided. In Kyrgyzstan, the tool has been adapted for women who use drugs, sex workers, and LGBTQI, and researchers are currently working with the community on a version of Wings for users of new psychoactive substances.

Despite the fact that the problem of gender-based violence is not new and has become especially relevant during lockdowns and isolation due to COVID and the war in Ukraine, in most countries of the region there are still no nationally accepted and working mechanisms, and referral schemes to respond to gender based violence. As part of the EHRA project “Access to comprehensive care for women who use drugs in case of violence” within the framework of the COVID-19 Response Mechanism (C19RM) of the Global Fund to Fight AIDS, Tuberculosis and Malaria to the Multicountry project “Sustainability of services for key populations in the Eastern Europe and Central Asia region”, civil society organizations from Ukraine, Kazakhstan, Serbia, Russia and North Macedonia worked to build referral schemes, educate and train shelter and police officers. Together with the Eurasian Women’s Network on AIDS in 2021 EHRA also released the “Help impossible to ignore” guide for organizations working in the field of harm reduction, HIV prevention, treatment, care and support, as well as combating and responding to gender-based violence.

Unfortunately, even in countries where there are laws addressing gender-based violence, they most often do not work, and seeking help especially for women who use drugs lead to re-traumatization instead of support. The work to combat violence is carried out mainly by the efforts of civil society and the non-profit sector, but for women who use drugs, even these services are not available. At the same time, harm reduction programs, with rare exceptions, do not address gender-based violence and do not work with it.

Leaving Almaty, already on the way to the airport, I heard a joke on the radio:

– A girl should be treated like a Christmas tree.

– What is it like? Knock her of and bring home?

The possibility of such an anecdote appearing on the air is another proof of the normalization of violence against women. Womens’ feminist, human rights organizations and activists still have a lot of work to do. But the epidemic of violence, like the epidemic of HIV, cannot be defeated without mutual support and unity of all women without exception.

Agenda (in Russian)

Presentations (in Russian)

Final webinar and project outcomes



Report on best practices integrating assistance to women affected by violence into harm reduction programs
Andrey Rylkov Foundation Gender violence brochure (in Russian)
Guide for dealing with women victims of gender-based violence who use psychoactive substances (North Macedonian)
Case management algorithm for cases in key populations subjected to gender-based violence, Kazakhstan (in Russian)
Analytical note on legal framework of response to GBV in Kazakhstan (in Russian)
Training program for social workers in Serbia (in Serbian)

Webinar on Police response to GBV against women who use drugs for the police from Central Asia

The aim of the webinar was to build capacity and knowledge about effective police approaches in provision of help and protection to women using drugs in case of domestic and intimate partner violence. The webinar was attended by police representatives from Central Asia


Webinar on Police response to gender‐based violence against women who use drugs


Police services provision, part of a multi-sectoral response to GBV. Standard Operating Procedures
Building bridges cover
Building bridges between survivor and provider, by Ionela Horga
Handbook on gender-responsive police services for women and girls subject to violence
Help impossible to ignore: basic needs and barriers in access to health and social care services and shelters in case of violence for women using drugs in the EECA region

Practical Information for Ukrainian Refugees Entering Portugal

The Portuguese government has applied temporary protection regime for people who are moving from Ukraine to Portugal. Under this regime, no proof of life risk is required upon entering Portugal and the necessary documentation is automatically assigned. As of March 3, the Immigration and Border Service (Serviço de Estrangeiros e Fronteiras – SEF) provides service desks exclusively for Ukrainian citizens in its delegations and National Support Centers for Migrant Integration (CNAIM). For addresses and working hours please visit:

For coordination of transport when entering Portugal and obtaining temporary protection status, you must complete the following form:



If you cannot afford a house in Portugal, you can ask for support from the High Commission for Migrations (ACM), which is working directly with Social Security to find accommodation for those in need.
You can send an e-mail to, fill out an online form:

You can also have access to the special regime of the Entry Door program (Entrance Door – Housing Portal ( in which financial support is granted to support the costs of accommodation in tourist resorts or the rent of a house. The support lasts up to 18 months and can be extended up to a maximum of 30 months. 

More information on housing and shelter can be found here:

With the temporary protection title, you automatically have access to the National Health Service Number (NSNS). For more information regarding Health insurance please visit:

Shelters in Portugal, which specifically focus and provide housing for key populations (people who use drugs, MSM, sex workers, people living with HIV, etc.):

In addition, there are three National Migrant Support Centres in Lisbon, Faro and Porto:

  • CNAIM Lisboa: Rua Álvaro Coutinho, 14, 1150 – 025 Lisboa
  • CNAIM Faro: Loja do Cidadão, Mercado Municipal, 1.º Piso, Largo Dr. Francisco Sá Carneiro, 8000-151 Faro
  • CNAIM Porto: Av. de França, 316, Edifício Capitólio, 4050-276 Porto

You can also send an email to:

Food and clothes can be obtained via Portuguese Red Cross.

For more information, contact by phone 213 913 900 or by email at teleassistencia@cruz , from Monday to Friday, from 9:30 am to 5:30 pm.

The counsellors from many backgrounds, work with different therapeutic modalities, and speak a wide variety of languages. What unites them is that they have agreed to offer free, online counselling for any person directly affected by the war in Ukraine. Most sessions are offered online. For more information please visit:

The Portuguese National Health Service is free of charge and includes OST, that is, you can access a hospital or health center and you will have to pay, at most, a user fee. With the temporary protection title, you automatically have access to the National Health Service Number (NSNS). Once you have chosen your place of residence, you must go to the local Health Center and register yourself and your family as a resident in the area, so that you can be assigned a Family Doctor and be included in the National Vaccination Plan.

In Portugal from OST medications Methadone and buprenorphine is available in treatment centres and Methadone in Harm reduction services.

The Portugal National Health Service is free of charge and includes ART, that is, you can access a Hospital or Health Center and you will have to pay, at most, a user fee. With the temporary protection title, you automatically have access to the National Health Service Number (NSNS). Once you have chosen your place of residence, you must go to the local Health Center and register yourself and your family as a resident in the area, so that you can be assigned a Family Doctor and be included in the National Vaccination Plan.

Temporary protection is an exceptional procedure that ensures immediate protection, approved by the Government to guarantee support for people displaced from Ukraine, because of the recent armed conflicts in the country. Any means of proof, such as an identification document, is accepted and is sufficient to receive ART.

Regardless of legal status, medical appointments and public health medication are always free. Hence people can receive OST or ART treatment without applying for refugee status.

If you need support with translating, please contact the Telephone Translation Service (STT) of the High Commissioner for Migration (ACM):

Opening hours: Monday to Friday, from 09:00 to 19:00; Saturday from 09:00 to 17:00

Contact: +(351) 218 ​​106 191 or 808 257 257

More information:

Practical Information for Ukrainian Refugees Entering Croatia

To enter Croatia, you need a foreign or international passport. No visa required. If you travel with children, you need documents that prove your family ties. You do not need any documents for pets.

The Border Police will carry out border control and give you a card with basic information. Depending on your wish to stay in the Republic of Croatia, you must apply for a short-term stay or temporary protection status at the place of accommodation.

Please, see the detailed procedure and frequently asked questions in Ukrainian HERE

As a person under temporary protection, you have the right to:

  • stay for the duration of your temporary protection,
  • get a card for a foreigner under temporary protection, which is considered a residence permit,
  • work without a residence, get a work permit or a certificate of registration for work,
  • the right to healthcare – by presenting the card of a foreigner under temporary protection, you exercise all rights from the basic health insurance, and if you get a job, you will receive the card of a health insured person,
  • fixed assets for living and accommodation,
  • primary and secondary education at the same standard as Croatian citizens, family reunification and information on rights and obligations.

After entering the border areas of the EU (Poland, Romania, Slovakia, Hungary) you may be offered the following options for further transportation to Croatia:

Free transportation can be provided by buses, minibuses or private cars of volunteers.

Information on housing, shelters, accommodation in Croatia. As a person under temporary protection in Croatia, you can be accommodated in:

Reception accommodation – the stay here is short, usually up to 48 hours and you will be provided with a place to sleep, food, internet access, and psychosocial and health support. After that, you will be offered more permanent accommodation in one of the collective accommodations.

Employees of the Directorate of Civil Protection, the Croatian Red Cross, police officers, and health workers are in the shelters, and if necessary, mobile teams of other relevant bodies and operational forces of the civil protection system are organized (social work, employment office, education, civil protection operational forces etc.

Acceptable accommodation includes:

  • Varaždin – City Sports Hall (small hall), Šetalište Franje Tuđmana 1 (location link),
  • Osijek – Sports Hall South 2, Ulica kralja Petra Svačića 67 (location link)
  • Gospić – City Sports Hall, OŠ dr. Jure Turića, Ulica Miroslava Kraljevića 19 (location link).

Collective accommodation – this is a more permanent form of accommodation in which you are provided with accommodation, food, and internet access. At these locations, there are hotel staff for all issues related to accommodation and stay, and employees of the Directorate of Civil Protection and the Croatian Red Cross will visit you every day and coordinate all activities for all your questions and needs. 

Individual and/or private accommodation – accommodation with citizens, relatives, friends, acquaintances, or if you are the owner of real estate in Croatia. You continue to exercise other rights that belong to you.

The information mentioned above in Ukrainian is available HERE

There are no shelters in Croatia, which specifically focus on and provide housing for key populations (people who use drugs, MSM, sex workers, people living with HIV, etc.)

As a person under temporary protection, by showing the card of a foreigner under temporary protection, you have the right to treatment for acute conditions and chronic diseases by family doctors, pediatricians, gynecologists, and emergency dental services, the right to vaccination, testing and treatment against COVID-19, and the right to vaccination against other infectious diseases. This practice refers to ART and medical services related to HIV, OST, Hepatitis C and TB.

Your children are fully equal in rights with Croatian children, and they have the right to access complete medical care.

If you need emergency medical care, call 194 or 112.

To exercise your right to health care, always have an ID card of a person under temporary protection!

The Croatian Red Cross provides refugees with clothing, hygiene products, and food packages. Offices of the Red Cross are in every county (region) of Croatia

You can also send a request to one of the groups on Facebook:

When deciding about private accommodation, keep in mind that organized accommodation facilities for displaced persons (hotel facilities, hostels) provide all necessary services and free meals, clothing, etc. Such help will not be constantly provided if you live on your own, financial assistance from the state is one-off and small, and food and hygiene products in Croatia are not cheap.


NGO FLIGHT / Udruga Let

Ratarska 7, Zagreb
Executive Director : Iva Jovović, +385 (0)1 5803726,
Work time
Office: Mon–Fr 8:30–16:30
Outreach schedule:
Works in City of Zagreb, Zagreb County


Šetalište Bačvice 10
Split, Croatia 21000,
Tel. 021/346664. 
Work time
Office: 8:00–19:00
Works in Split, Dubrovnik, Šibenik, Knin (Seaside region), Osijek, Vukovar, Varaždin (Continental region)

Udruga TERRA

Krešimirova 12, Rijeka
+385 51 337 400
Works in Rijeka, Primorje-Gorski kotar County


Dobricheva 32, Pula
+385 52 222-502
Works in Pula, Istria County


Ilije Smiljanića 2, 23000, Zadar
+385 23 302 107
Sos tel: 095 902 17 49
E mail:

Udruga za borbu protiv ovisnosti “NE – OVISNOST”

Europske avenije 8/I, Osijek, tel.+ 385  31 271 471, email:

Croatian Red Cross (Zagreb, Zadar, Nova Gradiška, Krapina). You can find contacts of the relevant offices at the website:

People can receive psychosocial support upon request as they arrive. Please, ask Croatian Red Cross staff for referrals and assistance.

You can receive psychosocial support from professional specialists at the Centers for Social Welfare. You can find the local branches’ contacts by googling ‘Centar za socijalnu skrb’. Each Center in each region has its website.

You can get psychosocial support in HIV-service organizations mentioned in p.7.

Psychologists work in all organized accommodation facilities for displaced persons. Relevant translation services are also available.

In Croatia, the OST (supstitucijska terapija) and all relevant health services are available free of charge within the basic health insurance package available to refugees and people under temporary protection.

Only specialist office-based medical doctors (e.g. general practitioners) and treatment centers can prescribe substitution treatment. However, this treatment is predominantly administered by general practitioners. OST is provided in outpatient settings through drug prescribing.

Outpatient treatment of drug addiction is provided with the help of 21 Services for the Protection of Mental Health and Addiction Prevention at the County Institutes of Public Health, the Counseling Center for Prevention of Addiction (Poreč), and the polyclinic of the KBC Sestre milosrdnice (Zagreb).

The services include:

  • substitution therapy,
  • psychosocial treatment and
  • other specific methods and procedures according to user needs.

You have to arrange an appointment with a general practitioner (a family medicine doctor) in the nearest Health Center (Dom zdravlja). You need to bring your person under the temporary protection ID, and relevant medical documents about your therapy and health condition (originals or copies). You can refer to the Croatian Red Cross to assist you with the meeting, translation, and choosing GP, especially if you are waiting for your ID to be ready.

GP will refer you to the doctor in Services for the Protection of Mental Health and Addiction Prevention which will examine your condition and issue an OST prescription and other recommendations. As soon as GP gets this opinion, he/she issues an electronic prescription.

Addresses of mental health and addiction prevention services of county public health institutes:

In Croatia the following OST medications are available:

  • Methadon
  • Buprenorhpine
  • Buprenorphine and naloxone (Suboxone)

Opioid substitution therapy (OST) is predominantly administered by general practitioners and is available in prisons as well.

In Croatia, the ART and all relevant health services for PLWH are available free of charge within the basic health insurance package available to refugees and people under temporary protection. 

In Croatia, treatment, care, and support for PLWH are provided centrally at the University Hospital for Infectious Diseases Fran Mihaljević, which offers proper treatment to those who need it (free of charge). The Clinic drug store provides the ART medicines. To get a prescription, you need to make an appointment with a specialist and a medical examination. 

You have to arrange an appointment with a general practitioner (a family medicine doctor) in the nearest Health Center (Dom zdravlja)  and bring all relevant medical documents about your therapy and health condition you have (originals or copies). You can refer to the Croatian Red Cross to assist you with the meeting, translation, and choosing GP, especially if you are waiting for your ID to be ready or you want to stay in Croatia temporarily. 

GP will refer you to The University Hospital for Infectious Diseases (UHID) (Klinika za infektivne bolesti “Dr. Fran Mihaljević”) located in Zagreb:

Mirogojska 8,
10 000 Zagreb
+385 1 2826-222
+385 1 4678-235

If you live with HIV, please, consider accommodation in Zagreb or nearby locations so you are not too far from the Hospital.

If people are not applying for refugee status (i.e. have a status of migrants), they still can receive OST, ART or any other medical or psychological support.


Social Rights and Assistance

You prove your official status as a person with the card of a foreigner under temporary protection!

An expert from the social welfare center (Centar za socijalnu skrb) will talk to you to determine how you can best be helped. You have the right to

  • the first social service,
  • consultation,
  • psychosocial counseling,
  • accommodation if you meet the requirements per the Social Welfare Act (unaccompanied children, children with disabilities, the elderly, people with disabilities etc.), and
  • a one-time allowance for a single person up to EUR 300 and a family up to EUR 450.

You can submit a request for a one-time allowance to the on-duty social worker in the Reception and Collective Accommodation visited by Mobile Teams. If you are in individual private accommodation, you can apply at the Centers for Social Welfare and branches in Croatia.

This assistance is paid once in cash and is used to cover extraordinary expenses incurred due to current life circumstances. Additional information can be obtained at the contact phone +385 99 399 7317 and e-mail

Employment and Work

As a person under temporary protection, you can work in the Republic of Croatia without a residence and work permit or a certificate of registration, which means that you do not need an additional permit to enter the labour market.

Contact the Croatian Employment Service (CES) and register in the register of unemployed persons.

You can apply via e-mail:, or in person at the reception center to a CES representative, or by coming to the CES regional offices.

Important telephone numbers

Unique toll-free number 114 (8 a.m. until 4 p.m./ 7 days a week). The telephone number for the care of displaced persons from war-torn Ukraine (you can get information on accommodation, food, health care, children’s education, employment status, and other rights); supported languages are Croatian and Ukrainian.

People with voice, hearing, and speech impairments can send inquiries to the following e-mail address:

Embassy of Ukraine in Zagreb, Voćarska 52
Telephone: +385 1 461 6296


Consulate of Ukraine in Omišalj, Pušća 131
Telephone: +385 51 842 037

Consulate of Ukraine in Split, Coast of the Croatian National Revival 7
Telephone: +385 99 686 2797

Ukrainian Community of the Republic of Croatia, Cardinal Alojzija Stepinca 45, Vukovar
Tel / fax: +385 32 493 224
Mobile phone: +385 95 378 1199

Single European Emergency Number – 112
Police – 192
Firefighters – 193
Emergency medical care – 194
Roadside Assistance (Croatian Auto Club) – 1987
Zagreb bus station +385 72 500 400

Information and reservations for calls from abroad to the number: +385 1 647 1100
Zagreb Railway Station +385 60 333 444 * TRAIN (* 8525)
Franjo Tuđman Airport (Zagreb) +385 60 320 320 – for calls from abroad: +385 1 456 2170
Ministry of the Interior of the Republic of Croatia – Headquarters: e-mail:

Important Websites

A website with all the information you need . This website contains all valuable information for the reception and care of displaced persons from Ukraine and information for everyone who wants to help the displaced population of Ukraine.

Official website in Ukrainian that you can send to anyone seeking help in Croatia

Experience based information about seeking help in Croatia:

Croatian Railways passenger transport provides free transport to Ukrainian citizens on all routes in the national railway traffic of the Republic of Croatia in the 2nd class of trains.

Free tickets for Ukrainian citizens can be issued at the ticket office or on the train by presenting a Ukrainian passport, identity card or a decision on approval of entry into the Republic of Croatia.


Expert Group Meeting of the Eurasian Harm Reduction Association

Moving Together Towards Quality Harm Reduction[1]

5-7 October 2021

Meeting report


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.





[6] “Decision-makers cannot hope to develop and implement new strategies for quality without properly engaging health-service providers, communities, and service users”.


Practical Information for Ukrainian Refugees Entering Italy

Information on free transportation from boarders can be found here:

Travel with “Itabus” is free for people with Ukrainian IDs.  

To get assistance in finding accommodation contact local Prefettura:

You can also use the following sites to look for accommodation:

About healthcare for foreign nationals:

To obtain STP card “ISI – Informazione Salute Immigrati

At the point of entry to Italy the following health services will be guaranteed:

  • administration of anti Covid-19, Diphtheria, Tetanus, Pertussis and Polio vaccines;
  • optional administration of measles vaccine, mumps, rubella vaccines and tuberculosis screening test, as well as other vaccinations, following an evaluation of health authorities.

More information can be found here:

Food and clothes can be received from Caritas Italiana. Locations can be found here:

You can also request assistance from local government:

Find information about harm reduction organisations in Italy here:

or download Trip App:

Available OST medication include: Methadone solution/syrup, Buprenorphine, Buprenorphine/naloxone. After registering with Prefettura you should be able to receive OST from SerD. List of providers by region can be found here:

ID or passport are required to receive ART, plus you need to register your presence in the country to Prefettura.

List of providers by region can be found here:

Digital Security Information

The material was prepared using the original video and text available in Russian at the following links:

Digital security – or how to protect your online identity, data, and other assets?

Activists, human rights defenders and civil society organizations are at risk of violation of their right to information and freedom of expression.
In this section, find practical advices on how to protect your digital information.

First of all, you should answer the following questions for yourself and assess your risks

  • What do I want to protect?

(In case I want to protect, for example, document scans, and not communication, then the recommendation to use Signal will not be relevant)

  • Where is information stored?

(on a computer, in the office, at home, on which messenger, on which platform?)

  • Who has access to information?

(shared computers, folders, directories, you should specify what is important and what can happen to information. The answer is subjective)

  • What can happen to it?

(cases of phishing or account hacking attempts…)

  • What will be the consequences for ME?

If you have high risks

  • Seek help from colleagues, donors, community, organizations
  • Request an audit or assessment of your risk exposure

Digital hygiene

  • Messengers are better than SMS
  • Unique passwords for important accounts
  • Two-factor authentication on important account
  • Learn to recognize phishing
  • Backup copies of important information
  • Encrypt and lock devices
  • Update all programs
  • Uninstall programs you don’t use

How often are accounts hacked?

  • An attacker has learned your password from a hacked site and tries to log into Facebook with this password
  • Phishing – a fake site asks you to enter your password or two-step verification code
  • Your account has junk mail, an attacker has gained access to it and is trying to reset passwords on your other accounts

Check your email with

Phishing message

Phishing is when attackers send malicious emails designed to trick people into falling for a scam. The intent is often to get users to reveal financial information, system credentials or other sensitive data.

What Does a Phishing Email Look Like?

Takes you to a page which looks identical to Google, Apple or other official landing pages, in order to get your password.

Example of a fake landing page:

How to check files for viruses?

  • Save file but DO NOT open it
  • Open website
  • Upload file to be reviewed
  • View antivirus scan results

Protecting accounts from hacking

  • Account being registered on trusted mail address
  • Use unique passwords for important accounts
  • 2-Step Verification (SMS/generator/backup codes) should be configured
  • Use the account only on your devices
  • Customized ways to restore access to your account or securely saved password

Communication protection

  • Do not say anything secret on your mobile phone
  • Do not write anything secret in SMS
  • It is safer to talk over the Internet
  • Facebook Messenger, Telegram, Skype
  • WhatsApp, Signal, Telegram secret chat
  • Protect devices

Possible risks with devices

  • Breakage, theft, loss of device and loss of information
  • Virus infection, leaking or loss of information
  • Withdrawal and subsequent access to information

Computer protection

  • Use of legal operating systems and programs
  • Regular software updates
  • Back up important data
  • Account separation in Windows or MacOS
  • Lock with password
  • If you need protection against seizure and access to data, encrypt

Mobile Device Protection

  • Latest versions of Android OS or iOS
  • Regular software updates
  • Back up important data
  • Screen lock with password/pin code/bio-metrics
  • Hidden message content on locked device
  • If you need protection against seizure and access to data, encrypt
  • Do not give the phone to anyone

8 simple principles which can help you to distinguish truth from fake news​

  1. The primary principle is to distrust all sources of information. Choose one source with a transparent information policy and a good news service that you really trust.
  2. Now expand the list of sources, guided, as in the primary principle, by common sense and using the following tips:
  • a team is better than one person
  • better an independent team whose work is paid by readers
  • clearly defined anti-war position
  1. Select at least two to a maximum five sources, taking into account the time the information resource appeared (you should be wary of the newly created and unknown onces), and whether and if so, which personnel changes took place lately in the information resource you’ve selected.
  2. Ignore official sources, media with state participation. For example, the requirement of Roskomnadzor to use only information from Russian official sources when covering the war topic, is de facto military censorship.
  3. When it comes to infrastructure, read the primary sources. Information about flight cancellations should be taken from the airport website, about the injection of money into the economy by the Central Bank – from the press release of the Central Bank, etc.
  4. Don’t get emotional and keep cool. Try to avoid news with value judgments of the authors (“their vile spies”, “our brave scouts”, etc.).
  5. Social networks and instant messengers are unreliable. Especially in wartime, trolls who are given content plans about what and how to write become active, as well as coordinated campaigns are being organized to spread lies. You should ignore not only the messages in your feed, but also in the comments under your posts.
  6. Don’t be afraid to miss something. By following the informational diet described above, you will have more time for positive creativity and reflection.