Monica Ciupagea Program Officer Open Society Institute - Budapest

1. Monica Ciupagea Program Officer Open Society Institute - Budapest

2. IHRD Mission The mission of IHRD is to reduce the harm in the lives of people most directly affected by drug use and drug policy. IHRD will work to create a global public policy environment that reflects harm reduction principles and that supports a broad range of harm reduction services provided by and for affected communities

3. Photo: Hans Jürgen Burkard

4. Core Activities • Providing grants and technical support for more than 200 harm reduction programs in 23 countries • Supporting regional, population-based initiatives: sex work, prison, Roma, street kids • Promoting capacity building: training programs and fellowships for service providers and advocates, workshops and conferences for various stakeholders. • Creating an enabling public policy environment: influencing national drug and HIV policies through advocacy at all levels.

5. The situation in CEE/FSU • Highest rate of new HIV infections in the world, 80-90% through injection drug use. • Repressive drug policies further fuel the epidemic. • Widespread stigma against users and people living with HIV/AIDS. • Lack of support for effective interventions from national governments.

6. But there have been positive developments: • Harm reduction programs piloted and scaling up in 22 countries. • Methadone and other drug substitution therapies approved by governments in 19 countries. In 2002 alone, methadone was approved in Belarus, Georgia, Kazakhstan, Moldova, Ukraine, and Uzbekistan. • Vast increase in funding available for harm reduction in CEE/FSU.

7. But there have been positive developments: • Wide range of stakeholders involved in harm reduction: service providers, drug users, people living with HIV/AIDS, health professionals, politicians, government officials, international agencies and donors, lawyers, human rights advocates, and others. • Harm Reduction is seen as central to HIV/AIDS in the region and deeply connected to a broad range of related issues, including law, human rights, drug policy, etc. • HIV prevention is increasingly linked to treatment, care and support.

8. Key Issues in the IHRD’s Strategic Plan • Institutionalization of Harm Reduction Including legislative commitment and legal protections; financial and other support from local governments; increasing scale and sustainability of harm reduction services. • Equal Access to HIV Treatment and Other Medical Care for Drug Users • Drug Policy Reform Including access to high quality, user friendly substitution therapies; re-orientation of drug policies away from punitive tactics, and toward a humane, health-based approach; incorporation of human rights and other legal protections into drug trafficking programs.

9. 7 focus countries In order to maximize its impact, IHRD will focus its resources at the national level in 7 focus countries: Lithuania Poland, Georgia, Russia, Ukraine, Kyrgyzstan Tajikistan.

10. Examples of Policy Initiative Activities • Skills Building • Advocacy training program developed with IHRA, WHO, and HIT • Advocacy Fellowship program with GMHC • Technical assistance to PWA and user groups

11. Examples of Policy Initiative Activities • Education & Information • Police peer-to-peer training in cooperation with MONAR-Krakow, and police academy training program developed with LJI • Support for a Human Rights Watch program to document abuses against people living with HIV and drug users in Kazakhstan. Jointly funded with OSI’s Central Eurasia Project. • Methadone study tours to sites in Lithuania, Poland, Hong Kong, and Paris • Development of print and online information centers based in Ukraine and Lithuania, as well as ongoing IHRD publications and media outreach during major events. • Monitoring and critical review of drug legislation in Hungary, Czech Republic, and elsewhere

12. Examples of Policy Initiative Activities • International Dialog • Raising awareness and focusing the debate at international events, e.g. UNGASS, Intl Harm Reduction Conferences, AIDS Conferences, Dushanbe Health & Security Conference, Kiev AIDS Care & Support Conference, • Satellite session at the Commission on Narcotic Drugs session - to emphasize the effects of illicit drug policy on the spread of HIV in countries with injection-driven epidemics. • Working with other donors to coordinate programs and greatly increase funding throughout the region, including DFID, USAID, CIDA, and others.

13. Examples of Policy Initiative Activities • International Dialog • Illicit Drug Policies and the Global HIV Epidemic: Effects of UN and National Government Approaches - A working paper commissioned by the HIV/AIDS Task Force of the Millennium Project • Trends in European Drug Policies: A Meeting Between Eastern and Western European States organized in cooperation with Max Planck Institute for Foreign and International Criminal Law Department of Criminology

14. Legal Initiative and Police Training • Legal grants and training program, in cooperation with HCLU, supporting drug policy reform and legal aid to harm reduction programs. First grants to Russia, Ukraine, Tajikistan. • Police study tour series in Poland, involving police from Albania, Armenia, Belarus, Macedonia, Slovakia, Tajikistan, etc. • Police academy training module developed in cooperation with Justice Init.

15. HIV/AIDS Advocacy and Human Rights • Grant Program for organizations of people living with HIV/AIDS and/or drug users: funded by IHRD/Tides Foundation, and supporting treatment access and anti-discrimination programs. • HIV Treatment Guidelines: With Columbia University, IHRD has developed guidelines on care and treatment for PWAs in Ukraine. IHRD has also initiated development of separate specific clinical guidelines on ARV for injection drug users. Similar work has been initiated in Kazakhstan at the request of the Ministry of Health.

16. HIV/AIDS Advocacy and Human Rights • Human Rights and Harm Reduction: Conference organized in Budapest by IHRD and Human Rights Watch, with representatives from IHRD’s 7 focus countries. Main purpose was to bring together human rights and harm reduction organizations in order to identify potential areas of collaboration, common targets and develop joint advocacy strategies.

17. Lithuania • Respond to urgent needs to enhance support for harm reduction encompassing: • Facilitate the policy dialogue • support community organizing • Oppose the “zero tolerance” policy; • Share the best HR practices; • Enhance public relations/image of harm reduction efforts.

18. Poland • Advocacy aiming at the amendment of current laws • Education of the society led mainly with the support of the media • Education of the decision groups and groups enforcing the law (parliamentarians, judges, prosecutors and policemen). • Mobilization of efforts made by interested persons, so by the addicts themselves. • Establishment of the long-term action plan (strategic litigation).

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