Nicholas Thomson University of Melbourne and Johns Hopkins Bloomberg School of Public Health

1. Enhancing Partnerships Between Law Enforcement and Civil Society Organisations in the context of Drug Use and HIV: Lessons from the field Nicholas Thomson University of Melbourne and Johns Hopkins Bloomberg School of Public Health

2. The premise • In combination: police forces, military services, internal security forces are somewhere between 10 and 10000 times larger than the public health sector • In a world of shrinking resources for HIV we need to mobilise this human capital

3. Background and Context • Partnerships between LE and CSOs in the context of HIV service provision for people who use drugs are the exception rather than the norm • Highlighted by ongoing documentation of rights violations and negative impacts on access to essential services • How do we move through persistent conflict into partnership?

4. Historical efforts • There have been multiple efforts to implement harm reduction training into police curriculums….is it effective? Is it sustained? • Law enforcement and harm reduction in SE Asia – What works and what doesn’t work. Edited by: Prof Nick Crofts, Dr Timothy John Moore, Ms Brigitte Tenni, Dr Nick Thomson (2012) www.harmreductionjournal.com/series/policing

5. Investing in enabling environments • Avahan project in India (Gates) • Nepal Police HIV Policy (USAID) and Blue Diamond Society • Strengthening Indonesia’s Policing Institutions through institution Building (IOM) • “Creating enabling environments for through advocacy” Malaysian National Strategic Plan 2011-2015

6. Investing in partnerships between LE and CSOs • Friendly Police project in Kyrgyzstan • Sex Workers in Network Group • Isolated efforts across the Fiji and the PNG • Police nodal officers in India • Community policing efforts in Bangladesh If partnerships are so critical why arent we investing more heavily????

7. Law enforcement and CSO dialogues In the last half of 2013, UNODC and with the involvement of LEAHN began a series of dialogue workshops towards enhancing partnerships across high priority countries • To sensitise law enforcement officials about harm reduction services in the context of HIV and how law enforcement practices can influence (positively or negatively), the access of people who use drugs to harm reduction services; • To build capacity of the CSOs to advocate with LEAs to ensure greater access of people who used drugs to harm reduction services; • To create a space for LEAs and CSOs to share respective positions, concerns and ideas for enhancing future collaboration.

8. So what have we really learnt? • That law enforcement reform is key (what is the role of police in the National HIV Program and where is it documented, arrest quotas, police salaries, police partnership training) • That strengthening the ability of NGOs/CSOs/HIV programs to bring police in early is critical • That we need to get better at monitoring and evaluating efforts to address the enabling environment……that if we stop nurturing partnerships it can fall away very quickly • If police are so critical, why are their only 6 of them at AIDS 2014?

9. Civil Society Involvement Remains Critical

10. The Science of the Enabling Environment • We have all the tools but how do we go foster and promote partnerships to reduce harm at scale? It has to be multilayered and multipronged and simultaneous • We need to show that efforts to enhance partnerships between criminal justice and public health in HIV prevention have benefits for both criminal justice and the community • Evidence of decreased crime as well as improved access to HIV services makes a strong argument • The Win Win effect

11. PRE IMPLEMENTATION

12. PHASE I IMPLEMENTATION PHASE II PHASE III

13. Pre Implementation Preparedness Checklist Layer 1 Months 0 Pre Implementation Baseline Survey on Knowledge/ Attitudes/ Behaviors and Practices of Law Enforcement Officials around HIV/ AIDS Layer 2 6 IMPLEMENTATION PROCESS External Evaluation; Key Information interviews with other stakeholders from Health Service Sector, Communities and NGOs working with KAPs to assess impact of Law Enforcement Officials in enhancing services provision for people WID, PWIDS and other KAPs EVALUATION Layer 3 Part A Post Implementation Baseline Survey on Knowledge/ Attitudes/ Behaviors and Practices of Law Enforcement Officials around HIV/ AIDS Layer 3 Part B 12 POST 12 MONTHS Evaluation of Law Enforcement specific variables of interest including: a) perceptions of community safety b) crime rates c) use of police time and resources Layer 4

14. Figure : Challenges and Opportunities for Multi-sector Partnerships

15. Figure : High level representation of key stakeholders in a facilitated study advisory and working group

16. Figure : Road map for building enhanced partnership between law enforcement, public health and civil society

17. Acknowledgements • Law Enforcement and HIV Network (LEAHN) • UNODC • Research Institute for Health Science Chiang Mai • University of Melbourne Hotspots Team • Johns Hopkins Bloomberg team • Colleagues at the Open Society Foundations