Interview with Alice Pomfret | City Reports

The City Reports are the final segment of Correlation – European Harm Reduction Network (C-EHRN)’s Civil Society-led Monitoring of Harm Reduction 2023 Data Report. These concise harm reduction ‘case studies’ highlight either innovative practices or urgent issues demanding immediate attention in five different European cities. The reports will serve as advocacy tools to engage decision makers at all levels, either by showcasing best practices or as an urgent call to action. We asked the primary author, Alice Pomfret, about the process of preparing the reports, and how harm reduction organisations can use them in their advocacy efforts. Read the interview below!

Why did you decide to dedicate a volume of the 2023 monitoring report to the city reports?

The city reports are highly qualitative in nature, and they really zoom in to one particular issue or practice to provide a more nuanced understanding of the local context. We have found that traditional methods such as surveys and questionnaires, while great for capturing large amounts of data, are not so effective at achieving that level of depth. The city reports offer selected focal points an opportunity to authentically tell their story and shed light on issues that are unique to their cities. We hope that this will raise greater awareness of the particular issue, strengthening their advocacy efforts and ultimately leading to positive change.

How did you choose the cities that were included in the report series?

Focal points were invited to nominate themselves to be involved in the City Reports, and following a series of meetings, five cities were selected. This selection process involved extensive discussions with the focal points themselves, leading to a collaborative decision of the cities to be featured. A mix of capital cities and smaller cities were chosen to reflect a variety of contexts, populations and needs. We also thought about geographical variation to ensure coverage across regions. Additionally, we took into account whether the situation that they wished to share were examples of innovative practices or urgent problems to ensure that the reports were balanced in that respect too. It was important for us to strike a balance between positive and negative aspects so that we don’t just focus on the ‘doom and gloom’ and celebrate some harm reduction wins along the way.

Which methods did you use to collect the data for the city reports?

Semi-structured interviews were conducted with various stakeholders, including community representatives, policymakers, harm reduction service providers, and other relevant actors. Depending on the city, interviews were either conducted in the local language by the focal point, then translated into English, and analysed by myself. Or, where respondents were comfortable interviewing in English, I would conduct and analyse the interviews myself. I also gathered extensive literature on the topic to supplement the interviews.

How can harm reduction organisations make use of the city reports?

The reports have been designed to function as concise and easily accessible advocacy tools, aimed at engaging decision makers at various levels. They achieve this by either showcasing best practices, offering inspiration for other cities, or by highlighting an urgent problem that requires immediate attention and action. We purposely tried to keep these reports short and to the point, so that they are more likely to actually be read by decision-makers. The design of the report was influenced by input from the focal point, aligning them closely with their specific needs and goals. However, other harm reduction organisations can definitely use the reports. For instance, to benchmark their own city against other cities’ approaches, or alternatively, if they are experiencing challenges similar to those highlighted in a report, they can use them as resources to strengthen their own advocacy initiatives.

C-EHRN will also establish and implement a tailored Advocacy Mentorship Programme to increase the advocacy capacities of focal points and support the dissemination of C-EHRN reports and activities at the local and national policy-making levels. This will include a tailored advocacy training coordinated by the Rights Reporter Foundation and follow-up mentorship support for focal points who were involved in the City Reports for 2023. It will also involve a video being produced, with the findings presented at the European Harm Reduction Conference in December, which is really exciting!

Have you noticed any significant differences among the cities and if so, would you describe what these were?

What’s been really interesting to see across cities is how local and national politics play out differently when it comes to supporting harm reduction efforts. For instance, in Esch-sur-Alzette in Luxembourg, harm reduction initiatives, including the implementation of drug consumption rooms (DCRs), are a key part of the National Drug Strategy. So, any pushback against DCRs usually comes from the local level, so the city municipalities. Whereas in Warsaw, we see greater engagement from the local policymakers, at least at the district level, whereas decision makers higher up, whether at the city level or national level, seem to prioritise drug policy or harm reduction less. A similar dynamic can also be seen in Amsterdam, where the city government is extremely progressive, openly criticising the failures of the war on drugs, and advocating for drug regulation. Yet at the national level, the stance on drug policy remains much more in this prohibitionist paradigm.

 

Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam). The Executive Summary can be accessed here.

Get to know the work of Drogenberatung e.V. Bielefeld | Interview with Jan-Gert Hein

Drogenberatung e.V. Bielefeld joined Correlation – European Harm Reduction Network as a Member and Focal Point supporting the data collection for the Civil Society Monitoring of Harm Reduction in Europe in 2023. Below we bring an interview with Jan-Gert Hein, a member of the board of directors, to introduce the work of the organisation and why they find it relevant to be part of our Network.

Could you tell me about the work of your organisation?

The Drogenberatung has been running for about 50 years already. We are running several facilities that offer services for people who use drugs. We have different advice centres in Bielefeld and also in a town in a more rural area around Bielefeld called Detmold.  Besides these, we run a drug consumption room (DCR) that is connected to an advice centre and a doctor’s office that offers opiate substitution. In one of our advice centres in Bielefeld, we have an office for prevention work as well. We also have an advice centre that works on a more structural level and is focused on gambling addiction in North Rhine-Westphalia.

What harm reduction activities do you carry out?  

The biggest one is the DCR we are running where we have about 40,000 consumption processes per year. We also do street work where we offer syringe exchange programs and deliver harm reduction material to people who want our help. In terms of harm reduction, we are also running a very low-threshold hepatitis C detection program. People can get a PCR test for hepatitis in our DCR, and know if they are hepatitis C positive and if it needs to be treated.

What populations do you focus on? 

Our main focus is on people who use drugs, not only in the Bielefeld area but also in Detmold. We also work in several prisons around here, there is also a big group of clients we are focusing on. Most of them are currently using drugs or are relatives of people who use drugs. We also work with people who used drugs before but quit.

Would you tell us more about the work that you do in prisons?

In Germany, prisons have to offer advice to people from outside of prisons, they have to work together with drug advice centres and organisations like ours. We work in several prisons with different structures. Some of them are closed, but some of them have an open structure. Inside the prisons, we offer general advice. We inform people about harm reduction services outside of prison, but also of methods they can use inside the prison.

Another basic thing we do is to help people get into therapy. In Germany, there’s a law that offers the option to do therapy instead of staying in prison if a person commits a crime because of an addiction. That needs to be clarified by the court. If that happens, people have the option to do therapy and leave prison. We help people to get out of prison and into therapy.

Are there any other interventions that are not directly harm reduction-related that you would like to highlight? 

I think the biggest standout in our facility, the Drogenhilfezentrum (drug aid help centre) is that we combine different aspects of our work there. We combine treatment with the doctor’s office and care options for people with the possibility to get food, drinks, relax and rest. Besides that, we offer a drug consumption room and an option to seek advice. So we have an inclusive offer that people can use.

When we look around in Germany, we see that this concept works out, to have it all in one place so people don’t have to visit different facilities to get the help they need. Combining these key factors, treatment, care, and advice, is a very effective way to promote health for people who use drugs and especially for people who are experiencing homelessness. That’s what makes us kind of unique, and we have very good experiences with having everything in one place.

Is there any aspect you are especially proud of and would like to share about?

The Drogenberatung itself has been running, as I said, for about 50 years already. We started with opiate substitution in the 80s and we have a really good network in Bielefeld that is run by the Drogenberatung. I think what makes us special is that we are a really good networker. We have networks with prisons, with doctors, with people from almost every community. That is something we really benefit from as an organisation.

We have a really good network around Germany as well, we also keep in contact with other organizations which are not in or around Bielefeld. That’s how we got in contact with the European Harm Reduction Network, for instance.

Why do you find it relevant to be part of the Correlation – European Harm Reduction Network?

Our motivation to join the network was that we noticed that networking is everything, especially in fields of work where you don’t have that many organizations or structures you can rely on. I think that is something that the harm reduction network provides, to seek information and talk to people who have the same struggles as you do. That is something I look forward to.

I’m excited about meeting everyone else and getting in contact because it’s on us. In Germany, we have a far-right party that did well in state elections last year and we see that our work is getting politically and therefore financially under pressure. I think that is something that a good network can help you to endure.

What does harm reduction mean to you?

Harm reduction is the basic pillar of our work because if we can’t reduce harm, people endanger themselves. Harm reduction is the first thing that needs to happen for people to get more options. Harm reduction is the first step, not only when we look at the population in Bielefeld, but also if we look into prisons and other settings. It is the first step of everything.

Insights from WHS 2024 | Strengthening Hepatitis Elimination Through Community-Led Monitoring

The World Hepatitis Summit (WHS) 2024, held from 9th to 11th April, spotlighted the pivotal role of community-led services in the global fight against hepatitis. Among the voices contributing to this discourse was Katrin Schiffer, director of the Correlation–European Harm Reduction Network (C-EHRN). Katrin’s participation in a plenary panel focusing on the power of community-led services in elimination underscored the significance of community-based monitoring activities in advancing the agenda of hepatitis elimination. Katrin’s presentation also underlined some of the main challenges faced in the C-EHRN Monitoring activities and approaches to overcome these.

At the core of WHS 2024 was a commitment to a multi-stakeholder, multi-sector public health approach, uniting diverse actors from civil society, policymakers, the private sector, and academia. Organised by the World Hepatitis Alliance with the support of the Ministry of Health of Portugal, the summit aimed to translate aspirations into action, driving tangible progress towards the elimination of hepatitis.

The session in which Katrin Schiffer participated explored the value of community-delivered services to the people they serve and to the health systems they support, highlighting best practices in the design and implementation of services, and how by working together communities and healthcare systems overcame the challenges of implementation to build trust and maximise impact. Katrin’s presentation focused on the importance of investing in civil society-based monitoring and data collection, introducing the C-EHRN Monitoring activities.

Why is it important to invest in civil society-based monitoring and data collection? 

 

What kind of challenges do we face when it comes to monitoring?

 

Challenge 1: Keeping a balance between science and community needs

Among the challenges is the delicate balance between scientific rigour and community needs. C-EHRN recognises that striking this equilibrium necessitates a nuanced approach that tailors monitoring methods to the unique needs and dynamics of the communities we work with. 

It’s about finding the spot where monitoring methods meet scientific quality standards while being practical and feasible for those working directly in the field. The aim is that data collection is accurate, reliable, relevant, and done in a way that respects and responds to the needs of People Who Use Drugs, being meaningful to the communities we serve.

To respond to this challenge, C-EHRN will comprehensively review our monitoring methodology this year. The objective is to develop an enhanced monitoring framework and a set of indicators linking to HCV and essential harm reduction services.  This new framework will allow longitudinal and cross-sectional comparisons. An external scientific expert will support this review in close cooperation with our internal monitoring team, the focal points, and the scientific advisory board.

Challenge 2: Limited resources for monitoring

The data collection for the Civil Society Monitoring of Harm Reduction in Europe is realised with the support of the Focal Points (FP), members of the C-EHRN. They are the backbone of the monitoring and our network, serving as national reference points for gathering data and information about harm reduction-related issues.

Our Focal Points collect data on a voluntary basis, which is time-consuming and comes on top of their regular work, requiring commitment from both the individual Focal Points and the related organization, which is willing to support and invest additional resources. Therefore, resource constraints are a serious obstacle, impeding the scalability and sustainability of monitoring efforts.

The Focal Points also value their role as Focal Points, as being a Focal Point is more than collecting data and information:

Challenge 3: Sustainability of the Monitoring 

Ensuring the longevity of monitoring initiatives requires diversifying funding streams and exploring alternative financing avenues. C-EHRN is supported by an Operating Grant from the EU4Health Programme, which has provided us with the means and resources to develop and implement network and monitoring activities in the past years. Although we hope for continued financial support, this remains uncertain. Against the backdrop of uncertain financial landscapes, the imperative of sustainable funding mechanisms cannot be overstated.

Challenge 4: Disseminating findings to the policy level

The dissemination of findings to the policy level emerges as a pivotal imperative. Beyond data collection, the ultimate goal is to effectuate policy change, bridging the gap between research outcomes and actionable policy insights. We aim to shed light on gaps in service delivery and emerging drug trends, ultimately driving positive change in policies and practices.

C-EHRN recognises that many of our focal points and members may not have the resources or expertise for advocacy work. This is why we are rolling out an Advocacy Mentorship Programme in 2024, an initiative providing support and training to effectively advocate for policy change at both local and national levels. From webinars to face-to-face trainings, we’re committed to building the advocacy skills of our community members.

In addition, we are launching a city initiative to foster collaboration and support between cities, policymakers, civil society representatives, and affected communities. This platform will serve as a space to address local challenges, explore practical solutions, and promote innovative drug policy approaches. By working together, we can amplify our advocacy efforts and drive real change in communities across Europe.

 

Stay tuned for the streaming of the session and delve deeper into the discourse shaping the global response to hepatitis! On this note, we’d also like to bring to your attention the Global hepatitis report 2024: action for access in low- and middle-income countries, launched by the World Health Organization on the 9th of April, which you can access here.

Recording – City Report Launch | Civil Society Monitoring of Harm Reduction in Europe

The video is the recording of the report launch webinar that took place on Tuesday, 9th April 2024.

The City Reports are the final segment of Correlation – European Harm Reduction Network (C-EHRN)’s Civil Society-led Monitoring of Harm Reduction 2023 Data Report. These concise harm reduction ‘case studies’ highlight either innovative practices or urgent issues demanding immediate attention in five different European cities. The reports will serve as advocacy tools to engage decision makers at all levels, either by showcasing best practices or as an urgent call to action.

Panellists:

 

Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam). The Executive Summary can be accessed here.

City Report – Bălţi. Violating confidentiality: The disclosure of medical data of people who use drugs

In Bălţi, Moldova’s second-largest city, the prevalence of HIV and HCV among people who inject drugs in Bălţi is disproportionately high. Despite the presence of harm reduction services throughout Bălţi, accessibility to these services remains a key problem. Barriers, including inadequate psychosocial support, employment and travel constraints, and fear of discrimination, hinder participation in treatment and harm reduction services. A notably prominent barrier is the pervasive stigma and discrimination exhibited by healthcare staff towards key populations, deeply rooted within healthcare settings. Approximately one quarter of people who inject drugs avoid medical care and HIV/HCV testing due to fears about their drug use becoming known. This is linked to healthcare personnel disclosing sensitive medical information such as a person’s HIV status, which can lead to stigma, discrimination and even dismissal from employment. It also hinders access to HIV services and breeds mistrust in the wider health system. Legal restrictions criminalising HIV exposure and transmission, drug use, and certain sexual activities further obstruct safe behaviours and service access. Though a national network of specialist paralegals established in 2017 has helped to bring justice to affected individuals, addressing these issues at their core is crucial for systemic, lasting change.

 

Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam). The Executive Summary can be accessed here.

C-EHRN Activity Report 2023 – Summary of Activities and Impact

C-EHRN is proud and grateful to present its 2023 Network Report, providing a summarised version of the activities undertaken last year. In this document, we are looking back at a year full of tasks, challenges and opportunities.

Launch of the City Reports | A New Addition to the C-EHRN Civil Society-Led Monitoring of Harm Reduction in Europe 2023

To mark the publication of the City Reports, we invite you to join our webinar on Tuesday, 9th April, 12:00 (CEST/Amsterdam time).

The City Reports are the final segment of Correlation – European Harm Reduction Network (C-EHRN)’s Civil Society-led Monitoring of Harm Reduction 2023 Data Report. These concise harm reduction ‘case studies’ highlight either innovative practices or urgent issues demanding immediate attention in five different European cities. The reports will serve as advocacy tools to engage decision makers at all levels, either by showcasing best practices or as an urgent call to action.

During the webinar, primary author Alice Pomfret will be joined by the five representatives of the participating focal points to delve into the findings and discuss the next steps for advocacy based on the reports’ conclusions. Participants are invited to engage in an interactive Q&A session.

 

Panellists:

 

 

Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam). The Executive Summary can be accessed here.

Recording – Roundup Webinar | Civil Society Monitoring of Harm Reduction in Europe

 

The video is the recording of the webinar organised to celebrate the core publications for the C-EHRN Civil Society-led Monitoring of Harm Reduction in Europe that took place on the 7th of March.

The event brought together four volumes of the 2023 Data Report:


Moderator:
 Rafaela Rigoni (C-EHRN)

Speakers:
Iga Jeziorska (C-EHRN) – Essential Harm Reduction Services
Tuukka Tammi (THL) – Eliminating Hepatitis C in Europe
Daan van der Gouwe (Trimbos) – New Drug Trends
Guy Jones (TEDI) – Drug Checking Observations and European Drug Checking Trends via TEDI

 
Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam). The Executive Summary can be accessed here.

Essential Harm Reduction Services: Report on policy implementation for people who use drugs

In 2023, C-EHRN and its members assessed the state of essential harm reduction services in European cities for the fourth time as part of the Civil Society-led Monitoring of Harm Reduction In Europe, with 35 cities responding to our survey in 30 countries. You can now download the resulting publication, Essential Harm Reduction Services: Report on Policy Implementation for People Who Use Drugs, and read the interview with Iga Jeziorska, C-EHRN’s Senior Research Officer and the primary author below.

Which type of harm reduction services are most lacking in the cities that contributed to the report?

The ones that are not that well established are those not related to the prevention of infectious diseases as closely as needle and syringe programmes and are not aiming to minimise injecting use like opioid substitution treatment does. Namely, drug consumption rooms and drug checking are lacking in Europe overall the most. This underdevelopment of DRCs and drug checking may become a serious problem, especially in the context of the opioid crisis that we might be facing very soon.

Another problematic issue is harm reduction services in prison. Except for opioid agonist treatment (OAT), this is also an area where there are very big gaps in the service provision in terms of harm reduction. OAT is officially available in prison in most cities, but that doesn’t mean that it is easily accessible everywhere. We know that in Budapest, Hungary, for example, it is theoretically available, but there are no records of people using the service, and definitely not because there are no people who use opioids in prisons.

What would you highlight regarding the barriers in the outreach of harm reduction services based on the findings?

Funding, lack of political will and lack of or insufficient involvement of people who use drugs in services were reported as the main barriers to reaching out to specific subgroups of people who use drugs. Of course, all of these aspects are related to one another. Funding is an evergreen topic which is always there, and the lack of or insufficient funding is a direct consequence of the lack of political will. If there was political support for harm reduction, there would have been funding as well.

 

Are there any main differences in the availability, accessibility and quality of the services between the cities of the focal points?

On the one hand, we have opioid agonist treatment, needle distribution programs and all of the infectious diseases-related services, such as testing and treatment. These are well-developed in general in terms of availability, accessibility and quality.

On the other hand, there are some more innovative services that maybe, as I said before, are not that much connected, at least in the minds of the general public and the policymakers, with direct prevention of infectious diseases. These services that go beyond the ‘traditional’ harm reduction and focus primarily (but not exclusively) on overdose prevention are the drug consumption rooms (DCRs) and drug checking. These are in general more available in Western European countries. Snorting kits, kits for smoking, and fentanyl strips are also less available and accessible.

There are no DCRs in Central-Eastern Europe and Western Balkans. They are quite well developed as a network in Germany, Switzerland, Spain and maybe two other countries. In some countries, such as Greece or Portugal, there are one or two services. Drug checking is similar. There is a clear division between Central-Eastern Europe and Western Balkans on the one hand and Western Europe on the other,  in terms of service scope, service accessibility, low versus high threshold of various services, and the very service existence in the first place.

Harm reduction is chronically underfunded everywhere, but that means something different in the West and in Eastern-Central Europe and Western Balkans. In the East and Southeast, underfunded means that an insufficient number of services are operating or – in extreme cases – they are not funded for several months in a year because there are gaps between grants. Underfunded in the West seems to mean mostly that services don’t have enough funds to develop the offer, scale up activities and broaden their scope. We can also see that in the West, in general, services are more integrated into the health and social care systems, and in the East, they are more standing alone. One of the worrying phenomena that we observed this year, however, is the extremely low availability and accessibility of social integration services, such as housing, income generation and employment, and legal support. Furthermore, for the two latter types of services, we’ve observed significant deterioration in availability over the last couple of years.

We also know from the previous Monitoring edition that there are divisions between the urban and rural areas. Services are focused and concentrated in big cities, and they are lacking in the countryside. The question is also to what extent they are needed in the rural areas, as we also know that the concentration of people who use drugs is also in bigger cities. Some level of services is necessary in rural areas, but what level of availability and accessibility is necessary is something that would require additional assessment.

 

How do you think that harm reduction organizations can use the report? 

We are trying to follow the requests of the Focal Points in terms of the focus and to make our assessments address the topics that are important to people at any given moment.

When it comes to using the report in advocacy efforts, harm reduction organisations can use it to highlight cities and countries that can serve as good practice examples, like Bern or Amsterdam, with holistic, integrated services. The report is a general overview of the situation in Europe, and it can serve as a starting point in orienting oneself in what’s happening in different cities.

In the context of talking to policymakers, the report – in conjunction, for example, with the European Drug Strategy, which calls for scaling up harm reduction services – can help to showcase the gaps in harm reduction services at the city level compared to what is declared by a country or a city in official policy documents. This can potentially be quite a powerful tool in helping organisations in their advocacy efforts.

 

What do you think is the added value of civil society-led monitoring in comparison with other types of monitoring done by major agencies?

One of the added values is trust and the hands-on experience of our Focal Points, and the related kind and detail of the information collected. Civil society organisations are close to people who use drugs, and people who use drugs trust them enough to share honest information. For example, from the point of view of drug checking, this means that we can have very detailed information on how people use drugs, what drugs they use, in what contexts, etc. This is in sharp contrast, for example, to wastewater analysis that can tell us how much cocaine is in the wastewater but cannot provide information about the people who used it and the circumstances, if they used it at all.

For our monitoring, we collect data in a way that is contextualised. This is quite different from data collected, for example, by the national Reitox focal points that focus on the existence of services and perhaps the number of services.

On the other hand, when we ask to what extent particular types of services are available to specific communities and to what extent they are accessible, we implicitly include the element of the needs. That is this contextualisation of data that I mentioned, which includes additional information. For example, seven services existing in one city can mean something completely different than the same number of services in another city because the needs are different, and this is what we address with our monitoring. This is one of the main values of C-EHRN monitoring compared to other data.

Another point is focus on the city level. Most data is collected by European agencies and country governments is collected at the national level. Our data is collected at the city level, which is important primarily because the implementation of drug policies is done mostly at the local level in European countries.

We are also quite timely with our data. We are now at the beginning of 2024, and we are reporting on the data between 2022 and June 2023, a bit over one year of delay in reporting. This is also something that makes us different, less bureaucracy and resulting quicker data processing give us the possibility of being quicker with our reporting.

 

Would you pick one graph that you find significant and explain why it is relevant?

All of them are significant in their own way. What I would suggest is Figure 9 on service delivery for ageing people who use drugs, a category that we introduced last year.  Ageing people who use drugs are becoming a more and more significant group among the clients of harm reduction services all over Europe. The people for whom the first harm reduction services were established in the 1980s are ageing, and there is an increasingly recognised need for developing and adjusting services to their needs, which significantly differ from those of the other subgroups, and there hasn’t been sufficient focus on them so far.

Another question that we asked last year for the first time is the extent of involvement of people who use drugs in service governance, service implementation and evaluation. There are very few cities where people with living and lived experience are involved in the governance of services. They are involved in implementation and, to some lesser extent, in evaluation but not really in the governance of organisations and services. This is something that we need to keep monitoring. The debate about community involvement, community empowerment and community-led services is very lively across the continent, but we are still not there yet in terms of practice of harm reduction services functioning. We should keep a close eye on this and possibly combine the monitoring with capacity-building efforts to improve the involvement of people with lived and living experiences in services.

 

Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam). The Executive Summary can be accessed here.

Executive Summary | Civil Society-led Monitoring of Harm Reduction in Europe 2023

Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam).