Individually-tailored support and education: Eurosider

It is very well-known that there are ways to prevent HIV/HCV transmission in people who inject drugs (PWID). Access to needle syringe programs (NSP) and opioid substitution treatment (OST) are two of those; we could start naming.

Then, why are these interventions not universal enough? How can harm reduction organisations prove these practices’ undeniable impact? What can be done to reduce the risk of HIV-HCV transmission in different political contexts?

EUROSIDER, developed by the French Research Institute INSERM, is one of the European projects we are partnering in, alongside Aides. The project is individually-tailored face-to-face support and education for safer injection (ITSESI) for people who inject drugs.

A two-year-long transferability study that was currently implemented and tested on-field by four European harm reduction organisations in their respective countries as Praksis (Greece), ARAS (Romania), IHF (Bulgaria) and GAT (Portugal).

After its evaluation phase, the training will be modified with outcomes, and the project will produce several tools and publications to disseminate, promote, and support the implementation of the method.

We will also be presenting it at both Lisbon Addictions’ Conference and the 3rd HEP C Community Summit to further advocate the intervention. 

Are you joining us at one of the conferences, if not both?

Statement on the intention of the Mayor of Porto to reintroduce criminal penalties for use in the public space

ln recent years, Portugal is regarded as a guiding country when it comes to the implementation of an evidence-based drug policy and the decriminalisation of drug use. ln May 201-9, the Mayor of Porto – Mr. Rui Moreira – opened the lnternational Harm Reduction Conference in Porto. He declared his full support towards harm reduction and an evidence-based and human-rights based approach in drug policy, We are therefore more than surprised to hear, that the same Mayor just recently called for the reintroduction of criminal penalties for drug use in the public space. Such a measure conflicts with existing evidence and experiences elsewhere that repression doesn’t work and violates significantly the human rights of People Who Use Drugs. Drug use in public spaces can effectively be tackled by harm reduction measures such as a good coverage of drug consumption rooms, drop inn centres and housing facilities. We openly condemn the intention of the Mayor of Porto and call him to commit himself again to his previous efforts and support towards a justice and human-rights based drug policy in Porto.

Criminalisation of Drug Use is not based on evidence.
Criminalisation of Drug Use is a violation of the human rights of People Who Use Drugs.
Criminalisation of Drug Use is a step backwards for Portugal.

Our Participation in the 3rd Lisbon Addictions’ Conference

Next week we will attend to Lisbon Addictions Conference, for the third time in a row. The multidisciplinary conference is a forum for networking across the addictions, mainly focusing on addictive behaviours and dependencies.

This year, we participate in the conference with a poster presentation and three workshops. Busy, insightful days will be ahead!

We are a member of the Nobody Left Outside initiative. Alongside its other members, this past year, we have worked on developing a Joint Statement as well as a Service Design Checklist. Our Joint Statement will have its round of presentations on several occasions to come while we will be presenting the Checklist during the conference.

The Service Design Checklist has been developed to help service providers and policymakers design and deliver services that are accessible to underserved, marginalised people, and for community advocacy use.
Come by our stand for more information and juicy discussions.

The workshops we will collaboratively be leading will focus on harm reduction, civil society organisations, and capacity building. They will strategically guide the participants through developing strategies, tools, and individually-tailored support and education.

Below is the list of our workshops, you do not want to miss:

Developing new prevention strategies to improve the situation of
clients and employees of harm reduction services

Developing  tools for monitoring of drug policy and practice
from the viewpoint of civil society organisations in Europe

Individually-tailored support and education for safer injection

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Machteld Busz

Can you tell us about your background?

I’ve worked with Mainline Foundation in the Netherlands for the past seven years, first as international programme manager and now as director. A year ago Mainline initiated a new initiative: a museum about drugs. The name is Poppi: Drugs Museum Amsterdam. Our plan is to engage the general public and educate them about drugs and drug policy, to employ people who use drugs, and to make loads of money and channel that back to fund harm reduction work.

Before I started at Mainline, I specialized in migration and worked for quite some years as a social worker with refugees. In a far away past I studied Social Psychology and International Development Studies.

How would you describe your work in general?

I would say it is a mix between total chaos, complete ecstasy and near exhaustion. You need a lot of stamina to work in our field ?.

What drives you personally to work in your area of work?

The way the international community approaches drugs, to my opinion fuels one of the greatest forms of social injustice of our time. The end to this is not even in sight. Worse, we seem to regress. I am becoming more and more motivated to speak out and keen to move beyond the health silo that harm reduction is sometimes stuck in and reach out to people in the justice and development sector.

What is your current focus?

  • Broadening harm reduction to include people who snort, smoke and ingest their drugs and not only those who inject. Moving beyond a biomedical model for harm reduction towards a human rights-based approach.
  • Broadening harm reduction to include, in addition to people who use opioids, people who use stimulant (and other) drugs and suffer marginalization, stigma and discrimination as a consequence.
  • Create independent funding streams (we hope in the future via Poppi: Drugs Museum Amsterdam) to move away from donors and subsidies.

Why do you think that your current focus is important?

Funding for harm reduction in the international ‘arena’ is often linked to HIV prevention. The fact that there is still funding is fantastic, but it is not sustainable. Governments are not jumping on board and donor funding is on the decline. We need to fit harm reduction under a different/new umbrella and work more inclusive.

Harm reduction is still underfunded in many countries, even if there is enough evidence that it works and is cost-effective. Why is that?

Ignorance, fear, recklessness and a lack of compassion.

Please tell us what harm reduction means to you.

Human dignity.

C-EHRN Member Meeting in Helsinki

Last week, we had our members’ meeting in the vibrant seaside capital of Finland, the laid back and yet refreshingly active Helsinki. The meeting programme covers all relevant topics, gathered the essential feedback on our previous achievements as well as our plans and last but not least, created a ground where our collaborators exchanged their expertise with one another.

Since the launch of our monitoring tool for harm reduction in the European Union and some neighbouring countries, our Focal Points have been working on compiling the required data, selflessly. During our meeting, we discussed their feedback on the tool and the process and carried it out with a thorough evaluation.

You can read our interview about the tool here

While our members updated us about the developments in their respective countries in regards to drug policy and harm reduction interventions, we shared our plans concerning our future priorities.

The meeting was closed with a peak of its own. On Friday morning, in the context of the presidency, we joined HIV Finland at the seminar Wellbeing Economy – A way to sustainability in the HIV and AIDS response? We talked about practical ways to reach sustainable wellbeing with dignity and fairness for people who use drugs. How rewarding!

Become a member to take an active part in our future activities and interventions.

Hepatitis C Initiative Website is Updated!

Our ever-growing network supports the integration of Hepatitis C (HCV) related activities as a regular practice. Since we have started Hepatitis C Initiative, our activities experienced a significant increment in depth and scope.

Together with a wide range of partners from across Europe, we developed and implemented a substantial number of surveys, tools, training and advocacy materials, which are all summoned under one wonderful and resourceful centre, our Hepatitis C Initiative Website.

Today, it offers the following:

The frequent up-to-date shares on the website would be beneficial for anyone working with the topic of viral hepatitis.

Visit the site now

Interview with Peter Sarosi

Can you tell us about your background?

I don’t like the term “expert” so I just say I am an activist working in the field of drug policy reform advocacy. I am recently the director of the Rights Reporter Foundation, a small human rights NGO based in Budapest, and the chief editor of the Drugreporter website.

How would you describe your work in general?

What we try to do is to change policies and public attitudes on drugs and people who use them. We create contents such as online articles, blogs and videos to educate the public about the alternatives of current punitive drug policies, we advise decision makers, we document human rights abuses, we make the drug control system more transparent and accountable and we train and empower other professionals and activists to make their voices heard.

What drives you personally to work in your area of work?

I am a humanist in the sense how Thomas Mann defined this word: I love justice, freedom, knowledge, patience, humility, joy and doubt. For me, this is not only a profession but a lifestyle and philosophy too, I cannot breathe without trying to fight for these values. Not only for myself, but for those who are marginalised and excluded from society.

What is your current focus?

Usually, I work on many things simultaneously. But one of the questions that always kept me thinking is how social attitudes on drug policies are formed and how can we change them. I’ve just started my PhD at the ELTE university in Budapest, so now I will have an opportunity to research this question.

Why do you think that your current focus is important?

Because this is a key question for advocacy. We have been trying so many methods and tools to convince the public that harm reduction works or that we shouldn’t punish people for what they put into their own bodies. Some of them seemed to work, some of them didn’t, but still, we know very little about what arguments, messages are convincing and how they can change people’s attitudes to drugs.

Harm reduction is still underfunded in many countries, even if there is enough evidence that it works and is cost-effective. Why is that?

Tolstoy famously said “happy families are all alike; every unhappy family is unhappy in its own way.” Well, by filming about harm reduction in so many countries of the world, I have learnt that this is true for harm reduction in individual countries or cities. In some countries for example, it is simply lack of resources and commitment to support public health and social care in general. In other countries it is not about the lack of money but there is a very strong ideological opposition to harm reduction. And there are cities where the NIMB (not in my backyard) attitudes obstruct harm reduction. But at the core of these problems we always find the inequality and injustice of the societies we live in, the desire of the powerful to discipline and punish the poor and powerless and manipulate society with fearmongering.

Please tell us what harm reduction means to you.

I define it as the philosophy and practice of compassionate pragmatism. In regard to drugs and people who use them it means that we have to support people who use drugs where they are at, as citizens in need of help, with non-judgmental interventions that respect human rights and are based on evidence. Although harm reduction, as a term, is a double negation, it is important to recognize that what we fight for is not only “reducing harms” but to help individuals and communities to live in dignity, freedom and solidarity.

Street Support Project – 
Good Practices Collection

When we built the Street Support Project on the idea that each person has the potential to learn and do something meaningful, we already knew that homeless people were not the problem, but the situation was.

We wanted to tackle this situation and the challenges it conveyed with an inclusive strategy and a pro-active and comprehensive approach. Therefore, we developed the Good Practice Collection with tools to support your efforts.
As a harm reduction network, this collection can be seen as our substantial contribution to improve current service provisions for people who use drugs and/or alcohol in public spaces.

Our collection has 21 elected services and programs, providing different types of support services, including means of social inclusion, housing, community-based work, peer support, harm reduction services, advocacy, etc.

We hope that the concrete examples in our collection will not only inspire service providers and policymakers but also help you promote your work within the social re-inclusion of groups that are in a situation of homelessness.

Read The Collection

Hepatitis C interventions by harm reduction organisations in Europe – Analysis and Examples

Since our foundation in 2004, we have always given special attention to the impact of blood-borne infectious diseases on the well-being of people who use drugs.
Hepatitis C is one of those diseases. According to researches, its viral stage is a lot higher than HIV and Tuberculosis combined. It is therefore of crucial importance that harm reduction and community organisations offer the necessary cascade of care in their facilities, which are as holistic as possible, easily accessible, and non-discriminatory.
 
It is always highly motivational, inspiring, and influential to see how our co-professionals deal with our shared challenges and move their practices further.
With this in mind, in 2018, we set our goal in collecting good practice examples working in the field of HCV interventions and made an open call to the harm reduction organisations in Europe. We received more than 80 reactions, covering more than 170.000 clients, visitors, and eventually, patients.
 
Shortly after, a review group was working on the final selection with the following criteria; the coverage of awareness, testing, treatment, and advocacy, and the challenges experienced. Finally, each story offered recommendations as well to encourage others.
 
We are now delighted to share the full report with data, findings, and conclusions as well as the good practice collection of 14 elected programs. They provide a thorough overview of the collaboration of harm reduction and community organisations, working under different legal and socio-economic conditions.
 
We feel, however, almost obliged to mention that the publications aim to present neither any ‘golden standard’ nor an exclusive list but to represent encouraging and inspiring models of work in different settings.
 

Read the Collection here
Read the Full Report here
Go to Hep Initiative website

Service Design Checklist – Improve Healthcare Access for Marginalised People

The Nobody Left Outside (NLO) initiative is currently a 2019 Thematic Network under the Health Policy Platform of the European Commission.
We are one of its members, collaborating with other organisations in Europe toward improving healthcare access for communities we represent.

In the year 2019, we will develop a Joint Statement, aiming to rationale for concrete EU actions in that matter and raise awareness around priority health problems and barriers (social and legal) among underserved, marginalised communities of people at high risk of vulnerability; namely homeless people, lesbian, gay, bisexual, transgender and intersex (LGBTI) people, people who use drugs (PWUD), prisoners, sex workers and undocumented migrants.

The NLO initiative has an available Service Design Checklist which comprises a series of questions and considerations to be used when services are being designed or redesigned.

Improvements in health and social care are fundamental for every group in our societies, especially for the vulnerable groups as it is easily looked over.

We highly recommend you to download the Checklist, use it and share your feedback with us and NLO initiative to help us produce further reiterations.

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