Today, in partnership with UNITE, NEWNet and IDPC, we launched the 2024 Manifesto for a Progressive EU Drug Policy, advocating for health, harm reduction, human rights, and evidence-based strategies in drug policy reform in anticipation of the upcoming European Parliament elections.

The European Union’s drug policy stands at a critical juncture as we approach the 2024 European Parliament elections. While the establishment of a new EU Drug Agency signals progress, in good part thanks to the work of the European Parliament in rooting the new agency in a health and social agenda, concerns arise over the European Commission’s support for a punitive ‘war-on-drugs’ approach. At the same time, the Commission has reduced funding and support for health interventions and for the role of civil society and communities in policymaking. Simultaneously, initiatives for a health-based regulation of cannabis, spearheaded by countries like Malta, Germany, and Luxembourg, highlight evolving perspectives across the continent.

In March, Correlation, NEWNet and IDPC initiated the Drug Policy Manifesto for the 2024 European Parliament Elections, laying down a vision for a pragmatic, innovative, and human rights-centred European drug policy that will foster healthier and safer communities. Since then, the Manifesto has gathered more than 600 signatories, including over 250 European drug policy NGOs, over 150 drug policy experts, and over 25 elected officials.

Today’s launch event, chaired by Katrin Schiffer, Executive Director of Correlation-European Harm Reduction Network and Head of the International Department of Stichting De Regenboog Groep, brought together MEPs, candidates, representatives from Civil Society Organisations and other drug policy experts, all committed to steering towards an EU drug policy that would make Europe safer, healthier, and more just.

Decriminalisation and a human-rights-based approach were reiterated as central themes during the event, emphasising the importance of meaningful community involvement in shaping effective drug policy.

“Let communities lead! Several groups of people who use drugs are not registered formally as NGOs. Nevertheless, they have a lot to teach us. These voices should be amplified!”
– Alexei Lakhov, Executive Director of the European Network of People Who Use Drugs

MEPs from the Pirate Party, Janka Michailidu and Sven Clement, emphasised the necessity for a more pragmatic EU drug policy, advocating for a holistic approach that integrates mental health perspectives and abandons the punitive ‘war-on-drugs’ paradigm. They also stressed the importance of coordinated approaches across EU member states to advance progressive drug policies.

“It doesn’t help if a European country is very progressive in drug policy if their neighbours are the complete opposite. It is very important, when it comes to drug policy, that we work across borders in Europe”.
– Sven Clement, MEP

MEP Isabel Santos highlighted the urgency of action at this pivotal moment, described as a ‘turning point’ as the European Parliament, the European Drugs Agency, and the European Commission embark on renewal processes. She also underscored the significance of enhancing cooperation with civil society, as outlined in Article 55 of the new EU Drugs Agency mandate.

“Whether it is about representing the diverse perspectives and empowering the voices of the affected communities; communicating relevant research, data or information on emerging challenges and trends; or upholding human rights and social justice, by prioritising harm reduction and treatment over punishment or enforcement-only view of the drugs phenomenon, this is the place to do it.”
– Isabel Santos, MEP

In conclusion, the initiators of the Manifesto presented several recommendations for MEPs,

asking for their support in presenting the Manifesto to the LIBE Committee;
calling on MEPs to consider the possibility of creating an informal working group within the European Parliament dedicated to drugs and drug policy discussions, which would regularly consult with civil society;
encouraging them to ensure that civil society is invited to all drug-related hearings organised at the European Parliament;
calling on MEPs to ensure that the European Commission implements the EU drug strategy 2021-2025 in a balanced way, and to hold EU institutions accountable for the securitisation of drug policy;
urging them to encourage the European Commission to develop a new funding mechanism for drug policy projects, focusing on health and in particular harm reduction, as this topic has been neglected over the past few years over projects focusing on drug law enforcement and supply reduction.

Reaffirming our commitment as civil society, we will continue to discuss how to elevate the Manifesto and stimulate dialogue at both national and EU levels regarding our recommendations.

Join the movement – Find out more about the Manifesto and sign it here!

Watch the event’s recording:

The European AIDS Treatment Group (EATG) together with AIDS Action Europe (AAE) and Correlation – European Harm Reduction Network (C-EHRN) are issuing this Call for Participation in “5-5-5 – We won’t be left behind!”, a networking zone in the Global Village at the 25th International AIDS Conference (22 July – 26 July 2024) in Munich, Germany.

Please carefully read the application details before submitting your application. Click here to submit your application: https://forms.office.com/e/bL7xzEMVvq

Application deadline 23 May 2024, 23:59 CET.

Unfortunately, we are not able to provide financial support for presenters or participants. Organisers must find their own funding for travel to Munich, Germany and all costs associated with participation in AIDS 2024. For more information about the conference visit: www.aids2024.org.

Entry to the Global Village is free and open to the public. It does not require the payment of a conference registration fee.

If you have any questions, please contact Chiara Longhi (chiara.longhi@eatg.org).

Objectives

The 5-5-5 – We won’t be left behind! zone will examine gaps and solutions to achieve the 95% targets, and how to reach the remaining 5% with a focus on the WHO European region (partners beyond the region are welcome to apply). There will be one theme per day with inspirational talks, presentations, and recaps on key learnings.

The objectives are:

To foster and strengthen cross-sectional and cross-country collaborations by providing a space for mutual-learning and networking together means for them.
To strengthen the inclusivity and participatory nature of HIV related organisations by consulting communities on what meaningful engagement.
To strengthen and sharpen advocacy initiatives, by providing a space to discuss communities’ advocacy priorities, challenges, and ways to work.

The zone will provide space for community organisations to organise sessions around 5 themes. The overarching themes will be to address stigma and discrimination, improve health outcomes of inadequately served populations and social justice.

Thematic days:

Mobility and HIV (21 July).
Sexuality and sex positive approaches (22 July).
Well-being, quality of life and mental health (23 July).
Substance use and harm reduction (24 July).
Blind spots in the HIV response (25 July).

Who can apply?

We are calling for participation from grassroots and national NGOs, community-based organisatios, networks, researchers, institutions, civil society organisations, human rights organisations, advocacy associations for people living with HIV and other social justice organisations, as well as leaders in the field of HIV from around the WHO European region to join us in advancing the above objectives. Partners beyond the region are welcome to apply.

In our networking zone, we are particularly looking for applications from people living with HIV and other co-infections, trans and gender-diverse people, migrants and people on who move, women, people who use drugs and people in prisons and closed settings.

Activities

We invite you to apply to host an activity related to one the thematic days (Mobility and HIV; Sexuality and sex positive approaches; Well-being, quality of life and mental health; Substance use and harm reduction; Blind spots in the HIV response) including, but not limited to, the following types:

Posters, presentations and discussions
Demonstrations of innovative advocacy or equity initiatives
Display of art projects
Presentations of new research findings and evidence
Interactive skills-building sessions and workshops
Film screenings and digital storytelling
Stories from community representatives
Presentation of policy papers and community resources
Roundtable discussions with key stakeholders in the field of HIV, viral hepatitis, and STIs
Facilitated networking events

Last week our Head of Policy, Roberto Perez Gayo, participated in the Congress organised by UNAD ‘La red de atención a las adicciones’ in Oviedo, Asturias, to reflect on current developments and challenges in the provision of care and support to people who use drugs in Spain.

Under the banner “A journey through the pathways to addiction care with a gender perspective”, the Congress dedicated an important space to examine the public health challenge posed by synthetic opioids. Together Mireia Ventura, director of Energy Control -ABD‘s Analysis Services, and Roberto Perez Gayo participated in the panel “Nitazenes and other synthetic drugs: a rigorous analysis for drug dependence care professionals”.

In their presentation, the pair of speakers demonstrated how scientific evidence dismantles the media alarm about some substances, such as fentanyl. Nitazenes, on the other hand, were highlighted as a reality already present in some countries, where synthetic substances are beginning to be used as adulterants of other drugs, considerably increasing the risk of overdose due to their consumption. Faced with such risks, both Perez Gayo & Ventura highlighted the role of harm reduction, and more specifically of supervised consumption rooms and drug checking services to identify emerging trends in the drug market and increase care and protection for marginalised and underserved people who use drugs.

The event was also attended by different institutional representatives such as the Government Delegate for the National Plan on Drugs, Joan Ramón Villalbí Hereter, and the General Director of Public Health and Mental Health Care of the Health Service of the Principality of Asturias, Ángel José López Díaz. During his speech, the Government Delegate for the National Plan on Drugs referred to the first responses that were given to addictions, recognising that they came “from civil society” in the form of the first organisations of family members of people who use drugs. Villalbí praised the role of those first organisations, which “started their work to find each other” and “helped public administrations not to make mistakes and to do better” in the face of the consequences of drug consumption.

Following the event, Perez Gayo & Ventura gave an interview to Agencia EFE, a leading news agency in Spanish, which gained coverage in several news platforms including infobae and deia.

Photo credit: UNAD

Based on the results of the voting process, the following candidates have been elected: Magdalena Bartnik, Irena Molnar, Aura Roig and Marios Atzemis.

C-EHRN would like to take the opportunity to thank all the members who submitted an application. Also, to emphasize the high level of expertise and the excellence of applications received for this election.

In the coming days, the newly elected members will participate in their first Advisory Committee Meeting. In this event, they will have the opportunity to meet the current remaining members and to connect with those who leave their seats.

C-EHRN would like to invite you all to join us in congratulating the four new committee members. We are truly excited to start working with them!

With profound sadness, we share the news of the loss of our beloved colleague and friend, Tonny van Montfoort. Despite a long battle with illness, Tonny remained resilient and optimistic.

A steadfast supporter of C-EHRN, Tonny dedicated many years to actively participating in many of our activities. He was a passionate and tireless advocate for the rights of people who use drugs. Tonny was known for his sharp wit, critical thinking, unwavering commitment and a wonderful sense of humour. He was also kind-hearted and empathetic, always taking a personal interest in those around him with genuine empathy.

Tonny’s presence and contributions will be greatly missed within the harm reduction community. We extend our heartfelt condolences to his family, friends and colleagues during this difficult 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. 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 Care, Essential Harm Reduction Services, New Drug Trends, Mental Health of Harm Reduction Staff, TEDI Reports and City Reports (Warsaw, Bălţi, Esch-sur-Alzette, London, Amsterdam). The Executive Summary can be accessed here.

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.

In 2023, C-EHRN dedicated a segment of its Civil Society Monitoring of Harm Reduction in Europe report to the mental health of harm reduction workers for the first time, an area of pressing importance that has barely been discussed in relevant literature so far. To accompany the publication The Mental Health Challenges Faced by Harm Reduction Staff, we bring an interview with the primary author, Laoise Darragh below.

Why did you decide to dedicate a chapter of the 2023 monitoring report to the mental health of harm reduction staff?

There were a number of factors. During the development of the monitoring report last year, the mental health of staff was something that kept coming up on a more informal basis, as well as that there was a lot more attention given to the mental health of frontline workers after the COVID-19 pandemic. It took quite a toll on frontline workers, but there was nothing at all on harm reduction staff as a particular group that might need specific support or may face specific challenges. When we conducted a literature review, there was almost nothing. I think that was the main driver.

There was also a need for more qualitative research within the monitoring. That was something that focal points felt was quite important. I think this was the perfect topic to dive into in a more qualitative sense as well. It also gives the opportunity to advocate more for staff, because they’re kind of overlooked when the focus is mainly on clients.

What do you think the most pressing issues were regarding the mental health of harm reduction staff? What are the main challenges they face?

It’s a complicated web of challenges, but I would say that the most pressing factor would be the lack of political support in most of the cities. There’s a lot of stigmatization as well coming from local societies and from other services that are used by people who use drugs. This trickles down and instigates or influences all of the other challenges that staff face. The job itself can often be quite difficult, but it’s exacerbated by these unsupportive political environments, and that can cause difficulties in the relationships between services, between staff members and between staff and clients. I would say that that’s probably the most pressing issue.

Harm reduction staff should be able to have pride in their work. I think that can be very challenging for staff in a lot of cities given the stigmatization towards both clients and staff. Trying to combat that stigmatization, the organisation pushes that they are fighting against it as well, I think that was something that came up when we launched the report in the panel discussion. It’s nice for the workers to be able to feel that the organization is also fighting against that. It acknowledges the difficulties that press down on staff too.

What are the areas where the support is mostly missing or where change would be most urgently needed?

The political environment and in particular the lack of funding is probably the biggest change that we need to see. Organizations struggle with resources and being able to support their staff because all of the funding has to go on clients. Even for organizations that do have maybe more funding than others, there are usually specifications for the funding – that it can’t be spent on, for example, team-building exercises. It’s often not just the funding itself, but all of the specifications of the funding that can be quite challenging. I think that having more political support would trickle down into all of the other areas and alleviate some of those challenges as well.

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

Cities with more progressive policies and support from local communities were able to implement more support in terms of mental health for staff. It was interesting that the focal point from Switzerland, for example, was quite shocked by the lack of mental health support in some of the Eastern European countries, because they’ve had it for 20-plus years. It’s mandatory to have counselling opportunities for their staff, which is very different to what’s being experienced in Eastern European countries, where a lot of the time there’s none.

I think it was interesting that there were also quite a lot of similarities. All of the focal points mentioned that this is a really important topic and something that hasn’t been addressed in the past. It was interesting that no matter what the political situation was, there was a feeling that this was a really important topic to focus on going forward.

Despite the difficulties and barriers, including the lack of financial support, are there any best practices for organisational support that you would highlight?

We have a number of recommendations at the end of the report, some of which do depend on funding, but several which don’t, so that organizations can implement them no matter what their political situation or funding situation is. For example, trying to create a culture where there’s an openness to speak about mental health issues is really important. Having a mental health strategy is another one.

We have a member of staff working on more concrete guidelines for organizations which will come out at the end of the year and will highlight more specific things that organizations can bring in to support the mental health of their staff members no matter what their situation is. That’s quite exciting and I think it’ll be nice to have something more concrete in that sense as well.

Would you pick a quote from the report and explain why you find it relevant?

It’s very difficult to pick one. I have a couple here because it was quite a broad report and a number of different challenges and coping mechanisms came up.

One that highlights the importance of the issue is a quote from our focal point in Budapest:

“Everybody told [me] that yes, this is a very important issue now and especially in countries where resources are scarce and that organisations are stretched and all [of] these problems we have and so, I think it is a very relevant issue to focus on for the whole network.” (FP Budapest, p. 11.)

Another one is that

“It’s in the hands of politics. Because harm reduction workers are everywhere in every country, but depending on the political situation, their working situation changes accordingly. If the political situation is against harm reduction, it makes the work more difficult.” (FP Bern, p. 12.)

And a third highlight:

“The harm reduction worker, he really believes that this matters and harm reduction is the right way to go in this politics of prohibition and criminalisation. And workers build relationships with people who are extremely marginalised in society and have a lot of stigma and prejudice against them. And these relationships are important for both people, both the clients and the workers.” (FP P Reykjavik, p. 26.)

What emerged from the report was the importance of building relationships, a number of different relationships between staff and clients, between staff members themselves, between staff and other services, and also political relationships. Developing professional networks on the local, national or international level is really important because it prevents workers from feeling isolated. It protects them against the stigmatization that they feel from other areas of society or politics. The last quote highlights that building relationships is important for not only the clients but also for the harm reduction staff.

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

Apart from the recommendations and hopefully the guidelines that are going to be developed, I would hope that organizations can use the report as a tool to advocate for the importance of addressing the mental health of their staff. That they can share it with local or national policymakers, people who are involved in funding, other relevant stakeholders, or even colleagues working in other services, to highlight the need for increased support, less stigmatization and further resources for harm reduction staff and how that affects both staff and clients.

The report highlights that a holistic approach is needed to be able to help the situation, raising awareness of the topic of harm reduction. The harm reduction community in general is quite important too, as like I said, it’s something that people felt wasn’t spoken about before. Hopefully, they can use it for advocacy.

Then the guidelines, in a more practical sense. They’ll be able to pick out things at other organisations that maybe they hadn’t thought about in the past, best practices, from the report too, and implement them in their organization.

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?

Civil Society Monitoring serves as a vital accountability mechanism, holding governments accountable by independently monitoring and collecting data, and examining the efficacy and impact of policies and programs.
It complements official data by providing up-to-date grassroots-level insights on developments and trends. The intention is not to duplicate existing data collection efforts from EU agencies such as the ECDC and the EMCDDA, but to complement that with civil society perspectives and information that may not be captured by official channels.
Civil Society Monitoring identifies gaps in services and policies, thus catalyzing targeted interventions. The data collected identifies gaps that may not be apparent from official data alone, which can be used to call for action and advocate for improving the implementation of programs and policies, based on the needs of the community, including people who use drugs.

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:

FPs are provided with tools, information, and training to support their work and potential advocacy activities at the national and local levels.
The FP role can be used as a quality label and FPs can use the C-EHRN Focal Point Branding in their communication and advocacy.
Being a Focal Point means being part of a bigger community and providing the opportunity to exchange and share information with other members and FPs.
FPs can actively contribute to the focus and the methodology of the monitoring framework, ensuring that monitoring reports and results support their practical work.

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.

On the 20th and 21st March, our Policy and Project Support Officer, Arianna Rogialli, attended the EFUS Security, Democracy and Cities Conference in Bruxelles and took part in the panel discussion on Drugs and Harm Reduction moderated by Laurent Maisse, Deputy Director of Transit ASBL and together with Nadia Zourgui, Deputy Mayor of Strasbourg and José Martinez Espasa, Chief Commissioner of the Gandia Local Police.

The session focused mainly on the challenges that cities face when providing support to people who use drugs, people who are experiencing mental health challenges or other marginalised populations while coordinating different social support services and communicating to the public about them.

During the session, C-EHRN emphasised its dedication to organising collaborative initiatives with city-level actors in the harm reduction field, including mayors, policymakers, and civil society. We also highlighted the urgent need to eliminate barriers to accessing mental health support services and to support and fund low-threshold services that can better reach and assist people who use drugs and are experiencing mental health challenges. Furthermore, we drew attention to the importance of funding harm reduction services. We also shared best practices for effective communication about harm reduction and neighbourhood cooperation between harm reduction services, residents, and business owners.

During the second day of the conference, we had the opportunity to visit the drug consumption room Gate, which is a member of the European Network of Drug Consumption Rooms [ENDCR], and the day and accommodation centre operated by Transit ASBL. Alongside the drug consumption room, Gate offers weekly drug-checking services, opportunities for testing for communicable diseases and community activities.

The Future of European Drug Policies: Launch of the 2024 Manifesto for a Progressive EU Drug Policy

5-5-5 Zone – We won’t be left behind! at AIDS 2024 conference: Call for Proposals