Using EU Structural Funds for Harm Reduction

12 June 2016

How to use the European Union (EU) structural funds to support harm reduction programmes in EU countries, appears to be a complicated issue. During our two-day workshop, this issue was outlined in general terms to gain a better understanding of the decision-making process that is used to determine EU funding priority areas in a number of countries within the region. We learned from experience of those who had already received funds or implemented co-funded low-threshold services to provide needle exchange, opioid substitution treatment and counselling to people who use drugs.

In the framework of the European structural and investment funds, the European Union provides considerable funding prioritising social inclusion to reduce inequalities and combat discrimination, which often involves people with dependencies as one of the affected target groups. The workshop brought together delegates from seven Central Europe and Baltic countries to discuss how the EU assistance can be used to help overcome marginalisation of people who use drugs, in particular to improve access to services outside the governmental health and social welfare sectors, through an increased involvement of PWUD.

In some countries such as Romania and Lithuania, tuberculosis was highlighted as a prospective area that can see immediate improvements through the involvement of the EU structural funds. In Lithuania, the number of needle exchange sites could be tripled and the number of OST sites doubled with the involvement of EU structural funds. These plans are bold but challenging to implement.

Unfortunately, the workshop made it clear that most participating NGOs have not been involved in the planning and priority-setting processes at the country level to develop sub-programs under the EC structural funds. It is hard to influence any established decisions once EU priorities have already been set for the current financial period of 2014–2020. Even when some NGOs managed to become fund recipients, they found themselves facing “highly over-bureaucratised” reporting requirements and expenditure controls (as one delegate put it, "much higher than those within the Global Fund”).

However, some people have already received assistance through the structural funds. In Tallinn, over 400 clients have been provided with access to vital services not supported by the state at the moment. In Romania, it was with the help of the structural funds that a 3,000-client needle exchange site has survived in 2010 after the withdrawal of Global Fund harm reduction funding; in addition, a new opioid substitution therapy site was open by ARAS, a leading harm reduction organization, to serve 500 clients with substance dependencies.

As a result of the workshop, one-half of the audience said they were going to consider applying for the structural funds, however complicated it may be. As regards resolving administrative issues in the current financing period of 2014–2020 as well as determining EU funding priorities for the next period, a conclusion was made on the importance of putting more advocacy efforts (both nationally and at the EU level) to ensure NGO involvement into agenda processes within national agreements with the EU structural funds prior to every new fund disbursement cycle. Based on the available experience, advocacy at the country level appears to be most efficient when it comes as a collective (rather than individual) effort by a consortium of NGOs interested in getting funding from this source, such as in Romania.

Advocating at the EU level requires coordinated efforts of regional networks. Valuable experience was shared by organizations working in other areas, such as mental health, to protect human rights of people with disabilities and to advocate for the so-called "de-institutionalization," i.e. replacing specialised long-stay facilities with less isolated community mental health services for people diagnosed with mental health disorders or orphans. As a result of advocacy efforts aimed at developing community-based services and supporting societal integration, the "deinstitutionalization" issues have been incorporated into EU-funded programmes with a set of specific program tasks and indicators.

This workshop is the first in a series of activities to be held by EHRN under the regional project "Harm Reduction Works! Improving funding for harm reduction and HIV prevention in the European Union." In addition, two workshops will be held by November this year, with a particular focus on budget advocacy and securing funding to support harm reduction programmes at the national level, as well as strengthening PWUD community systems through the monitoring of HR services quality and community empowerment to protect human rights. NGOs and community-based organizations from EU countries covered by EHRN are eligible for additional technical assistance, such as trainings, program exchanges and internships. Find out more about assistance available from EHRN to apply for the internship program here.

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