Technical Support for Members and Community

People who use drugs (PWUD) are often not considered valid policy or service partners in issues that directly affect their lives. However, EHRN recognizes that PWUD are part of the solution and should not be seen as the problem. EHRN works to support the meaningful participation and community mobilization of PWUD.

Technical Support for Members and Community

What does community capacity development mean to EHRN, and how and why do we do it

EHRN's key objective is regional advocacy for sustainable harm reduction funding and non-repressive drug policy (Strategy).

As a regional network constantly engaged in regional advocacy and the support of regional and national policy changes, we are increasingly aware that to effectively influence the politicians it is not enough for just a few representatives of clients, people who use drugs, to share their problems at national meetings. In order for political decisions to meet the needs of the community and be effective in the response to HIV, TB and hepatitis epidemics among vulnerable groups, it is necessary that the community leaders were fully involved in the evaluation of programs and services, and in the planning, implementation and advocacy for local or state funding of these services.

In the past two years, EHRN has had a unique opportunity, with the support of the Global Fund, the Robert Karr Foundation, the MAC AIDS Fund and the Levi Strauss Foundation, and the Regional Platform for Community Development, Human Rights Protection and Gender Sensitivity, to introduce a system for developing and "professionalization" of the community leaders, allowing them to fully participate in advocacy at all levels. This approach includes the following directions:

- Training PUD community leaders in monitoring and evaluation of service quality, budget advocacy methods (Training for trainers on community-led advocacy), including the understanding of the budget cycle, setting advocacy goals, understanding advocacy targets, and applying various advocacy methods, from meetings to video materials, as well as the training on the protection of rights, and the methods for documenting cases of violation of rights of PUDs (Training module for online webinars for street lawyers in EECA on human rights and the development of drug policies), which later becomes an important factual material for advocacy;

- Provision of small grants to self-organized PUD community groups and organizations (Small grants for PUD community self-organized groups) for local and national advocacy action to ensure access to justice and services for PUD and to protect the rights and to document the cases of violence against women. It is important that community groups themselves determine their advocacy goals, and gradually learn to be effective in advocating for their interests in practice. In addition to financial assistance, EHRN in this case provides the groups with technical support on advocacy, the development of materials and project management;

- Bringing together community leaders at the national and regional levels. Ongoing support in organizational development of the Eurasian Network of People Who Use Drugs. To date, an effective system of internal communication and knowledge exchange has been set up, the Network's management potential is being developed: a Secretariat has been established, and EHRN and ENPUD are carrying out a regional project on the impacts of repressive drug policies and the limited access to drug treatment at AIDS and TB hospitals on the development of HIV epidemic.

The productive partnering of all communities vulnerable to violations of their rights and at high risk of HIV infection is also taking place as a part of the Regional Platform for Community Development, Human Rights Protection and Gender Sensitivity, and a project for Partnership for equitable access to the HIV care continuum in the EECA region.

- Securing the opportunity to advocate at the highest level: inviting community leaders to high-level meetings on the national and regional level, and joint trips to international events with Ministers of Health, Ministers of Interior and Ministers of Justice allows for direct and effective advocacy;

- Engaging community leaders as experts and trainers to train the community in advocacy and technical skills; engaging experts from among the community to conduct evaluation, prepare articles, reports, and analytical materials enables them to develop professionally and become more effective in the future.

This approach allows the PUD community to gradually start influencing the policies and decisions, thereby creating:

  • Sustainable existence of community systems and civil society (readiness to expand, structured management, regularity and openness of activity). Ability to mobilize resources to ensure sustainability of CSOs and PUD community groups;
  • "Visibility" of community: visibility of civil society and PUD community participation for decision-makers and the general public;
  • Shared vision and advocacy goals have been defined and agreed upon by civil society and the PUD community;
  • Effective representation: PUD Community is represented in state and local decision-making bodies, the representation is supported by open feedback and regular communication with the PUD community;
  • Advocacy capacity: capacity in harm reduction budget advocacy and in the monitoring and oversight of harm reduction budgeting;
  • Influencing the decisions: PUD community influences the state/municipal decisions on the sustainability of harm reduction programs.

Below are a few examples of EHRN's work in capacity development and "professionalization" of community leaders from several EECA countries, which resulted in the PUD community's contribution to HIV response:

Ukraine: In 2015, the organization of PUD and PLHIV communities Svitanok received from EHRN funding for emergency response to crisis situations, in which clients of opioid substitution therapy living in the territories affected by military operations, lost access to vital drugs: OST, ART, and TB treatment. Community advocacy resulted in the creation of Donetsk Regional Order to issue take-home OST medication. As a result, 40 people from the war zone, of which 13 were HIV-positive, were able to continue treatment; 12 people also continued their ART treatment. One woman was prescribed ART and methadone. Methadone was issued as take-home doses for self-administration. For two HIV-positive critical patients co-infected with TB from the city of Krasnoarmeysk, home hospitals have been organized to administer required drugs.

Kazakhstan: In 2014, under the Regional Program supported by the Global Fund "Harm reduction works - Fund it!" the PUD community in the city of Taldykorgan, Kazakhstan, conducted monitoring of the availability and the quality of harm reduction services.

Natalya Zholnerova, Community Organization Amelia (Taldykorgan, Kazakhstan) reports on the completed work: "We evaluated 9 NSPs in Almaty Region, and discovered low quality of services. Only 4 out of 9 NSPs were "functioning." The PUD clients were not even aware of the existence of the other 5 NSPs. Supplies did not meet the needs of the PUD community. The HIV epidemic in the country is at the concentrated stage, which means that it mainly spreads among vulnerable groups. And people who use drugs do not have access to high-quality sterile materials and counseling.

Throughout 2015 we have been working on a goal to include a PUD community representative in the State Working Group developing the budget for the procurement of commodities for NSPs, so that we could influence the quality of harm reduction programs. During the supervisory visit of CCM representatives to Almaty Region, we announced the results of the monitoring of harm reduction programs by the community. As a result of this, as well as other hard advocacy work, including writing letters and making phone calls, local advocacy efforts, various conflicts and compromises, the PUD community representative was included in the State Working Group. Consequently, the materials required for preventing HIV which meet the needs of the community were procured through the latest tender."

Russian Federation: Thanks to EHRN's and ENPUD's support and development of PUD community-based organizations and the leadership capacity of PUD community representatives in Russia, more than 40 cases of torture and violence against PUDs under the pretext of "rehabilitation," which resulted in death, have been documented. A large contribution to this work was made by the ENPUD representative from Tatarstan. Within six months, he has documented 12 similar stories in Kazan. As a response mechanism, it was resolved to appeal to the Public Chamber and to the Ombudsman of the Republic of Tatarstan, providing them with the collected and documented facts of violations of rights of people who use drugs. As a result, a meeting was held with the Ombudsman, the representatives of the state addiction services, lawyers, members of the Supervisory Committee and the representatives of local human rights NGOs. It was decided at the meeting to establish a Committee to monitor the activities of organizations providing rehabilitation services for drug users. Based on the Committee's work, an appeal to the President of the Republic of Tatarstan was prepared and sent. In response, the Prosecutor's Office was ordered to conduct a wide inspection. Consequently, the RT Prosecutor's Office inspected 35 private drug rehabilitation centers in Kazan, Naberezhnye Chelny, Zelenodolsk and other cities. Serious violations of fire safety, urban development and health and disease control laws were discovered. Following the inspection, 12 recommendations were made, and 18 cases of administrative offenses were opened. The Prosecutor's Office initiated proceedings against 19 centers, banning their operations until they remedy the violations, because their current operations present a threat to human lives. The monitoring of remedying the violations and the advocacy for access to conduct the inspection of all rehabilitation centers in the Republic of Tatarstan is ongoing.