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Code of Good Practice for NGOs Responding to HIV/AIDS
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The ‘Code of Good Practice for NGOs Responding to HIV/AIDS’ was developed in 2004 by a number of international non-governmental organisations (NGOs) – including IHRA. It aims to guide the work of NGOs by providing the key principles, practices and evidence required for successful responses to HIV, as well as a framework to which they can commit and be held accountable.
When the Code was first launched, 160 NGOs committed to the shared vision of good practice. To coincide with World AIDS Day on December 1st, the Code has been re-opened for new endorsements. All NGOs working in the field of HIV are welcome to endorse the Code and become part of this global community. A new website has been launched to make the Code more accessible - www.hivcode.org– including a number of tools to help signatories such as a new self-assessment tool.
The Code sets out to:
• assist NGOs to improve the quality and cohesiveness of their work and their accountability to partners and beneficiary communities
• foster greater collaboration between the variety of NGOs now actively engaged in responding to the AIDS pandemic
• renew the 'voices' of NGOs responding to HIV by enabling them to commit to a shared vision of good practice in programming and advocacy
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Click here to view the ‘Code of Good Practice for NGOs Responding to HIV/AIDS’
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Effective and Proven Treatments for Drug Addiction in the HIV Era
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The Institute for the Study of Mental Health Problems, Transatlantic Partners Against AIDS (TPAA) and International Harm Reduction Development programme (IHRD) invite you to participate in their international conference entitled “Effective and Proven Treatments for Drug Addiction in the HIV Era”. The conference takes place in Moscow, Russia from 18-19 February 2008.
The conference aims to deliver an open discussion on the questions surrounding the provision of up-to-date and effective support for drug problems in Russia, taking account the experiences and best practice from other nations and of the HIV epidemic. There will be discussions about the medical, legal and ethical aspects of certain approaches and procedures in Russia and the rest of the world, as well as attempts to develop strategies to improve treatment systems.
The conference will involve leading specialists from the former Soviet Union, Europe and the USA (including doctors, psychiatrists and psychologists specialising in drug treatment) as well as experts from the World Health Organization and the United Nations Office on Drugs and Crime. There will be plenary sessions, sectional meetings and roundtable discussions on a range of subjects including the treatment of drug addiction, treatment as a science, up-to-date treatment methods and HIV treatments.
The conference should appeal to representatives from patients’ and/or parents’ organisations, NGOs and those responsible for developing government policies in this area. To participate or to submit your paper for presentation, please click here to email and provide your details (full name, organisation, accommodation needed, contact number and e-mail address) before December 29th 2007. Alternatively, please contact +7 843 238 60 74.
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World Health Editors Network (WHEN) Launches for World AIDS Day
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In November 2007, a new network was launched to bring together over 400 national and international health professional journals. The World Health Editors Network aims to provide a multi-disciplinary communication platform for researchers, civil society and international organisations to promote and discuss their work with their peers and the international media.
To launch the network, a meeting was held in London, England on the topic of HIV/AIDS – ahead of World AIDS Day on December 1st. The meeting featured briefings from a range of key organisations conducting work on this topic – including the London School of Hygiene and Tropical Medicine,theOxfam, and the European Centre for Disease Prevention (a newly formed European Union agency that is charged with collecting and analysing national data on communicable diseases from all European countries). Each organisation provided a succinct overview of their work in this field – ranging from small-scale qualitative research on stigmatisation to international reports on the shortcomings of the large pharmaceutical companies.
Also at the launch, Stephen Lewis (the former UN Special Envoy for AIDS in Africa, and currently the Co-Director of a new organisation called AIDS-Free World) delivered a passionate keynote speech on the failings of the international response to the HIV epidemic, in which he told delegates that “those who are chosen to lead have failed to lead”. In particular, Mr. Lewis highlighted the inability to roll-out male circumcision programmes in Africa (“when the case is already clear”), and the “inexcusable ambivalence” surrounding injecting drug users and harm reduction. He also describes some of the alarming contradictions and statistical inaccuracies in the recent ‘UNAIDS Epidemic Update 2007’ which reported an estimated global prevalence that was almost seven million lower than in 2006.
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 Click here to view excerpts from Stephen Lewis’s [PDF:45KB]
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Introducing the Brazilian Harm Reduction Association
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REDUC – the Brazilian Harm Reduction Association - was founded in 1998 in Sao Paulo with the aim to advocate for harm reduction, allow the voices of people who use drugs to be heard, and to coordinate national activism. The key goal was for people who use drugs to be recognised as ordinary citizens, despite their unique vulnerabilities.
In Brazil, since 1998, there have been some very positive developments as well as a series of prominent debates and public hearings about issues such as drug policy, the therapeutic use of cannabis, and human rights. When REDUC was formed, it was important to validate harm reduction strategies as legitimate public health measures. This was achieved by taking part in key discussions and communicating effectively with the relevant councils, technical chambers and government departments in order to foster an open dialogue and discuss legislative changes and the multifaceted nature of drug use.
REDUC currently work alongside a wide range of partners - such as government, civil society, universities, health professionals and the media – and are always seeking to establish new partnerships both nationally and internationally. These partnerships allow REDUC to improve communication links between these organisations, thus optimizing advocacy for harm reduction policies and interventions.
Since 1998, REDUC have made investments in national harm reduction research, engaged the media with these topics (to encourage them to treat people who use drugs with more respect and dignity) and participated in a number of international meetings and conferences on HIV/AIDS and harm reduction. The organisation has also had several articles published about harm reduction concepts and strategies, and the history of harm reduction. The REDUC website contains a wide range of information such as harm reduction news, articles, courses and events, links to other websites, and an online harm reduction discussion forum.
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Click here to view the REDUC website
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IHRA Launch Alcohol Website and Network
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The International Harm Reduction Association (IHRA) is pleased to announce the launch of a new website dedicated to the topic of alcohol harm reduction – www.ihra.net/alcohol. The website aims to be a central source for information on this developing topic – including key events, publications, resources, contacts, and details of IHRA’s work in this field. The website will also be the home for IHRA’s new ‘Global Alcohol Harm Reduction Network’ (GAHR-Net).
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Drinking alcohol brings health, personal, cultural and social benefits for many people around the world – yet also causes significant mental, physical and social harms. In the last 20 years there has developed an increasing interest in alcohol harm reduction interventions. These tend to focus on particular risk behaviours (such as drinking and driving, binge drinking), particular risk groups (such as pregnant women, young people) and particular drinking contexts (such as bars and clubs). These approaches have also broadened the sphere of interest in alcohol related harms to include social nuisance and public order problems.
In 2004, IHRA made a strategic decision to expand its focus from illegal drugs towards ‘all psychoactive substances’ - including alcohol - in recognition of the need for new developments and ideas in the alcohol field. Since then, IHRA has campaigned to seek acceptance for alcohol harm reduction from national governments, local agencies and international organisations. This new website and network are part of IHRA’s 2007 ‘Alcohol Strategy’.
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Click here to view the new IHRA Alcohol Harm Reduction website
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Click here to join GAHR-Net
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United Nations Drug Strategy Review: Advocacy Guide and Consultations
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As the harm reduction community begins preparations for the forthcoming United Nations review on it’s drug strategies since 1998, the International Drug Policy Consortium (IDPC) have released the first version of their ‘Advocacy Guide’ to provide some insight into the review processes. At the same time, the ‘Beyond 2008 NGO Forum’ have begun their programme of regional consultations around the world to try and coordinate civil society input into this review.
The first version of the ‘IDPC Advocacy Guide’ – released in October 2007 -serves as an introduction to the structure and operation of the United Nations drug control systems, and describes the review processes that will take place throughout 2008, culminating in a high-level political meeting in 2009. The IDPC is a global network of national and international NGOs that specialise in issues related to illegal and legal drug use – including IHRA. This report introduces the main advocacy themes that the IDPC will be concentrating on throughout this process. As the review process progresses, updated versions of the ‘IDPC Advocacy Guide’ will be released in order to update civil society and refine the IDPC positions.
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Click here to view the ‘IDPC Advocacy Guide’ [PDF:591KB]
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Also in preparation for the United Nations review process, the ‘Beyond 2008 NGO Forum’ have begun their programme of regional consultation events. The Forum is an international attempt to collect, analyse and disseminate the views and experience of civil society organisations in relation to the United Nations global drug control efforts since 1998. It is being organised by the Vienna NGO Committee, and will culminate in the ‘4th International NGO Forum’ in Vienna, Austria (7 – 9 July 2008).
The regional consultations will provide essential information from a wide spectrum of organisations working in the drugs and drug-related fields – led by a selection of ‘Regional Lead Organisations’ (RLOs), which include many harm reduction groups (such as the Asian Harm Reduction Network, Intercambios in Argentina, Persepolis in Iran, and the Eurasian Harm Reduction Network). For a full list of RLOs and Regional Consultation dates, please visit the ‘Beyond 2008 NGO Forum’ website.
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DHA Submission to the UK Government
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 In October 2007, the Drugs and Health Alliance (DHA) submitted a response to the UK Government’s consultation – entitled “Drugs: Our Community, Your Say”.
In 1998, the UK Government published “Tackling Drugs to Build a Better Britain” – a ten year national drug strategy which brought together various different agencies and professions and paved the way for increased investment in drug treatment and services. With the strategy due to end in 2008, this latest consultation document is aimed at informing the next UK strategy. However, the consultation has been widely criticised for being too narrow and restrictive, and being based on flawed evidence and statistics.
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Click here to view the original consultation leaflet [PDF:424KB]
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Click here to view the original consultation document [PDF:2.21MB]
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Rather than submitting individual yet similar responses, the members of the DHA have worked together to formulate a collective reaction. The DHA is a group of organisations and individuals from across the UK – including IHRA – which support an evidence-based, public health-led approach to dealing with illegal drugs.
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Click here to view the DHA submission [PDF:144KB]
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Click here to view the DHA website
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Nothing About Us Without Us: UK Report from Warsaw Conference
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In May 2007, the UK’s National Treatment Agency for Substance Misuse (NTA) sponsored a delegation of people who use drugs to attend the IHRA conference in Warsaw, Poland. The delegation’s task was to gather information on new evidence-based harm reduction initiatives from around the world in order to guide and improve services in the UK. The delegation released their report in October 2007.
The report – entitled “Nothing about us, without us: The English user representatives' report from the 2007 International Harm Reduction Association conference” – was formally launched at the National Conference on Injecting Drug Use in Glasgow, Scotland on 16 October 2007. It focuses on the five key messages that the delegation took home from the conference:
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- Widespread testing and treatment for all blood-borne viruses should be made available to injecting drug users.
- Needle exchanges must be rejuvenated and must provide a comprehensive range of equipment and services.
- Advocacy for harm reduction in prisons must continue, as there is still much to achieve.
- Sex workers who also use drugs face twice the marginalisation and harms, so services and service user groups must address these needs.
- Service user representation is relatively well developed in the UK (compared with the challenges faced elsewhere in the world).
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Click here to view the report [PDF:179KB]
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Alternatively, individual hard copies and bulk orders can be obtained by phoning +44 (0) 8701 555 455 and quoting product code ‘IHRA’.
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Click here to view the report launch presentation by Jimi Grieve [PDF:655KB]
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Nominations Invited for 2008 IHRA Awards
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Nominations are now being invited for the 2008 International Rolleston Award, the 2008 National Rolleston Award and the 2008 Travis Jenkins Award – to be presented during the closing ceremony of Harm Reduction 2008: IHRA’s 19th International Conference. Each year, IHRA presents these awards to leading individuals or organisations in the field of harm reduction.
The International Rolleston Award is presented each year to an individual who has made an outstanding contribution to reducing harm from psychoactive substances at an international level. At the 18th IHRA conference in Warsaw (May 2007), the award was given to Dr. Vladimir Mendelevich for his continued advocacy and support for harm reduction and medication assisted treatment in Russia in the face of widespread vilification and the threat of imprisonment for his stance. For 2008, nominations are invited from all around the world.
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Click here for the International Rolleston Award Nomination Form [WORD:49KB]
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The National Rolleston Award is presented each year to an individual or organisation who has made outstanding contributions at the national level. At the 18th IHRA conference in Warsaw (May 2007), the award was given to Marek Zygadlo in recognition of his pioneering efforts in Poland, where he has been at the forefront of harm reduction for over 20 years. For 2008, nominations are open to individuals or organisations in Spain.
These two awards are named after Sir Humphrey Rolleston, the President of the Royal College of Physicians who chaired the UK Departmental Committee on Morphine and Heroin Addiction. In 1926, this committee determined that it was legitimate medical practice to prescribe heroin or morphine to people dependent on those drugs. This decision epitomises a benign, pragmatic and humane approach to drug problems, and was a landmark event in the history of harm reduction.
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Click here for the National Rolleston Award Nomination Form [WORK:47KB]
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The Travis Jenkins Award is presented each year to a current or former drug user or injecting drug user who has made an outstanding contribution to reducing drug related harm. The awards are named after the extraordinary jazz musician and composer who died of cancer in 2004. Travis Jenkins overcame a heroin addiction in order to marry and raise two sons, travel around the world with his anthropologist wife and create his music. At the 18th IHRA conference in Warsaw (May 2007), the award was given to Alexandra (Sasha) Volgina, a Russian drug user activist who works in a hostile environment to ensure that drug users are seen not as problems, but as partners and experts. The winner of this award receives a cheque for $500US – kindly donated by the family and friends of Travis Jenkins.
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Click here for the Travis Jenkins Award Nomination Form [WORD:40KB]
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Nominations must be made using the official forms, and must be received by the IHRA Secretariat before 28th February 2008.
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Click here for more information about the IHRA Awards
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New Resources from IHRD
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The International Harm Reduction Development Program (IHRD) of the Open Society Institute (OSI) is pleased to announce the release of three new documents in October 2007 to assist global advocacy efforts for harm reduction. They have launched two new ‘Public Health Fact Sheets’ - on ‘Women’s Health and Harm Reduction’ and ‘Public Health and Public Order’ – and a policy paper on ‘Women, Harm Reduction and HIV’.
These are the latest in a long list of resources freely available to download from the IHRD website. The fact sheet on women’s health documents the punitive policies and practices from governments, health care systems and law enforcement agencies which drive women who use drugs away from potentially life-saving care. Even when women drug users do reach services, they often find them unwelcoming and poorly suited to their needs – creating a costly gender inequality in healthcare, harm reduction and drug treatment. The second fact sheet aims to emphasise the public health benefits of a harm reduction approach, while trying to dispel the myths that such interventions encourages crime and public disorder (in fact, research shows that some harm reduction programmes can decrease criminal activities by illicit drug users).
The policy paper on ‘Women, Harm Reduction and HIV’ is written by Sophie Pinkham and Kasia Malinowska-Sempruch, and discusses the difficulties that women who use drugs often face in accessing harm reduction, drug treatment, and sexual and reproductive health services. The report offers recommendations for policies and better-designed services to protect the health and rights of women who use drugs (with a primary focus on Eastern Europe and Asia - IHRD's principle areas of work). The report will be followed in 2008 by the release of assessments of women drug users' access to services in Georgia, Russia, and Ukraine. In addition, in May 2008, IHRD will be hosting a major session on women and harm reduction at Harm Reduction 2008: IHRA’s 19th International Conference.
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The International Harm Reduction Development Program works to reduce the harms relating to injecting drug use, and to press for policies that reduce the stigmatisation - and protect the human rights - of illicit drug users. For more information about IHRD, please visit www.soros.org/initiatives/health/focus/ihrd
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Click here to view the ‘Women’s Health and Harm Reduction’ fact sheet [PDF:46KB]
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Click here to view the ‘Public Health and Public Order’ fact sheet [PDF:64KB]
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Click here to view the ‘Women, Harm Reduction and HIV’ policy paper [PDF:260KB]
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New Name for the Central and Eastern European Harm Reduction Network
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 After ten years of operation, the Central and Eastern European Harm Reduction Network (CEEHRN) changed its name in October 2007 to EHRN - the Eurasian Harm Reduction Network. Alongside the new name, EHRN have also launched a new logo and a new website - www.harm-reduction.org.
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CEEHRN was founded in 1997 by a group of harm reduction pioneers and has worked for the last decade across Central and Eastern Europe and in the countries of Central Asia (including Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan). As such, the new name is simply a reflection of the geographic scope of the network – and their mission, goals, membership and structure will all remain unchanged. Importantly, however, the email addresses for the network staff will now have the suffix ‘…@harm-reduction.org’ (although the old addresses will still be used as well for a transitional period).
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Click here to visit the new EHRN website for more information
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Click here to view the official EHRN Alert (in English) [PDF:41KB]
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Click here to view the official EHRN Alert (in Russian) [PDF:192KB]
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November 2007 Article of the Month
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Wolfe D (2007) Paradoxes in Antiretroviral Treatment for Injecting Drug Users: Access, Adherence and Structural Barriers in Asia and the Former Soviet Union. International Journal of Drug Policy, 18 (4), pages 246 - 254.
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This commentary, by Daniel Wolfe from the Open Society Institute’s International Harm Reduction Development program (IHRD), attempts to highlight reasons why drug users are disproportionately less likely to receive life-saving antiretroviral treatment (ARV) for HIV. Whereas, historically, most of the focus at the policy and practice levels has been on moral decisions about who “deserves” treatment and who can be trusted to comply, this article expertly argues that it is the structural impediments within treatment systems which discriminate against drug users, set them up to fail and presents them with “paradoxes and double binds”.
In particular, despite guidance from the World Health Organization stating that physicians must not discriminate on the basis of drug user status, ARV systems are inherently biased – especially in the developing world, where HIV is increasingly driven by injecting drug use. Such services are rarely integrated into harm reduction programmes (such as needle exchanges and substitution treatment) despite evidence of effectiveness. They also often label drug users as untrustworthy which creates an “incentive to dishonesty” amongst those who hide their status in order to access treatment – a self-fulfilling prophecy. Additionally, services are often withheld from drug users who are seen as unable to comply with regular treatment sessions and schedules and yet, in many countries, ARV is not offered to HIV-positive prisoners who would find it easier to comply in the “closed, highly structured settings into which they are forced by the state”. This is despite universal testing for HIV upon entry into the prison systems and, in some cases, prisoner segregation on the basis of HIV status!
This article is part of a recent International Journal of Drug Policy ‘Special Issue’ on HIV treatment and care for injecting drug users. The entire issue (Volume 18, Issue 4) has been guest edited by Andrew Ball (from the World Health Organization), Michel Kazatchkine (from the Global Fund to Fight AIDS, Tuberculosis and Malaria) and Tim Rhodes (from the London School of Hygiene and Tropical Medicine). The journal is available free to Premium or Institutional IHRA Members.
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Click here to Issue 2 of ‘ARV4IDUs’ – a specialist newsletter on this topic [PDF:292KB]
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