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Alternatives to NSEPs: community -based initiatives

Alternatives to NSEPs: community -based initiatives. Providing access to syringes in the politically hostile environment in Moscow, Russia Anya Sarang, Andrey Rylkov Foundation for Health and Social Justice . Moscow . * Population – 12 mln (official) 10% of all Russia

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Alternatives to NSEPs: community -based initiatives

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  1. Alternatives to NSEPs: community-based initiatives Providing access to syringes in the politically hostile environmentin Moscow, Russia Anya Sarang, AndreyRylkov Foundation for Health and Social Justice

  2. Moscow * Population – 12 mln (official) 10% of all Russia = population of Georgia x3; Moldova x 4; Estonia x 10; Switzerland x ~2, * Remains top 4 most expensive cities in the world shifting between 1-4 (highest cost of living) and Europe’s most expensive city • Most billionaires city (Forbes, 2011) • Ex-mayors wife is 3d richest woman/world

  3. Moscow background: epi • Estimated drug users: 1.5 mln(chief narcologist of russia), 70-100K – IDUs • 65% - opioids (heroin, street methadone, pharmacy opioids, poppy seeds preparations) • 41.000 official HIV, 7 new registered infections per day (2011), epidemic growing • BUT 25% IDUs don’t know their diagnosis • HIV prevalencegrowing: 2004 – 14%, 2011 – 18%. • Hep C incidence increased by 7.5 times in 98-2010 • Hep C prevalence in IDUs – 69% (2011) • TB – 4700 new cases in 2010

  4. Background: politics • Federal “government” opposes Harm reduction interventions: • Opioid substitution illegal • NSPs = thread to the national drug control strategy • However, several NSP programs work in Russia, with support of GF and IHRD. • Grey legal zone • unsustainable

  5. Background: politics • Resolution of the Moscow Department of Health prohibits realization of HR programs on the basis of municipal medical institution • Several aggressive statements from ex-mayor • However, technically NSP is not illegal in moscow. -- just nobody wants to mess with it! Myth of “HR illegality” inhibited development of services in the city eg our application for funding from the Global Fund grant has been refused on the basis that we don’t have established relations with the health authorities.

  6. ARF, what do we do: • Small grass-root NGO fighting for health and human rights of people who use drugs in Russia. • mission is to promote and develop humane drug policy based on tolerance, protection of health, dignity and human rights. • advocacy, human rights watchdog, service provision and capacity-building of affected communities and individuals.

  7. Community based outreach: • Daily on-foot outreach – provision of syringes, condoms, HIV rapid tests, ointments, bandages, naloxone counseling and referral • Drug users ‘spots’ • Medical specialist 1-2 times a week • Case management of clients • Legal counseling available on request • Training for drug users

  8. Numbers 2011 • Ovrerall clients – 774 • Of them women – 312 • Syringes and needles provided – 40 K • Condoms ~ 3K • HIV tests – 41 • HIV Counseling / referral - 61 • Counseling / referral to drug treatment etc - 60 • Most burning issue: • post injection complications - 76

  9. Challenges • No problems with police or municipal authority • No office or convenient storage of materials • Not possible to carry enough materials to one outreach • No regular spaces for trainings • Seasonal challenges: one month of -40C and 4 month below -10C • Lack of services for IDUs or homeless people in the city, including OST • Unsustainable funding

  10. Pluses: • No office!! • No unnecessary conditions to our participants including NO TORTURE BY CODING and etc !!! • No work ‘discipline’ • Horizontal self management • We love each other • No overregulation or unnessasary bureaucracy • Flexible system of reporting = minimizes burn out

  11. Funding • Intermittent funding, long periods of volunteer work • Not included into the GF program • Application for the presidential funds declined • 2 years funded by UNODC • 2011-12 funding from Crystal of Hope Award • No perspective of funding in the near future

  12. Funding • Mocro-donation campaign to buy a mobile unit • www.en.rylkov-fond.org • Successful in terms of awareness but not actual fundraising

  13. The ‘government’ is going nuts Censorship of Internet, ARF site illegally shut down, but soon it will be legal Crack down on the NGOs (all NGOs who do some advocacy = Foreign Agents Just say no to HIV prevention Its illegal to protest all that

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