Government funding of NGOs for harm reduction in the region Anna Dovbakh, EHRN , Chisinau, Moldova It is hard but possible

2

Harm reduction sustainability components 4 elements of influence: Evidence base on HR Collaborative environment Media environment Advocacy capacity building State HR funding and procureme nts Financing through NGO Quality of programs Commun ity involvem ent Sustainable HR funding

Moldova is in the regional focus PWUD community is visible and represented in decision making bodies Two alternative mechanisms for contracting NGOs by the Ministry of Health with state funding (government agencies and state insurance company) Harm reduction programs are identified as a 2016 funding priority from the Mandatory Health Insurance Fund PWUD needs have been included in the National Program to Fight HIV Service delivery standards for harm reduction are developed, piloted and approved

We are lacking THE DECISION 5 Harm reduction pilots in 2016 from state funding Support of national AIDS program

How services provided by NGOs are supported? -Tenders and calls for proposals on national level (Russian Federation, Estonia); -Tenders and calls for proposals on local/oblast level (Kazakhstan, Ukraine, Russian Federation); -Structural funds of EU (Romania, Estonia, Lithuania) -Using tobacco/alcohol taxes for prevention services (Poland, Lithuania) -Partly self payed services (Georgia, Lithuania) 6

How community advocacy and watch dogging are supported? -Private charity foundations -Membership fee -Core funds for community based organizations with important mission from state budget (Netherlands, Sweden) -2% of the taxes citizen could donate to NGO (Lithuania) -Crowdfunding (Ukraine) 7

Romania, ARAS: using EU structural funds for harm reduction services: Methadone Syringes Medical supplies Social-psychological-medical assistance HIV/ Hep B and C testing Counselling for professional integration Vocational training Financial rewards Condoms Outreach, drop-in, substitution centre expenses Training for peer educators 8

Estonia: state funding for harm reduction NSP, condoms, naloxone OST HIV testing and counseling. Social work/outreach social work Information Outreach work Operational costs Training of staff 9

Role of state in new harm reduction Social order fro investment: understanding needs in services, planning coverage Flexibility in services regulations up to drug scene Service monitoring and quality control 10

11