Harm Reduction and CSOs in Transition Period Current status and perspective in Bosnia and Herzegovina CEECA Regional HR Conference, Vilnius 2017 Presentation by Samir Ibišević

Bosnia and Herzegovina: Located in the western part of the Balkan Peninsula; estimated population - 3.825,000; complex political structure; upper middle-income country; low HIV prevalance (HIV prevalence of less than 0.1% in the general population and less than 5% among identified KAPs); KAPs estimation: MSM 6,900 – 9,500 persons; PWID 9,500 – 15,500 persons; SW 2,500 – 5,500 persons. From 2006 -2016, the Global Fund supported implementation of HIV/AIDS programs (approx. $40m.in total). NFM introduced by the Global Fund in 2014 claim BiH ineligible for further support under the eligibility criteria based on a combination of income level and burden of disease.

Policy Successful examples of key factors Strategies used by HR NGOs to sustain programming for people who use drugs Consequences of improperly planned/managed transition Transition plan exist since the end of 2015. HR reduction is tolerated by police in most cases while legal and policy barriers to implementation of harm reduction programs have been documented by one or more stakeholders. HR policy document is adopted in the Government of Federation of Bosnia and Herzegovina. Essential contribution to TP development. Organization of HR trainings for law enforcing agencies incl. prisons; daily contacts with police officer. NGOs initiated and played a main roll in development of HR policy in FBiH. Advocacy and lobbing are improperly addressed in transition process. No results oriented programs. NGOs failed to built-up its advocacy skills and capacity during the GF programs.

Finance Successful examples of key factors Strategies used by HR NGOs to sustain programming for people who use drugs Consequences of improperly planned/managed transition There has been a need projection and costing process to develop a budget for the transition period and/or beyond. System for OST procurement established during the GF program is put in place during transition period. Opioid substitution therapy medications are included in the domestic budget. Provision of costs for TP budget. No finance available for NGOS HR activities.

Program Successful examples of key factors Strategies used by HR NGOs to sustain programming for people who use drugs Consequences of improperly planned/managed transition Standards for OST exist on entity level MOHs. Accreditation Standards for drop in centers in Bosnia and Herzegovina contain a total of 13 standards and 87 criteria divided into four sections: 1. Center; 2. Services and interventions in the center; 3. Fieldwork (outreach); 4. Evaluation. NGOs developed set of standards with Agency for accreditation of medical services. Harm reduction is defined as social service in BiH, not medical. Poor advantages of being accredited HR NGO.

Governance Successful examples of key factors Strategies used by HR NGOs to sustain programming for people who use drugs Consequences of improperly planned/managed transition CCM is in function with the secretariat supported by GF till the end of 2018. Existence of National Advisory Board. NGOs active in HR are members of CCM.

Current status in NGO sector BiH achieves a Transition Readiness Assessment score of 33% as of April 2016. As of march 2017, only one DiC is active in BiH run by volunteers. NGOs Viktorija and Poenta are not active anymore. PROI and Margina are operational due to programs other than HR.

What we need: Empower NGOs to deliver result oriented advocacy for HR on all levels including social contacting. Engagement of other international stakeholders and donors for backing HR in BiH. Emergency funding mechanisms that allows the Global Fund to provide support after the transition period for HR programs at risk of disruption due to the lack of government will and/or the capacity to maintain them.

Thank you!