SUPPORT AND RESOURCES CENTRE FOR THOSE AFFECTED BY HIV/AIDS Model of support for low-threshold harm reduction services in Riga – cooperation of government, city and NGO Regional Harm Reduction Conference 2017 HARM REDUCTION IN THE NEW ENVIRONMENT Session: Local funding and other support in achieving the sustainability of HR programs 4-6 April 2017, Vilnius, Lithuania  Ruta Kaupe, Board Chairperson, MBA

Latvia 6972 registered HIV+ ; 1786 – AIDS patients (2017.01.01.) Municipalities with HPP Harm reduction, HIV prevention work: 19 HIV Prevention points in 16 municipalities - HPP network in Latvia Data source: Center for disease Prevention and Control Concentrated HIV epidemic in male IDU’s community (WHO experts, 2011) PWID: HIV prevalence 25%- 32% , hep C - ~82%; in Riga ~10 000 pers New cases – 38% heterosex contacts; 37% unknown; 17% IVDU

DIA+LOGS: fact-sheet NGO DIA+LOGS – support centre for those affected by HIV/AIDS working in HIV/AIDS and HR field in Latvia for 15 years Registered: May 15, 2002 Implemented: ~ 80 projects Core program: HR – NS Exchange program 20 emplyees + 3 volunteers Center, 2 mobile units, outreach >70% of HR work in LV Budget: >180 000 EUR per year Riga Municipality + Government + other International & local funders Environment: Clients: 27-32% are HIV+; Distributed ~50 syringes per IDU / per year; 30% of employees & 40% of D+L members - drug use experience; In 2016 ~1000 unique clients, 7000 contacts, in data base registered 5700 pers.

HR work model in Riga HIV prevention and psycho-social services for IDUs and their contactpersons in Riga city Center NS exchange Condoms HIV tests Social workers counsultations Psychologist’s counsultations Life with HIV Psycho-Social support Info&education Events&parties Mobile Social worker or psychologist councelling Info Outreach Outreach workers Volunteers involvement

Key sources and funding mechanisms Riga Municipality Welfare department – local authority Program implementation expenses *Specialists salary expenses *Mobile bus operating costs *Center maintenance costs *Utilization *Administration Centre for Disease Prevention and Control – government HIV prevention materials *HIV, hep B, C, syphilis tests *Syringes, needles, condoms, alco-pads, cotton *Materials for wound treatment *Printed info-materials

Financing models of HR services Project financing - city Grant – city Purchase of services – DIA+LOGS HR program 2003 - 2016 HIV prevention materials - government

HR Budget and results 2012 - 2016   2012 2013 2014 2015 2016 Increase /times/ Municipality funding for program 75 900 85 % 78 % 71 % 81 600 65 % 61 % 1 x Government funding for prevention materials 13 400 15 % 21 700 22 % 31 000 29 % 44 400 35 % 47 800 39 % 3,5 x Total HR budget 89 300 100 % 97 600 107 000 126 000 129 400 1,5 x Distributed syringes / returned used syringes 214 000/ 178 000 230 500/ 196 000 276 500/ 228 000 380 000/ 297 000 530 000/ 381 000 2,5 x/ 2,1 HIV tests 933 950 1167 1180 1402

Key factors for starting municipal financing for HR programs Few local authority leaders - understanding, well-aware, motivated, inspired from best practices; NGO – trusted, motivated, with proven work quality and close link with community; Local strategic policies and HIV situation; International strategies & support, agreements Success! - all factors coincide!

Key factors for ensuring the sustainable municipal support for HR Constant advocacy – following policies and changes; Leadership – continuous growth, don’t let its own accord; Perfect management & reporting, excellent accounting; Increase of work results and quality, improvements for effectiveness; Maintain good partnership & relationships with contact persons and chief officials; Communicate: your results growth, community, added value In high crisis situation – rebel! National cooperation, International support.

Survival strategy for NGOs= adaptation Adopt flexibly changes and requirements different financing models (projects, grants, purchases); Be responsive to all requests safety is priority (city policy); Be friendly and (rather) personal Risky, if political power changes; Be open and honest Invite for visits, show reality, don’t expand results Search for additional financers and projects Don’t put all eggs in one basket, more support for community!

Sustainability of Riga HR model Pros: Long and good experience of partnership; 3 side cooperation and common responsibility; Community trust and growing results. Cons: No sustainability for service provider (3 y-s contracts); Changes in political power could decrease HR work; Weak perspectives for expanding services.

Sustainability for HR – Conclusions People come first! – community needs&involvement! Cooperation+ reporting+ quality+ trust+ flexibility Funding for HR services could become sustainable: If providing HR services is the delegated function to NGO by government (included is state budget) or If it is dissuaded by law that providing HR services is every municipality responsibility HR programs should be supplemented by additional supporting projects.

YOU ARE WELCOME FOR COOPERATION dialogs@diacentrs. lv. Ms YOU ARE WELCOME FOR COOPERATION dialogs@diacentrs.lv   Ms. Ruta Kaupe – Board Chair (ph +371 67243101); e-mail: dialogs@diacentrs.lv Dzirnavu street 135, Riga, Latvia, LV-1050 home page: www.diacentrs.lv

DIA+LOGS life

Campaigning