Fabienne Hariga Senior Adviser, HIV/AIDS Section Fast tracking HIV response Implementing HIV programme for & with People who inject drugs Fabienne Hariga Senior Adviser, HIV/AIDS Section Eastern Central Europe and Central Asia Harm Reduction Conference VILNIUS 5 APRIL 2017

Realising SDG Target 3.3 & UNGASS2016 Commitments We were here at end of 2015 +33% Missed 50% reduction target (UNGASS) To achieve these targets, efforts have to drastic. Looking at the above figure this might look like impossible mission. However it is possible … In doing business differently In optimising the response

Effective HIV services for people who inject drugs WHO, UNODC, UNAIDS comprehensive package of interventions: Needle and syringe programmes (NSPs) Opioid substitution therapy (OST) and other evidence-based drug dependence treatment HIV testing and counselling (HTC) Antiretroviral therapy (ART) Prevention and treatment of sexually transmitted infections (STIs) Condom programmes for people who inject drugs and their sexual partners Targeted information, education and communication (IEC) for people who inject drugs and their sexual partners Prevention, vaccination, diagnosis and treatment for viral hepatitis Prevention, diagnosis and treatment of tuberculosis (TB) Opioid overdose prevention and management

In 158 countries, where injecting drug use has been documented… Availability of priority interventions for HIV among people who inject drugs In 158 countries, where injecting drug use has been documented… only 90 (57%) countries are implementing NSPs (to varying degrees) only 80 (51%) countries have at least one OST programme in place Source: HRI (2016)

Coverage harm reduction David Wilson, World Bank

Fast-track Strategy for ending AIDS among People Who Inject Drugs Removing barriers and Creating demand for HIV services Harm Reduction

I- DUIT SWIT MSMIT TRANSIT

CRITICAL ENABLERS Reform of laws, policies and practices Address stigma and discrimination Enhanced community empowerment

Development Co-led by UNODC and INPUD 100 + contributors: representatives from PWID harm reduction implementers scientists human rights experts programme managers UN experts

HOW TO IMPLEMENT Provides guidance on the “how to implement” in order to support the “what to implement” Intended for public-health officials, managers of HIV and harm reduction programmes, NGOs, community and civil- society organizations, health workers.

Chapter Community Empowerment 1 Working with communities of people who inject drugs Fostering outreach and service provision led by PWID Adapting to local needs and contexts Developing organizations of people who inject drugs Strengthening organizations and building capacity Shaping policy and creating enabling environments Sustaining the movement Monitoring progress

Chapter Legal Reform, Human Rights, Stigma and Discrimination 2 Reviewing and reforming laws and policies Removing criminal sanctions for drug use and possession for personal consumption Advocating for removal of age-related barriers for young people Advancing human rights Access to justice Documenting human-rights violations Access to health services in detention Addressing stigma and discrimination Local-level programming Changing attitudes towards PWUD Monitoring programmes

Chapter Health and Support Services 3 Chapter Health and Support Services Needle and syringe programmes Opioid substitution therapy and other evidence based drug dependence treatment HIV testing services Antiretroviral therapy STI services Sexual and reproductive health Condom and lubricant programming Targeted information, education and communiciation Prevention, vaccination, diagnosis and treatment of viral hepatitis Tuberculosis prevention, diagnosis and treatment Overdose prevention and management Psychosocial services

Chapter Service Delivery Approaches 4 Strategies for designing and starting effective services Considerations for providing services to specific groups Service delivery models Making harm reduction programmes acceptable to the local community Monitoring and evaluation Planning community-led harm reduction services Recruiting and managing community staff in programmes Peer-led outreach Recruiting and training peer outreach workers Implementing outreach Peer navigation Drop-in centres Steps in establishing and operating drop-in centres

Chapter Programme Management 5 Essential issues for designing & managing programmes serving PWID Assessment Population size estimates and mapping Developing national and local responses Understanding the environment Prioritizing geographically Planning Developing the programme plan Establishing management structures Hiring and training staff Programme implementation Community-led quality improvement Community committees Other approaches Monitoring and Evaluation

Rolling-out & Dissemination Translations: French and Russian (supported by Linkages) Development of training guide (INPUD UNODC) Webinar (UNODC INPUD) Rolling-out training guide in 6 HPC countries in 2016 (UNODC) Smart guides for community organizations (INPUD) Promotion of the I-DUIT in Global Fund Proposals

Thank You! @UNODC_HIV