0. Harm Reduction grant in five countries in West Africa Funded by the Global Fund, implemented by ANCS
24 July 2017 (11pt)
Paris, France
By Vanessa Rousselle

1. Outline Introduction: Harm reduction in Global Fund programs
The context of the PARECO
At a glance
Objectives
What is at stake
Methodology
Example of activities at regional and national level
Recommendations and lessons learnt

2. Intro: Harm reduction and Global Fund
Investment in programs for people who inject drugs ( ) estimated at 230 to 250 million dollars
GF will continue to prioritise harm reduction programs as a critical component of effective, evidence informed and rights based HIV response    
Trend and preliminary analysis indicates
Ratios of total resources within available GF HIV funding have increased for harm reduction
A positive shift towards higher impact interventions such as NSP and OST
The Global Fund remains the largest single financier globally
The gap between funding needs and available resources remains significant
Promoting and protecting human rights and gender equality is required to accelerate the end of the three epidemics.

3. PARECO: Context
Facts
Rapid increase in the number of people who inject drugs in Sub-Saharan Africa with a peak recorded in West and East Africa
13 out of 47 countries only collected data on the use of injectable drugs
Pop. Size est. 1.02M (300,000-6,4M) / est. 5 to 10% living with HIV
Gaps and barriers
Lack of harm reduction and treatment programs in the sub-region
Resources focus on seizure and repression rather than health
Opinion: harm reduction increases the use of drugs
According to UNODC and West Africa Commission on Drugs, and Global State of Harm Reduction
1.7 million people who inject drugs in Sub-Saharan Africa
221 000 have an HIV infection

4. At a glance PR: ANCS in Senegal
5 countries: Burkina Faso, Cap Verde, Côte d’Ivoire, Guinea Bissau and Senegal
SRs: IPC, Platform of NGOs, MdM CIV, and ENDA GNB
Amount: 5.89 Million euros
Implementation: January 2017–December 2019
Alliance Nationale des Communautés pour la Santé Senegal

5. Objectives
Overall: Improve access to services (harm reduction) and promote respect for the human rights (HR) of people who inject drugs (PWID) in West Africa
Improve the availability of strategic information to guide harm reduction interventions targeting PWID in 5 countries
Strengthen the harm reduction capacity of community actors and PWID to improve health services and HR for PWID
Enhance the social and legal environment to facilitate implementation of harm reduction activities targeting PWID in the 5 countries
Carry out innovative model harm reduction projects, document the best practices and implement them in the 5 countries

6. What is at stake ?
Preparing the ground for the development of harm reduction programs:
At sub-regional level: Policy, legal and decision making
At national level: Data and information for decision making
At local level: Piloting projects that can be replicated and expanded
Building capacity and enhancing knowledge
In next cycle: Countries have included harm reduction in HIV programming, next NSPs and funding requests

7. Harm reduction for PWID in WA
Methodology
MODULE 2
Legal and regulatory review and legal reforms
Policy advocacy on legal rights
Legal training for civil servants, health workers and police officers
Legal rights monitoring at the community level
10%
MODULE 1
Strategies and policies
Health legislation and regulations
28%
Harm reduction for PWID in WA
5.89 M
MODULE 4
Analyses, studies and transparency
Regular communication of information
26%
MODULE 3
Strengthen institutional capacity, planning and leadership within the community sector
Social mobilization, strengthening ties between communities, collaboration and co‑ordination
Community follow-up on accountability
16%
MODULE 5
Policies, planning, co‑ordination and management
20%

8. Example of activities IBBS and mapping in the five countries
Review of legal frameworks in the five countries
Elaboration of a Regional Strategic Framework and National action plans
Advocacy at Regional level and participation to high level meetings
Capacity building workshop for CCM members, 12 countries in the region
Training of security forces, journalists, decision makers

9. Pilot projects: activities in countries
3 models aiming at:
Promoting Harm reduction
Demonstrating the feasibility of interventions where there is no program and encouraging the others
Learning best practices for replicating and scaling up
Each country (CCM/SR):
Chose a model, based on context, experience, data available
Set up a small team (coordinator, social workers, mediators, etc.)
Set up the project: Partnerships, situational analysis, BCC tools, M&E tools, training of staff, etc.
At the end: evaluation and lessons learnt: relevance, feasibility, replicability, scale up

10. Three models Model 1 – Outreach in community settings
Burkina Faso
Guinea Bissau
Cote d’Ivoire
Model 1 – Outreach in community settings
Service delivery and empowerement at community level: supply adequate equipment for drug usage, prevention, condoms, as well as information, etc.
Model 2 – Cooperation with Security forces
Improve acceptance of Harm reduction programs through knowledge, and cooperation between social workers, users and forces in open settings (streets)
Model 3 – In prisons
Improve acceptance of Harm reduction programs through knowledge, and cooperation between social workers, users and forces in closed settings (prisons for men and prisons for women)
Cape Verde
Senegal
Model 1 – outreach – burkina, guinea Bissau and cote d’ivoire
Model 2 – cap verde and senegal
Model 3 - senegal

11. Recommendations and Lessons
Only 6 months of implementation Regional grant cannot support all efforts. It will require champions to make it work: in specific countries and among decision makers to sustain the efforts Financial sustainability of the activities at regional level (advocacy)

12. THANK YOU
24 July 2017 (11pt)
Paris, France
By Vanessa Rousselle