1. 1 Harm Reduction In Ukrainian Red Cross TO BE OR NOT TO BE: 8 th Annual ERNA Meeting, Krakow, 2004

2. Background Population (2004 est.): - Growth rate - Life expectancy 47,732 m. -0,7% 66,7 Economy: - Unemployment rate - GDP (2003 est.) - Minimum salary - Population below poverty line 9,1% 8,2% 38$ 30% HIV/AIDS rates: - Officially registered HIV cases (2004 est.) - International experts data on HIV cases - Number of AIDS cases - Adult prevalence rate - Deaths 68,187 400,000 7,465 1% 4,450

3. 3 Scope of the HIV/AIDS Epidemic in Ukraine (as of June 1, 2004)

4. 4

5. 5 Number of officially registered HIV-positive IDUs in different regions of Ukraine (1994-2004)

6. 6 Situation related to Injecting Drug Use in Ukraine -The highest rates of IDUs: Eastern, Southern Ukraine + Kyiv City -77, 267 officially registered IDUs (est. 2004) -According to expert assessment, rates are twice (thrice) higher -Opiates & ephedrine -> the most widespread drug substances -Adolescent drug usage – 11-13% -44% of IDUs use services of different drug dealers -29% of IDUs share needles -19% of IDUs never use condoms -38% of IDUs have casual sexual relations -40% of IDUs get basic knowledge on HIV/AIDS

7. 7 HIV/AIDS & HR in Ukraine 1987 1997 2000 2004 The 1st officially registere d case of HIV- infection The 1st HR project launched in Odesa for IDUs and CSWs 15 Ukrainia n NGOs, working in the sphere of HR 25 HIV- service organizati ons providing HR strategy

8. 8 http://uhrn.civicua.org/en/nepmap.htm HR Programs in Ukraine

9. 9 1.Efforts of the Ukrainian society are insufficient for effective counteraction of epidemic HIV/AIDS. The state strategies have a basically declarative character. Work of the non-profit structures is not provided by long-term state political and financial support and is possible only due to support of the international organizations. 2. The results of the scientific research in many countries and in Ukraine have confirmed Harm Reduction as an effective medical and social technology. 3. In addition to the Declaration of the Special session UNGASS Global crisis - we emphasize, that the most vulnerable groups are IDUs and their sexual partners, commercial sex workers and their clients, and also those in custody and prisoners in the State Department on Issues of Execution of Punishments. 4. Stigma, discrimination and denial undermine efforts on prevention, treatment and care, and existing social, cultural and economic factors interfere with the development of awareness and training to effective actions. 5. The NGOs expressing interest and basing their activities on community needs, vulnerable or mentioned by epidemic, must play a key role in granting outpatient care and other services necessary for successful prevention, care and support of PLWA. Main Constraints For HR in Ukraine

10. 10 HR in Ukraine International agencies: Open Society Institute International Renaissance Foundation AIDS Foundation East-West (AFEW) UNAIDS UNDP British Council MSF International HIV/AIDS Alliance in Ukraine NGOs: -‘Vera, Nadezhda, Lyubov’ (Faith, Hope an Love) – Odesa -Charitable Anti-AIDS Foundation – Poltava - Association ‘Victoria’ – Khmelnitsky - NGO ‘Victoria Club’ – Pavlograd - NGO ‘Poryatunok’ (Salvation) – Kremenchuk -Charitable Foundation ‘Insight’ – Cherkasy - Charitable Foundation ‘Salus’ – Lviv - Charitable Foundation ‘Red ribbon’ – Kharkiv -Charity Fund ‘Unitus’ - Mykolayiv Ukrainian Red Cross Society

11. 11 Place: Zaporizhzhya RC Branch Project staff: -Project manager (RC Branch) - Specialists from AIDS Centres -25 volunteers: students of Psychology from Zaporizhzhya Humanitarian Institute -2 professional psychologists: Heads of Zaporizhzhya City districts Project beneficiaries: -100 IDUs per month Ukrainian Red Cross experience in HR

12. 12 Arrangement of points of needle exchange: -3 out of 7 City districts are covered with 10 points of needle exchange -Wednesday/Friday afternoon -3-4 RC people -> point -> transfer syringes & sanitary kits, gather used needles (containers) ->utilizing Psychological and social support Informational prevention Fundraising Project activities:

13. 13 Project Budget (100 IDUs per month) DonorsZaporizhzhya RC Branch  Syringes 5,0 1000 units  Hygiene packages 1000 units  Condoms 1000 units  Leaflets 100  Staff salary  Volunteers’ incentives  Container for the used syringes  Premises rent  Utilities  Transport expenses  Disinfectants  Utilization of the used syringes.  Information products  Mass media campaign

14. 14 Constraints for URCS HR Programme  Late involvement into HR activities  Is HR priority?  Community indignation  Low publicity of URCS HR activities  Reduced attendance of the stationary exchange points  Lack of resources (financial and human)

15. 15 Problems of HR Programme in Ukraine  “Favorable” legislation  Illegal substantive therapy  No well-functioning CCM  High level of stigma

16. 16 THANKS FOR YOUR ATTENTION!