Harm Reduction Funding. Regional Trends Dasha Matyushina-Ocheret 2016-02-01, Vilnius, Lithuania

Natural history of the transition Accept the fact that the GF funding is over Declare availability of resources for HR Allocate all/most of available funding for testing and treatment Let HR NGOs close down Ask GF/other donors for possible funding

Natural history of the transition Accept the fact that the GF funding is over Declare availability of resources for HR Allocate all/most of available funding for testing and treatment Let HR NGOs close down Ask GF/other donors for possible funding Georgia Russia Moldova Belarus Romania Kazakhstan Serbia Bulgaria

Estonia: a case of self-recovery Accept the fact that the GF funding is over Declare availability of resources for HR Allocate all/most of available funding for testing and treatment Let HR NGOs close down Ask GF/other donors for possible funding Estonia

Treatment (advocacy) Make transition process transparent Accept the fact that the GF funding is over Make transition process transparent Negotiate gradual transition plan with GF and other donors Ask GF/other donors for possible funding Declare availability of resources for HR Assess HR financial needs Pilot models of state funding for NGOs Let HR NGOs close down Allocate all/most of available funding for testing and treatment Advocate for separate HR budget lines

Regional Report “Road to Success: Toward Sustainable Harm Reduction Funding” Result of 18 months work of EHRN members and partners in 6 countries Unified IMG & SMG methodology Financial analysis: 104 NSP sites and 59 OST sites. Community-led services assessment: >600 participants of discussion groups & >1,800 questionnaires completed by NSP and OST clients. Available @ www.harm-reduction.org

NSP & OST unit cost, USD Country NSP OST Belarus 36 612 Georgia 240 1372 Lithuania 332 816 Moldova 49 682 Tajikistan 110 553

Domestic funding for harm reduction for 2016-2018 (projections of mid-2015) Governments provide less than 15% of harm reduction funding in the region, which indicates region’s strong dependency on international donors’ support. Georgia currently projects no domestic contributions for NSPs through 2018 Moldova and Tajikistan projected domestic contributions that are below 15% and 2% of total needed funding Kazakhstan has committed substantial domestic funding for NSP, but support to OST is still pending for policy reasons Lithuanian government’s projected contributions cover only 37% of the demand for NSP

Key messages Epidemics among people who Inject вrugs cannot be reversed without greater, and sustained, state funding of harm reduction. Detailed and responsible transition plans for harm reduction are needed in every EECA country. Policy reform can maximize the impact and success of harm reduction.

What comes next?

Domestic finance for needle and syringe programs in 2016-2018 (for five countries, commitments in Tbilisi) $14 142 176,00

Needle and Syringe Program financed from domestic sources, % of the full demand

Domestic finance for opioid substitution treatment programs $17 808 361,00

Opioid substitution treatment financed from domestic sources, % of the full demand

and we have to continue negotiations All these commitments under threat because of unstable economic situation in all countries of the region and we have to continue negotiations