Community Action on Harm Reduction (CAHR) Programme Bibi Mbete Kenya AIDS NGOS CONSORTIUM (KANCO) ICASA Conference 08 Dec 2011

Kenya AIDS NGOs Consortium (KANCO) National membership organization: NGOs, FBOs, CBOs, research institutions… with interest in working on HIV/AIDS, TB, Malaria and other public health challenges KANCO aims to offer leadership and technical support to its partners in programming for various public health and human rights approach Linking organization for the International HIV/AIDS Alliance

Background Kenya has a generalized and emerging concentrated HIV epidemic Injecting drug users (IDUs) in relatively low Many IDUs engage in risky injection and sexual practices Stigma, discrimination and criminalization is common and affects IDUs health seeking behavior Legal and policy environment has influenced limited HIV prevention and drug treatment for IDUs Progressive policy developments lay firm ground for effective evidence based interventions e.g. harm reduction

What is Harm Reduction? Pragmatic approach to health with set of policies and interventions aimed at reducing the harm associated with drugs and HIV Shaped by both public health and human rights principal Uses the concept of hierarchy of risk to categorise HIV risk related to drug use Gives IDUs an opportunity for a wide range of health services

CAHR Programme 5 country programme supported by the Dutch government through the International HIV/AIDS Alliance Supports development of effective evidence based approaches to HIV and drug use Effective approaches are community focused and engage all service providers The momentum: Kenya can become one of the first countries in Africa implementing harm reduction at national scale

Objectives of CAHR Increasing access to HIV and harm reduction services that work for IDUs and non IDUs Improving harm reduction capacity of civil society and governmental institutions on HIV and harm reduction Influence the legal and policy environment for harm reduction space national and global levels Share and promotion effective HIV and harm reduction approaches Research, monitoring and evaluation

CAHR Activities

Improving Existing Services Strengthened and expanded outreach tailored to improve access of key sub-populations of IDU to essential services; Improved collaboration between service providers including referral systems; Increased availability of basic health care in community settings; Improved availability of prevention commodities

Introducing New Services Interventions to prevent transitions from smoking to injecting and promote cessation of injecting Needle and syringe disposal programmes Commodities to manage transition between injecting and smoking

Policy and Advocacy Engagement of civil society in policy development processes: Finalizing review of existing policies and guidelines, e.g. 1994 Drug Act Participation in review of policies under development, e.g. National treatment protocol for substance use disorders Leveraging opportunities presented by new Constitution Participating in development of new operating policies, e.g. related to collaboration between service providers and law enforcement

Monitoring and Research In depth understanding of the drug scene and IDU population Following the dynamics of drug scene and drug use patterns Possible research questions: Factors influencing the choice of mode of consumption; Field testing of prevention messages; Mortality rates and factors; Better understanding of bridging populations; Role of cultural factors (religion, family ties etc)

Tools http://www.aidsalliance.org/

Acknowledgements INPUD (International Network of People Who Use Drugs) IDPC (International Drug Policy Consortium) HCI (Health Communications International) PILS (Harm Reduction Programme in Mauritius) AFEW (AIDS Foundation East-West) IHRA (International Harm Reduction Association) Alliance Technical Support Hub in Ukraine Omari Project, MEWA,Reachout, Teenwatch and NOSET