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

2. 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

3. 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

4. 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

6. 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

7. 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

8. CAHR Activities

9. 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

10. 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

11. Policy and Advocacy
Engagement of civil society in policy development processes:
Finalizing review of existing policies and guidelines, e.g 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

12. 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)

13. Tools

14. 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