1. MDM Harm Reduction (needle exchange) program in Kabul-Afghanistan

2. Beginning of the mission in April 2006. Capacity building and trainings. The prerequisite conditions for the implementation of the program were fulfilled during the set up mission that took place between April and December 2006.

3. An Harm Reduction team was trained for working on the streets and in managing a reception centre (ways of meeting users, technical and medical knowledge, data collection etc) A drop in centre was set up and equipped to receive drug users

4. Target population Direct beneficiaries: 14,000 drug injectors (minimum) Indirect beneficiaries: 50,000 heroin users and their families

5. Overall objective To reduce the social and health risks related to drug injection among drug users in Kabul (Afghanistan) that do not want to or are unable to either stop using or change their method of use over a period of three years

6. Specific objectives To build the target population’s capacity to reduce risks To promote an open and facilitating atmosphere and strengthen both civil society and health care structures in Afghanistan with regard to the issue of Harm Reduction (HR)

7. Outreach activities Needle exchange Giving information about risks and taking users to the Drop in center

8. Drop In center activities Needle exchange Giving information on level of risks involved in different types of drug use Medical interventions (abscess) etc Food and personal hygiene

9. Present situation Around 70 injecting drug users, and around 120 smocking drug users in Kabul city Today we are covering:

10. Main problems 80% of the users are homeless Overdose and health problems No access to public health Low number of HIV and Hep B&C tested No HIV, Hep B&C therapy available No substitution therapy available

11. Additional activities Escorting users to the hospital (serious medical cases) Encouraging them to get tested on HIV and Hep B&C Collecting data on drug use, practices and knowledge Providing clothes and sleeping bags in winter time Special trainings on overdose and safe injection

12. Future activities Promotion of a pilot programme for opiate substitution treatments Supporting a community response for people living with HIV/AIDS among the target population Training and raising awareness of professionals and other actors involved in Harm Reduction and contributing to the promotion of Harm Reduction in Afghanistan Creating a local monitoring system on drugs and addictions issues Creation of a national Harm Reduction NGO (handover process)