1. How to improve law enforcement knowledge about HIV and to work with drug users and sex workers: experiences from Kyrgyzstan Aleksandr Zelichenko, Director of Public Fund Central-Asian Drug Policy Center, Coordinator CADAP-5, Police Colonel (ret.), PhD

2. Background Kyrgyzstan is situated on a drug trafficking route; it is a drug-transit country. According to specialists, about 20% of transported drugs usually left and consumed in the country of transit. About 10 000 drug-users are officially registered in Kyrgyzstan, the real figure is 2-3 folds higher - 20-30,000 people use illicit drugs throughout the country. Most of these are IDUs, and HIV prevalence among IDUs is 15%, which is 50 times higher than in general population.

3. Background After the collapse of the Soviet Union, most Central Asian states kept the strongly penal Soviet legal and policy approaches toward drug use, but Kyrgyzstan’s legal framework stands out as relatively favorable to risk reduction activities. Supportive legal environment Syringe sales Syringe possession Decriminalization of drug use Small-scale possession of drugs are decriminalized Methadone Services in prison

4. New Attitude Kyrgyzstan the first in the region introduced philosophy and evidence based harm reduction strategies. From the very first steps it became clear that: “Harm reduction cannot and will not work without the active participation of police” “Police can be the best friend or the worst enemy of harm reduction” Instruction 417: cooperation between police and harm reduction programs, Explain how Policeman in service should behave to minimize the risk to be infected by HIV the Ministry of Interior ordering police across the country to avoid discrimination, be polite and treat with respect the representatives of the vulnerable groups of people Explain them services available

5. Police Training In response to this policy change in support of harm reduction, we have been rolling out training programs over the past 15+ years to educate Kyrgyz police units about the law, and about HIV and harm reduction. Our ability to cooperate and find common ground with law enforcement officials has laid the groundwork for our approach in Kyrgyzstan. We have focused on educating police officers about how to respect human rights while protecting public health.

6. Police Training One of the single most important aspects of the program has been the collaboration between a diverse group of actors, including police, NGOs, the government, and IDUs. Cooperation with civil society has been absolutely fundamental to our work, and our experience shows that a successful harm reduction approach depends on a high level of collaboration with all involved parties. The NGO AIDS Foundation East-West (AFEW) has been one of the leaders in creating and conducting training with police officers, and they have done this by collaborating with a variety of local partners. AFEW formed groups of trainers made up of diverse groups including specially trained police instructors, representatives of NGOs, drug-addicted people, commercial sex workers, and PLWHA. It was the first time in Kyrgyzstan that such diverse groups directly addressed a police audience.

7. Police Training By the end of 2009, the training was rolled out across Kyrgyzstan, and in 2010, it was incorporated as an integral component of the in-service training for all police stations. All training materials had been translated into local language and in last 2 years all training sessions had been conducted in Russian or Kyrgyz, depending to the auditory.

8. Impact While there isn’t a lot of available data on the impact of the training yet, some research was conducted between 2009 and 2010 that surveyed NGO clients and staff, police, drug users, and sex workers. The research so far shows there was a notable improvement in attitude among police. This has yet to translate into behavioral change, but that doesn’t happen overnight and we are making progress. Attitude change in police resulted from training More likely to support informing risk groups about HIV/AIDS prevention Over half viewed syringe access favorably 5/6 unsupportive of detaining IDUs to improve public health 44% agreed that police should refer drug users to public health services (only 20% reported doing so) More open to networking and improving relations with NGOs

9. Clean Zone A most effective Psycho-Social Support Program for IDUs in Kyrgyz Penitentiary System is “Atlantis”. Modeled on the Polish program, “Atlantis” provides the drug treatment services, including very intensive psycho-rehabilitation component, but maximum stay is 1 ½ years. Then the former “Atlantis” clients commonly return to drug use when they joined the main prison population. That is why we provided a special penitentiary facility - “The clean zone ” - for people who have passed through the “Atlantis” and trying to stay off drugs and alcohol They have convoyed to the “Clean zone” from 11 prisons after completion the “Atlantis” course and can stay there through the rest of their term of imprisonment Currently more than 40 clients with a capacity of 100 Please note that these people are referred to as clients or patients, not inmates More donor support is needed to extend the program to the females facility

10. LEAHRN In 2010, with OSI support, in cooperation with Nossal Institute for Global Health, the University of Melbourne, we started a new project: Law Enforcement and Harm Reduction Network (LEAHRN) LEAHRN aims to connect people who want to know more about how police and harm reduction services can work together more effectively In order to provide with international platform for communication, we initiated a LEAHRN website http://www.leahrn.org/ - in English (moderated from Melbourne, Australia) and http://www.leahrn.ru/ - in Russian (moderated from Bishkek, Kyrgyzstan).

11. English (http://www.leahrn.org/) and Russian (http://www.leahrn.ru/)http://www.leahrn.org/http://www.leahrn.ru/ In recognition of the fact that HR is an integral component of the global HIV responce, we desided to broaden the website concept and extend its «area of interests» Whithin this new concept the site was re-named to Police and HIV Network The goal is to raise awareness and share best practices of successful cooperation of police, health workers, civil society, vulnerable groups, including IDUs and PLWHA.