1. © 2005, CARE USA. All rights reserved. Inter country consultation on preventing HIV among IDU from evidence to action Bangladesh Presentation

2. © 2005, CARE USA. All rights reserved. HIV IN male IDU from central-a over the rounds

3. © 2005, CARE USA. All rights reserved. Official estimates of opiate users & sources  Injection drug users low range- 20000  Injection drug users high range-40000 Ref: Working group on size estimation of HIV/AIDS infection in Bangladesh, March 22, 2004; final estimate recommended by the same group in Nov 28, 2004.

4. © 2005, CARE USA. All rights reserved. Coverage among IDUs  40% IDUs of lowest estimate  20% IDUs of highest estimate  50% Heroin smokers  Harm reduction program-through drop-in-center and out reach (peer approach)  Blended experience and contribution of multiple stakeholders, GoB, ICDDR,B, MSCS, APOSH and other PNGOs.  Drug treatment through FHI-Implementing Agencies, SHGs and private treatment centers

5. © 2005, CARE USA. All rights reserved. Opportunities to scale up Increase coverage of I/DUs Introduce ODS Facilitate linkages and ownership within government infrastructure for a sustainable and cost effective program (e.g. STI/OI mgt, Detox and GH). More community involvement e.g. to explore alternative options of DIC, its mgt and referral.

6. © 2005, CARE USA. All rights reserved. Challenges  NASP/DNC understands the importance of HR program and ODS but both not legalised. Proactive steps needed to legalize both.  Limited in-country technical capacity/resources in ODS, VCT, PEP, minimum standard STI etc.  Limited capacity of NGOs to implement harm reduction program  Resources are there but uninterrupted fund flow to field is poor

7. © 2005, CARE USA. All rights reserved. NEXT STEPS  Policy influence in favor of NEP and ODS  Sensitize and build capacity of GoB and local partners to deal the issues drug users.  Better community involvement in addressing the issues of IDUs  Job placement/social reintegration through multisectoral approach.  National and regional networking in addressing the issues of drug users  Coordination among donors and implementers in avoiding duplication of work  Strengthen IDU-SHGs so that they can articulate and meet their needs independently. Their organizational capacity is poor compared to other SHGs.