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Scaling Up Harm Reduction Services: Achieving Universal Access in Asia

Learn about models of good practice in scaling up harm reduction services towards universal access in Asia, focusing on the context and potential future injectors in Bali, Indonesia and Nai Zindagi in Pakistan. Discover the coverage, outcome, and impact of government-financed civil society partnerships, and the lessons learned for successful scale-up.

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Scaling Up Harm Reduction Services: Achieving Universal Access in Asia

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  1. Scaling-up harm reduction services towards universal access in AsiaModels of good practice • ICAAP IX • Bali, Indonesia • Nai Zindagi, • Pakistan

  2. The Context Potential future injectors • 15% yearly shift to injecting • Majority men of which 50% are married with 4 children • 20% HIV prevalence among persons injecting drugs and up to 15% among their wives • Mostly poor and uneducated • Injecting drug use driven epidemic in Pakistan

  3. Coverage • Government financed- Civil Society implemented partnerships • 15-18% have access to HIV prevention services • Services include SEP, minus OST • Quality of services varies • Mechanisms of engagement and monitoring in place • Scale up is possible

  4. Outcome and Impact • Public-Private Partnerships work • Uninterrupted, at scale and consistent availability of services reduces transmission and incidence of HIV • Where programs exist coverage has been above 80%, resulting in a decrease and/or maintained prevalence • Transmission of HIV among people using drugs can be reduced with appropriate targeted interventions if initiated timely

  5. Some lessons • Trust and time to build partnerships • Ownership - essential to mobilize • Compensate for weaknesses and strength • Accountability and transparency • Inclusion - not exclusion • Avoid pilots if you know it works - go to scale

  6. Proposed scale up2010-2014 • Province wide contracts to reach 60% coverage by 2012 • Resource allocation expected from Government and Global Fund Round 9 • Proposed program includes OST and services for wives and children • Access to HIV and AIDS services included • Evidence based workable plan, dependent on resources

  7. Our approach HIV prevention and AIDS related services (80%) HIV & AIDS Client conceptualized and client driven Poverty Drug Use Drug treatment services (40%) Skills training and employment (20%)

  8. Thank you

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