Harm Reduction Drug Project Uzbekistan - Contact Netz

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Preface A Fact Finding Mission 1 into drug abuse in Uzbekistan which was carried out more than three years ago made one thing absolutely clear: Uzbekistan faces an enormous challenge with regard to injecting heroin use and HIV/AIDS. It is for this reason that we decided to focus the Switzerland-Uzbekistan Harm Reduction Drug Project on HIV prevention. Contact Net, with the help of its Uzbek partners and the two Contact Centres in Tashkent and Samarkand, has been involved in implementing the ambitious Harm Reduction Drug Project for a period of two years. The “grass roots” approach of this project is unique. For a period of one week in June 2003, an Uzbek delegation made up of all the representatives on the project Steering Committee was given an insight into the theory and practice of Switzerland’s drug policy and the work done in the field in Switzerland. The Uzbek delegation visited the Federal Office of Public Health (SFOPH), the premises of Contact Net, and Suchthilfe Region Basel (Drug Addiction Assistance Programme for the Basel Region). The Switzerland-Uzbekistan Drug Conference which Contact Net organised in Tashkent in July 2003, and the Harm Reduction Conference of Central Asia which took place in October of the following year, have been important milestones in efforts to develop meaningful co-operation. Thanks to a more interactive concept and setting, participants at both conferences were able to engage in active dialogue. Both conferences included a presentation of theoretical and practical knowledge from Switzerland, as well as comparisons between our project in Uzbekistan and the experiences of other harm reduction projects in Kyrgyzstan and Tajikistan. The learning process and the dynamics thus created have proven particularly useful in creating awareness and building capacity in Uzbekistan and Central Asia. The results of the discussion on comprehensive access to drug addicts, and the transfer of knowledge which took place between harm-reduction organisations at the October conference are particularly encouraging. The whole process has led to new approaches that hold out great promise for the future. Particularly worth mentioning in this context is the Harm Reduction Network of Central Asia, which was created as a result of this conference. One result of our efforts in Uzbekistan has been an increase in the commitment to harm reduction in Central Asia and in the corresponding know-how, as well as an increase in the readiness for dialogue among the various players. It is already clear that there has been a fundamental shift in attitudes with regard to drug-dependent individuals and related problems in the past three years. In particular, the focus has shifted from seeing drug addiction as a criminal activity to seeing it as an illness. There is a growing awareness that although it will never be possible totally to eradicate the drug problem as a social phenomenon, there is nonetheless a need for radical action. As in the story of the iceberg and the Titanic, it is important to become aware of, and be on guard against, the major problems associated with HIV/AIDS that are presented by the high risk group of injecting heroin users in Central Asia. The most important task is to provide information about HIV and Hepatitis C, as well as clean syringes and condoms, to the 95 per cent of injecting drug users who are not being reached by current assistance programmes. The drug projects in Tashkent and Samarkand enable us to provide a clear example of how concrete results can be obtained through a “snowball” system which involves volunteers and the drug addicts themselves. A major challenge in this context is the need for a new kind of collaboration between professional harm reduction groups, the police, and law enforcement bodies in general. 1 Conducted in March 2001 by Jakob Huber 3
1. Abstract BACKGROUND The number of injecting heroin addicts has risen sharply in Uzbekistan in the past few years in all sections of society. This has gone hand in hand with the spread of HIV/AIDS and Hepatitis C. Since Uzbek drug policy and efforts to combat drug abuse are to a great extent inadequate and overstretched there is little likelihood of dealing with the massive problem of heroin addiction without international support. A model project focusing on harm reduction and on helping drug addicts to survive, was developed with support from the Swiss government, inspired by the four-pillar model on which Switzerland’s own drug policy is based. The dissemination of information about HIV/AIDS and Hepatitis C, and the provision of clean syringes and condoms and related counselling services, should help to reduce the frequency of HIV and Hepatitis C infections in Uzbekistan. METHODS Co-operation with NGOs in Tashkent and Samarkand, creating Contact Centres, confidence-building with drug addicts, the “snowball” system, supplying syringes with the help of volunteers, involving the community and drug addicts themselves, strategic integration through the co-operation between Uzbekistan and Switzerland, and between the Tashkent Steering Committee, the Swiss Embassy and higher-level Uzbek officials in the Public Health, Justice and Police Departments. INDICATORS OF SUCCESS The number of syringes distributed and returned, the number of condoms distributed, the take-up of services offered by the Samarkand and Tashkent Contact Centres, adoption of the model project as part of the normal services provided by the healthcare systems in Uzbekistan and Central Asia, a Central Asian drug policy focused on harm reduction, and a drug strategy based on the Swiss four-pillar model. RESULTS Greater understanding of and support for harm reduction among government representatives, distribution of 300,000 syringes in six months, 1,200- 1,500 heroin addicts supplied with syringes, condoms and information. Access to drug addicts’ is far greater via Contact Centres than via government-run Trust Points. CONCLUSIONS The difficulty of implementing a harm reduction approach within the context of Uzbek drug policy, a trailblazing project that makes sense, lasting prospects, endangered by financial problems, the limitations of an institutionalised harm reduction strategy, the need for changes in attitudes , confidence, long-term prospects and financing, and also for cultural change. 4
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Page 7 and 8: policy that is undifferentiated and
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Page 11 and 12: 3.2 Key project data Harm Reduction
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Page 31 and 32: The features that the three options
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Harm Reduction Drug Project Uzbekistan - Contact Netz

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