AHRN

This project is an AHRN initiative implemented in partnership with Mainline with financial support from the Dutch Ministry of Foreign Affairs

'From Margins to Mainstream' is an initiative of the Asian Harm Reduction Network (AHRN) implemented in collaboration with Mainline Foundation supported by the Dutch Ministry of Foreign Affairs. The 'From Margins to Mainstream' project is being implemented in Cambodia, India, Indonesia, Nepal and Pakistan. The core premise of the project is that HIV/AIDS and drug use in Asia are largely driven by poverty. Therefore, the project seeks to address the root causes of HIV/AIDS and drug use - poverty - through employment schemes and income generation projects to facilitate the reintegration of recovering drug users based on the situation in each country. In just a short time, the project has demonstrated that people recovering from drug use can be productive citizens if they are provided with the necessary support and opportunities.

The 'From Margins to Mainstream' project represents a unique collaboration between AHRN, Thailand and Mainline Foundation, the Netherlands. For a number of years, AHRN has sought to bring the expertise and knowledge possessed by Mainline to the Asian region. In 2004, this was realised through a joint and collaborative bid to the Dutch Ministry of Foreign Affairs (MOFA) to finance an Asian regional programme. The programme concentrated on the triple nexus that exists between poverty, injecting drug use and HIV/AIDS. AHRN’s local experience was invaluable in generating a strategy to respond to the challenges in the region by developing replicable impact-based models of intervention which support the continuum of care for drug users.

In Nepal (Kathmandu), Youth Vision has developed an outreach programme to current users in the Kathmandu valley. As part of this programme it is hoped that pharmacotherapy using buprenorphine will be trialled in Nepal.

In Cambodia (Phnom Penh), Friends International and Mith Samlanh are providing technical assistance to government departments and other actors to enlarge the capacity of outreach to young people (street children) who are increasingly drawn into drug use. In addition, a small business – Creative Design Studios – is focussed on teaching design concepts and unleashing the creative potential and entrepreneurial ability of young people completing rehabilitation.

In Indonesia (East Kalimantan), LARAS is pioneering outreach services to drug users in Samarinda and health and social care services to sex workers in sex villages outside Samarinda and Bontang.

The first year of the programme concentrated on developing the specific design of projects, the project structure, establishing principles of how outcomes would be delivered and building the implementation network. All partners have signed contracts which include details of the objectives to be achieved under the project.

The partnership with the Dutch Ministry of Foreign Affairs (MOFA) in the Netherlands was established productively. MOFA has proved to be a flexible and supportive partner and demonstrates an excellent understanding of development dynamics and in particular is extremely supportive of measures aimed at improving the debilitating nexus of drug use, HIV/AIDS and poverty.

This project will seek to improve overall quality of life through increased prevention and treatment health and social care service options. This will be achieved in large part through the design, implementation and transfer of advanced intervention models to local leaders in order to build harm reduction capacity and skills in Cao Bang and Son La.

At the outset, the project will have led to:
- Improved insight in the scope, characteristics and patterns of drug use
- Inception of a HIV and drugs resource center to serve as a model for such centres elsewhere;
- Improved advocacy and HIV/AIDS prevention capacity in the health, community, and mass organisation sectors;
- Improved capacity along with provision of essential materials on harm reduction advocacy among communications specialists;
- Improved HIV/AIDS management capacity among local and national government stakeholders;
- Development of platforms and materials to raise awareness, reinforce education and discuss HIV/AIDS prevention and harm reduction among local community groups;
- Improved counseling methods on the basis of harm reduction approaches;
- Development of protocols for peer-based outreach, needle and syringe exchange, pharmacotherapy, continuum of care, networking and referral services;
- Development of behavior change strategies based on the harm reduction approach;
- Developed strategies on community involvement.

These will be achieved through a wide range of activities, including:
· Rapid assessments and response (RARs), in both provinces (phased: first in Cao Bang, later in Son La);
· Collection, development, translation and tailoring of IEC and BCC materials to be used during training workshops as well as made available to the Resource Center and GTZ;
· Exposure tours to exemplary harm reduction interventions and organisations with key stakeholders;
· Training of local project staff in both provinces under leadership of and with inputs from trainers from AHRN Secretariat (Chiang Mai, Thailand) and through supervised hands-on experience.
· Harm reduction TOT workshops at the district, provincial and national levels to develop the technical skills of existing government and NGO staff;
· Advocacy meetings with key stakeholders in law enforcement, policy making, media, the Party, at the provincial and district level;
· Public awareness campaign through existing television and radio channels;
· Partnerships with local stakeholders;
· Continuous monitoring and midterm and final evaluations based on the indicators developed in the project proposal and workplan.

For further information please contact
Dr. Harm Peters, Project Manager Asian Harm Reduction Network (AHRN)
Second Floor,11 Hoang Nhu Street, Hop Giang WardCao Bang Town,
Vietnam Tel: +84 26 953702 Fax: +84 26 953875
email: peterh@ahrn.net

FHI / ASA Project

Over the years, AHRN's support to harm reduction in Indonesia has focused on advocacy, networking, and capacity building. AHRN also invested in the development of a nationwide scale-up strategy. In close collaboration with senior government officials, AHRN submitted proposals for nationwide scale-up of harm reduction service delivery. As these proposals were not endorsed by central level authorities, AHRN's services could not be retained and have resulted in the official suspension and closure of AHRN activities at the Jakarta office as of October 2006.

AHRN remains committed to service delivery to marginalised communities in Indonesia and continues to support LARAS Foundation in East Kalimantan. LARAS is pioneering outreach services to drug users in Samarinda and health and social care services to sex workers in sex villages outside Samarinda and Bontang. For more information, contact A. M. Aslam, Executive Director, LARAS at idus_sellang@yahoo.com or Shanya Attasillekha at shanyaa@ahrn.net.

In September 2005, AHRN-Indonesia closed its Harm Reduction for Advocacy project with FHI under its Aksi Stop AIDS (ASA, Action to Stop AIDS) programme which began in October 2002 under Camille Lemouchoux, former AHRN Country Coordinator. This harm reduction project was operated with Aksi Stop AIDS (a programme funded by the Family Health International) and the Centre for Harm Reduction (CHR-Australia).

This programme has facilitated:
- the establishment and training of the Indonesian Harm Reduction Network (Jangkar), including a local language newsletter, a discussion group (in Bahasa Indonesia), a website and a clearinghouse;
- a series of training and advocacy workshops with law enforcement personnel and local NGOs; and
- harm reduction policy orientation to the Netherlands for high-level government, NGO and media representatives.

1. Support the National Harm Reduction Network, JANGKAR (continued from previous Task Order);

2. Increase tolerance and coordination of law enforcement agencies (police, BNN, and BNP) towards harm reduction and harm reduction programmes.

After the successful establishment of JANGKAR in 2002-2003, and the provision of cost-effective means for communication and advocacy, from 2004, AHRN gradually saw to the network’s transition into an independent self-governed body. The process began with its new organisational structure, a newly-elected governing body under the leadership of its secretariat, a larger contribution in the content of its egroup discussions and the Kabar Jangkar newsletter. Access to the Levi Strauss Grant Funding has provided JANGKAR's secretariat stability and sufficient leverage to pursue other funding options in order to continue providing the services established with AHRN's collaboration, and to mechanise the network’s work plan.

The success of the NGO workshop and training that AHRN recently organised for programme managers and field workers on behaviour change, ARV access and adherence for IDUs, respectively, are new programme niches that need to be filled in partnership with other donor agencies.

The development of the protocol for NGO-Police collaboration and the pursuit of a harm reduction training course for the police were turning points in AHRN’s advocacy startegy and helped steer an imminent transition from the BNN to the Indonesian National Police. Akin to this is developing a strategy that will consider the National Strategy for the Prevention and Control of HIV/AIDS and Drugs Abuse in Indonesian Correction and Detention Centres (2005-2009), which will address police engagements at the national, provincial and district levels.

JANGKAR, the BNN (National Narcotics Board), the criminal justice system, the KPA (National AIDS Committee) and other donor agencies have been AHRN’s key partners in the broader response to drug use and HIV/AIDS in Indonesia in the last three years.

The success of AHRN’s programmes with FHI-ASA lie in the continuing coordination it has fostered and the consequent respect for the niche it has created among different sectors and partners within the national response to the injecting drug use and HIV/AIDS epidemic. This is being reflected in AHRN’s plans to further and broaden technical assistance to Indonesia.

In May 2005, AHRN, together with the Centre for Harm Reduction (MacFarlane Burnet Institute-Melbourne), secured a 12-month grant funding from Levi’s Strauss Foundation (15 June 2005 to 15 June 2006), covering these components:

1. Technical assistance and capacity building to a local NGO at one site in Java, Indonesia to implement evidence based, harm reduction and HIV/AIDS programmes (under CHR’s technical management); and,

2. Support to the ongoing development of the JANGKAR network of organisations specialising in HIV responses amongst IDU.

Because of its current relationship with JANGKAR from its inception, Component 2 was developed by AHRN in consultation with the network through its Secretary General, and considering its work plan that was ratified in February.

AHRN provided the Indonesian National Harm Reduction Network with technical support in office and fund management and administration for this Levi’s grant.

In October 2005, AHRN secured six months of funding from the Indonesia HIV/AIDS Prevention and Care Project (IHPCP, funded by AusAID) to provide capacity building and training in service delivery, and harm reduction for NGOs, community health centres and law enforcement agencies in Indonesia. Our activities included:

1. Training on prevention, care, support and treatment for HIV/AIDS among IDUs for field workers of new NGO and community health centres that IHPCP is supporting in six provinces;

2. Capacity building for implementing agencies on harm reduction for alcohol use for field workers of new implementing agency partners West Papua and West Timor;

3. Enabling environment for implementing agencies and IDUs through awareness and capacity building for narcotics and law enforcement agencies (strategic planning for national, provincial and district-level police collaboration, and organise a national workshop);

4. Training for field workers on needle and syringe programme (NSP) service delivery, and outreach.