Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Taking harm reduction to Capitol Hill


Viktoria (right) and her colleague handing harm reduction info and supplies © Alliance

Issues relevant to injecting drug users will be taken to Capitol Hill, during the Millennium Development Goals (MDG) Summit in New York this month (20-22 September).

Advocates and implementers of harm reduction from around the world will meet at a policy event in Washington to identify common challenges and synchronize advocacy asks. The event is sponsored by UNAIDS and the Injecting Drug Use Working Group of the Global AIDS Roundtable, of which the Alliance is a member. The purpose of the meeting is to strengthen the US response domestically and abroad.

Participants will largely be from the US, but also in attendance is Pavlo Smyrnov, Deputy Executive Director at Alliance Ukraine. He will share how Alliance Ukraine took harm reduction to the national scale through the USAID’s SUNRISE programme and programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The programme included the rapid scale-up of antiretroviral therapy (ART), a comprehensive package of care, support and prevention services for most-at-risk populations, including drug users and their partners, and the roll-out of substitution maintenance therapy. One of the people who benefited from the programme is Viktoria.

Viktoria’s story

Viktoria felt desperate when she first tested positive for HIV. She lives in Cherkassy, Ukraine, where stigma towards drug users and people living with HIV is routine. As an injecting drug user and a single mother with a small child to consider, she simply did not know where to turn. With no money and no job, continuing to gain comfort from drugs seemed, at first, the only option.

Fortunately friends were able to refer her for help and she took their advice. Three years on she is drug free, and her life and the life of her child have drastically changed.

Viktoria is testament that harm reduction and peer driven interventions work. Not only was she referred by friends, but she is now a peer outreach worker herself. Viktoria works for the Heart-to-Heart Foundation in Cherkassy, which is supported by Alliance Ukraine under the national programme on HIV prevention financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria. She started off as a volunteer and now works full-time.

Her work includes taking harm reduction materials out on the street, including clean syringes, spirit wipes and information, on how to prevent HIV and of the support available. As of July 2010, the Alliance Ukraine programmes funded by the Global Fund and USAID had reached more than 300,000 people who inject drugs with HIV prevention services, and have helped slowed the spread of HIV infection among injecting drug users in Ukraine.

Some of Viktoria’s clients are the same people she used to inject with.

“I had good connections with these people when I was using. Knowing me as a drug user and seeing how I’ve changed is a good example for them . . . they can see there can be a before and after, and they trust me because of my experiences.”

It’s not just the clients that Viktoria has developed trust with since giving up drugs with the help of substitution therapy over two years ago. She believes her son, now six, was deeply affected by her drug use.

“I believe before he didn’t open up that much to me, but now the relationship is very good. Before I wasn’t capable of spending much time with him, now we spend much more time together.”

Not being there enough for him previously troubles Viktoria but she is determined to make up for it and more. Her role as a mother is her number one priority.

“I am a single mother and he relies on me for all his support,” says Viktoria.

“I can wake up in the morning, spent time with my son, take him to kindergarten and go off to work. That makes me happy. Before I stopped using, I’d wake up feeling sick and didn’t have the strength to even get him to kindergarten.”

“I’m glad I don’t embarrass him anymore. He can be proud of me.”

    Through my transformation they can see there can be a before and after