Organisational Challenges to Organisational Challenges to scale up the responsescale up the response

Experience of Latvian Red Experience of Latvian Red Cross in HIV/AIDS workCross in HIV/AIDS work

Background on LRCBackground on LRCHistoryHistory– Movement since beginning of XX Movement since beginning of XX

centurycentury– Founded in 1918Founded in 1918– Soviet occupation and communism Soviet occupation and communism

regimeregime– Re-establishing of independence in Re-establishing of independence in

19911991– First peer education project on First peer education project on

HIV/AIDS in 1997 run by LRC YouthHIV/AIDS in 1997 run by LRC Youth– Permanent programme of LRCYPermanent programme of LRCY

– Concrete activities depend on Concrete activities depend on available resourcesavailable resources

HIV infections newly diagnosed, per million population, HIV infections newly diagnosed, per million population, WHO European Region, cases reported in 2001WHO European Region, cases reported in 2001

Estonia – 1067

Russia - 594

Latvia – 347

Cumulative number of HIV Cases in Different Transmission Groups July 1, 2002

2 2 2 516 18

57

99

1 2 2

50

7181

92 96

1 1 1 1 3 923

42

173

209

1 2 2 2

32

198

11

169

14 17 25 34

78 9

86

1412

86

1 16

125

311

685

13291576

0

40

80

120

160

200

240

280

320

360

400

1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

heterosexual

homosexual

unknown

from mother to child

injecting drug users

Overview of activitiesOverview of activitiesWe and AIDSWe and AIDS

– 1997, training seminars for adolescents 1997, training seminars for adolescents

Indirect InterviewIndirect Interview– Several stages on 1999, 2000 and 2001Several stages on 1999, 2000 and 2001– online website on HIV education online website on HIV education

questions of website visitors to HIV+ questions of website visitors to HIV+

opinions of different recognised persons opinions of different recognised persons and experts, discussionand experts, discussion

educational information, sitcom, etc.educational information, sitcom, etc.

comics provided by comics provided by Fondation pour la Fondation pour la Vie, La Tour-de-Peilz, Vie, La Tour-de-Peilz, SwitherlandSwitherland

other AIDS organisations used this page as other AIDS organisations used this page as an example for making their onesan example for making their ones

Overview of activitiesOverview of activities

TEAM 1 TEAM 1 – 2001/20022001/2002– Supported by Italian RCSupported by Italian RC– training of trainers – LRCY peer educatorstraining of trainers – LRCY peer educators

initiating phase to restart training seminars, initiating phase to restart training seminars, information campaigns and other activities in information campaigns and other activities in LatviaLatvia

includes not only prevention but also support includes not only prevention but also support work for young PLWHA, drug userswork for young PLWHA, drug users

will be no use for this training if there will not will be no use for this training if there will not follow centralise support and further trainings follow centralise support and further trainings and activitiesand activities

Overview of activitiesOverview of activitiesWe help to help yourselvesWe help to help yourselves

– 2001/20022001/2002– Supported by Italian RCSupported by Italian RC– syringes exchange syringes exchange

co-operation project with state co-operation project with state institution AIDS Prevention institution AIDS Prevention Centre and municipality’s Centre and municipality’s institution Drug Prevention institution Drug Prevention Centre of Riga CityCentre of Riga City

supporting information spreadsupporting information spread

providing syringesproviding syringes

Overview of activitiesOverview of activities11stst December 2001 December 2001 – in Rigain Riga

Ecumenical church serviceEcumenical church serviceTorchlight processionTorchlight processionPop / Rock concert Pop / Rock concert

– Activities in other parts in Activities in other parts in Latvia organised by Red Latvia organised by Red Cross Youth activistsCross Youth activists

Red Cross Day on 11Red Cross Day on 11thth May 2002May 2002– announcement on announcement on

launching of Global launching of Global Campaign Campaign

– symbolic blind folding of symbolic blind folding of famous youth pop starfamous youth pop star

Future activitiesFuture activitiesTraining Training

for trainers, volunteers, for trainers, volunteers, Focus on peer educationFocus on peer education

Information seminars and campaigns Information seminars and campaigns for adolescentsfor adolescents

Focus on peer educationFocus on peer education

Red Cross – open and safe place Red Cross – open and safe place where young people can meet and where young people can meet and either receive support, information, training or either receive support, information, training or be volunteer and help othersbe volunteer and help others

Future activitiesFuture activitiesMiscellaneous Activities Miscellaneous Activities

toward strengthening volunteer movement and youth toward strengthening volunteer movement and youth involvement involvement

– in interesting and useful activities in interesting and useful activities – giving them opportunity to escape or stop drugs usage, giving them opportunity to escape or stop drugs usage, – Restrict criminal behaviour Restrict criminal behaviour – Help learn lifeskills and change sexual behaviourHelp learn lifeskills and change sexual behaviour

Focusing on Focusing on – Peer educationPeer education– Harm reductionHarm reduction

Promotion of Red Cross Movement and its Promotion of Red Cross Movement and its involvement in HIV/AIDS preventioninvolvement in HIV/AIDS prevention

Commonly challenges Commonly challenges confronted in the development of confronted in the development of strategies for HIV prevention among strategies for HIV prevention among injecting drug users:injecting drug users:– Legal basisLegal basis– AwarenessAwareness– The The understanding of drug useunderstanding of drug use as a as a

social phenomenonsocial phenomenon– Multisectoral approachMultisectoral approach– Local responsibilitiesLocal responsibilities– AssessmentAssessment

From UNAIDS co-partner UNDCP research on drug use in From UNAIDS co-partner UNDCP research on drug use in Central and Eastern Europe and Central AsiaCentral and Eastern Europe and Central Asia

Legal basisLegal basis

A national strategy must build upon A national strategy must build upon legal frameworks adapted to allow a legal frameworks adapted to allow a comprehensive responsecomprehensive response

From UNAIDS co-partner UNDCP research on drug use in From UNAIDS co-partner UNDCP research on drug use in Central and Eastern Europe and Central AsiaCentral and Eastern Europe and Central Asia

AwarenessAwareness

A low level of awareness about the A low level of awareness about the problems of drug use and HIV/AIDS problems of drug use and HIV/AIDS among the general public, and among the general public, and inadequate knowledge about inadequate knowledge about measures of prevention, often leads measures of prevention, often leads to prejudices against drug usersto prejudices against drug users

From UNAIDS co-partner UNDCP research on drug use in From UNAIDS co-partner UNDCP research on drug use in Central and Eastern Europe and Central AsiaCentral and Eastern Europe and Central Asia

The The understanding of drug useunderstanding of drug use as a social phenomenon, as a social phenomenon,

and not purely a medical problem, and not purely a medical problem, must be fostered, and consensus on must be fostered, and consensus on HIV/AIDS prevention must be HIV/AIDS prevention must be reached among the general reached among the general population as well as among population as well as among professionals from various disciplinesprofessionals from various disciplines

From UNAIDS co-partner UNDCP research on drug use in From UNAIDS co-partner UNDCP research on drug use in Central and Eastern Europe and Central AsiaCentral and Eastern Europe and Central Asia

Multisectoral approachMultisectoral approachThere must be cooperation among all There must be cooperation among all

sectors in order to prevent HIV/AIDS sectors in order to prevent HIV/AIDS infection among drug users. This infection among drug users. This major public health objective can be major public health objective can be tackled using a multidisciplinary tackled using a multidisciplinary approach, which can be a new approach, which can be a new concept for most professionals. concept for most professionals. Constructive collaboration is Constructive collaboration is particularly important between the particularly important between the health and law-enforcement sectors health and law-enforcement sectors

From UNAIDS co-partner UNDCP research on drug use in From UNAIDS co-partner UNDCP research on drug use in Central and Eastern Europe and Central AsiaCentral and Eastern Europe and Central Asia

Local responsibilitiesLocal responsibilities

In the light of the experience of the In the light of the experience of the case studies, more responsibilities in case studies, more responsibilities in terms of decision-making powers and terms of decision-making powers and funding should be delegated and funding should be delegated and decentralized to the local leveldecentralized to the local level

From UNAIDS co-partner UNDCP research on drug use in From UNAIDS co-partner UNDCP research on drug use in Central and Eastern Europe and Central AsiaCentral and Eastern Europe and Central Asia

AssessmentAssessment

The extent of drug use and of The extent of drug use and of behaviour that puts a person at risk behaviour that puts a person at risk of HIV/AIDS is, in many cases, largely of HIV/AIDS is, in many cases, largely unknown. There is a need to carry unknown. There is a need to carry out research studies to assess and out research studies to assess and monitor the evolution of risk monitor the evolution of risk behaviour in order to inform national behaviour in order to inform national strategy development over timestrategy development over time

From UNAIDS co-partner UNDCP research on drug use in From UNAIDS co-partner UNDCP research on drug use in Central and Eastern Europe and Central AsiaCentral and Eastern Europe and Central Asia

Common Challenges at the Policy levelCommon Challenges at the Policy level

Awareness raising and advocacyStrategic planning of a multisectoral responseDesign of implementation policies – that are able systematically to broaden and

diversify existing treatment and care approaches,

– including reduction of the health and social consequences of drug abuse

Situation analysis of available resources and needs assessmentSustainability of interventions

From UNAIDS co-partner UNDCP research on drug use in From UNAIDS co-partner UNDCP research on drug use in Central and Eastern Europe and Central AsiaCentral and Eastern Europe and Central Asia

Common Challenges at the Policy levelCommon Challenges at the Policy levelIT IS VITAL in the implementation of preventive interventions TO INVOLVE of non-governmental organizations and the target populationBroad local alliances and constructive partnerships with all stakeholders must be established:– the local administration, – the police and – providers of health care from the state and non-

governmental sector, – as well as representatives of the target populations.

Also – improve services on the basis of local assessments and tailor them towards the target population

From UNAIDS co-partner UNDCP research on drug use in From UNAIDS co-partner UNDCP research on drug use in Central and Eastern Europe and Central AsiaCentral and Eastern Europe and Central Asia

RC/RC National SocietiesRC/RC National SocietiesMust be one of leading partners in Must be one of leading partners in HIV/AIDS preventionHIV/AIDS prevention– Especially in countries where it is not Especially in countries where it is not

active yetactive yet

Must take the leading role in Must take the leading role in combating stigma and discriminationcombating stigma and discrimination

Share and use experience of others Share and use experience of others in advocacy work and policy makingin advocacy work and policy making

Must use influence and power of Must use influence and power of global Movement of RC/RCglobal Movement of RC/RC