Scaling-up harm reduction services towards universal

access in AsiaModels of good practice

ICAAP IXBali, Indonesia

Nai Zindagi,Pakistan

The Context15% yearly shift to injectingMajority men of which 50% are married with 4 children 20% HIV prevalence among persons injecting drugs and up to 15% among their wivesMostly poor and uneducatedInjecting drug use driven epidemic in Pakistan

PotentiaPotential future l future

injectorsinjectors

CoverageGovernment financed- Civil Society implemented partnerships15-18% have access to HIV prevention servicesServices include SEP, minus OSTQuality of services variesMechanisms of engagement and monitoring in placeScale up is possible

Outcome and Impact

Public-Private Partnerships workUninterrupted, at scale and consistent availability of services reduces transmission and incidence of HIVWhere programs exist coverage has been above 80%, resulting in a decrease and/or maintained prevalenceTransmission of HIV among people using drugs can be reduced with appropriate targeted interventions if initiated timely

Some lessonsTrust and time to build partnershipsOwnership - essential to mobilizeCompensate for weaknesses and strengthAccountability and transparencyInclusion - not exclusionAvoid pilots if you know it works - go to scale

Proposed scale up2010-2014

Province wide contracts to reach 60% coverage by 2012Resource allocation expected from Government and Global Fund Round 9 Proposed program includes OST and services for wives and childrenAccess to HIV and AIDS services includedEvidence based workable plan, dependent on resources

Our approach

HIV & AIDS

Drug Use Poverty

Client conceptualized

and client driven

Drug treatment services(40%)

HIV prevention and AIDS related services

(80%)

Skills training and employment

(20%)

Thank you