Scaling-up harm reduction services towards universal

access in Asia

Models of good practice

ICAAP IXBali, Indonesia

Nai Zindagi,Pakistan

The Context15% yearly shift to injecting

Majority men of which 50% are married with 4 children

20% HIV prevalence among persons injecting drugs and up to 15% among their wives

Mostly poor and uneducated

Injecting drug use driven epidemic in Pakistan

PotentiaPotentia

l future l future

injectorsinjectors

CoverageGovernment financed- Civil Society implemented partnerships

15-18% have access to HIV prevention services

Services include SEP, minus OST

Quality of services varies

Mechanisms of engagement and monitoring in place

Scale up is possible

Outcome and Impact

Public-Private Partnerships work

Uninterrupted, at scale and consistent availability of services reduces transmission and incidence of HIV

Where programs exist coverage has been above 80%, resulting in a decrease and/or maintained prevalence

Transmission of HIV among people using drugs can be reduced with appropriate targeted interventions if initiated timely

Some lessons

Trust and time to build partnerships

Ownership - essential to mobilize

Compensate for weaknesses and strength

Accountability and transparency

Inclusion - not exclusion

Avoid pilots if you know it works - go to scale

Proposed scale up2010-2014

Province wide contracts to reach 60% coverage by 2012

Resource allocation expected from Government and Global Fund Round 9

Proposed program includes OST and services for wives and children

Access to HIV and AIDS services included

Evidence 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