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PROGRAMME HIGHLIGHTS 1 Thursday, 31 March 11:00 - 12:00 Lebanon Press Club Palm Ctr bldg, 7th flr, Furn El Chabbak Press conference: Harm Reduction 2011 launch Harm Reduction in the Middle East Speakers include: Rick Lines, Executive Director International Harm Reduction Association (IHRA) Elie Aaraj, Secretary General of Soins Infirmiers Développement Communautaire (SIDC), Director of the Middle East and North Africa Harm Reduction Network (MENAHRA) Paddy Costall, Managing Director, Conference Consortium Georges Kordahi, MBC TV personality Rahaf Abdallah, Miss Lebanon 2010-2011 Saturday 2 April 12.00-18.00 Metropolis Art Cinema Empire Sofil - Achrafieh Lebanon MTV international Drugs and Harm Reduction Festival Opening speaker: Georges Kordahi Opening film: This is My Destiny (Afghanistan) Film Full public program available at ihra.net/conference Note: A more extensive film festival runs from 12.30-18.00 daily ONSITE for conference delegates only ihra.net/conference Sunday 3 April 16.20-18.00 Banquet Hall 1+2 Opening Ceremony Speakers: Rick Lines, Executive Director, International Harm Reduction Association Elie Aaraj, Secretary General of Soins Infirmiers Développement Communautaire (SIDC), Director of the Middle East NAD North Africa Harm Reduction Network (MENAHRA) Nabil Kahalah,President of the Municipality of Sin el Fil Jude Byrne, Chair of International Network of People who use Drugs Anita Krug, YouthRISE Hussein Gezairy, Regional Director, World Health Organization Moahamad Jawad Khalifeh. Minister for Health, Lebanon Georges Kordahi, MCB TV personality Keynote speaker: Joanne Csete, Associate professor of Clinical Population and Family Health, Columbia University, USA Intersecting inequities: In search of drug policy justice Monday 4 April 09.00-10.30 Banquet Hall 1 +2, Plenary Room The experience of implementing harm reduction in Indonesia Nafsiah Mboi, Secretary, Indonesian National AIDS Commission, Indonesia By 2006, unsafe drug injecting contributed a significant proportion (48 - 50%) of reported HIV infections in Indonesia, the world’s fourth most populous country. Indonesia’s response was hampered by laws criminalising the carrying of needles and syringes and controlled substances and the resistance of some in government to change existing regulations and attitudes toward the injecting of drugs. By 2009, 281 NSPs and 54 OST were established in 16 provinces. In 2009 a new drug law recognised the human rights of PWIDs including the right to treatment, rehabilitation and protection from prosecution for drug use. Reported new HIV infection among PWIDs declined from 1517 (2006) to 1156 (2009); HIV prevalence among PWIDs decreased from 48%50% (2006) to 39% - 42% (2009) 09.00-10.30 Banquet Hall 1 +2, Plenary Room Evolving harm reduction strategy in MENA region: the experience of the Middle East and North Africa Harm Reduction Network (MENAHRA) Elie Aaraj, Director, MENAHRA 14.00-15.30 Banquet Hall 1+2 ,Plenary Room Social marketing of safe injecting kits in Kabul, Afghanistan Presenter: Murtaza Majeed, CEO, one23, Afghanistan Very limited resources were allocated or mobilised for harm reduction interventions. By the end of 2010, OST has been introduced in Morocco, Afghanistan and Lebanon. Pakistan has mobilized resources for introducing OST and scaling up other harm reduction services. Tunisia and Syria attempted mobilizing resources for harm reduction from the Global Fund (GF). Oman initiated actions for introducing OST and Bahrain requested MENAHRA’s assistance to explore possibilities. MENAHRA mobilised substantial resources for harm reduction from the GF. Social Marketing utilises private sector delivery channels, in this case pharmacies, to deliver essential health products. Utilising existing facilities such as pharmacies allows better accessibility and choice among IDU to decide where they access their clean equipment. It is also far more cost effective as the infrastructure already exists. 11.00-12.30 Banquet Hall 1+2, Plenary Room Lobbying for national policies: a lesson in diligence and collaboration Presenter: Nadya Mikdashi, Executive Director, Skoun, Lebanon A network of 30 pharmacies who have been sensitised keep a regular stock of kits that IDUs can visit at their convenience and exchange a voucher and used equipment for clean injecting kits. The pharmacies have a branded sign indicating a “trust point” where IDUs can exchange a voucher for a clean injecting kit. The pharmacist exchanges vouchers received for new stock and also a financial incentive for each kit distributed The Lebanese Dug laws were revised in 1998 decriminalizing addiction. 11 years later too many people are still being incarcerated and have no access to services. The response to the Lebanese drug problem has lain mainly in the non governmental sector and in drug control efforts by the government with little or no ministerial budgets and policies allocated towards effective responses. 14.00-15.30 Banquet Hall 1+2, Plenary Room A women's drug clinic in Iran: improvements in drug use, social functioning and low HIV/HCV seroincidence Presenter: Shabnam Salimi, National Centre for Addiction Studies (INCAS), Iran 11.00-12.30 Banquet Hall 3,Major Room The use of modelling to improve drug policy: experiences from the Australian drug policy modelling program Presenter: Alison Ritter, Acting Director, National Drug and Alcohol Research Centre, University of New South Wales, Australia In 2007 we established a Women’s Drug Clinic with methadone, sexual and general health care and NSP to improve their health. We aimed to build capacity among drug workers and researchers in Iran. The study aimed to monitor women in treatment and those who left treatment early. Good drug policy is based on a solid evidence-base however the evidence-base is problematic: in some areas we lack evidence; in others the evidence is contradictory; and overall, much research does not address questions of direct relevance to policy. One possible way of overcoming these limitations is to use alternate methods for generating policy relevant evidence – that is models or simulations. 14.00-15.30 Banquet Hall 1+2, Plenary Room The status of the HIV epidemic among injecting drug users in the Middle East and North Africa Presenter: Ghina Mumtaz, Senior Epidemiologist, Weill Cornell Medical College, Qatar 3 A comprehensive systematic review of HIV and IDUs in MENA was conducted through the MENA HIV/AIDS Synthesis Project. 20 years, restriction on alcohol promotion, sale and advertising. We conducted a qualitative study among under-aged youth to examine the nature of alcohol consumption and the relationship between alcohol and sexual risk behaviours. 14.00-15.30 Rabieh, Concurrent Room Meeting the needs of female drug users in Cambodia Chhen Reksmey, The Satrey Programme, Cambodia 16.00-17.30 Rabieh, Concurrent Room 25 years of safe injecting facilities and 15 years of heroin-assisted treatment as a regular treatment option in Switzerland: present state and future directions Presenter: Robert Haemmig, University of Psychiatric Services, Berne, Switzerland The Satrey programme conducts outreach services to 23 ‘hotspot’ and provides services at the Korsang drop in centre in the capital city of Phnom Penh. Services include health education, medical care, referral for HIV, STI and ARV services, drug overdose prevention, counselling, and temporary shelter. The combination approach of outreach and drop in centre services by female staff are essential to meeting the needs of women who use drugs. 16.00-17.30 Hamra, Concurrent Room Why I did drugs: a glimpse into the life of young Lebanese drug users Presenter: Patricia Haddad, MENAHRA, Lebanon 14.00-15.30 Hamra, Concurrent Room Alcohol related violence: a real but as yet undefined obstacle to development in the Pacific region Presenter: Robert Power, Principal for Disease Prevention, Burnet Institute, Melbourne, Australia. There are few studies related to illicit drug use in Lebanon. According to local rehab centres the number of drug users is on the rise even though the studies that are done do not reflect this. The objective of this study was to consider and appreciate the points of view of young adults that have experienced illicit drug use to gain a better view of why youth initiate and/or continue to use drugs in Lebanon in order to contribute to the design of local preventive programs. The Pacific was virtually alcohol free until twenty years ago. Our recent rapid assessments in Papua New Guinea and Fiji explore the relationship between alcohol consumption and polysubstance use and violence. Tuesday, 5 April 14.00-15.30 Hamra, Concurrent Room Alcohol drinking environment and sexual risk among underage young Thai Bangorn Sirirojn, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand 09.00-10.30 Banquet Hall 1+2, Plenary Room A global review of the risks and services needs of women who inject drugs Presenter: Bronwyn Myers, International Reference Group to the United Nations on Injecting Drug Use and HIV Background –Thailand’s per capita alcohol consumption is fifth highest in the world and has tripled over the past 14 years and Thai youth have high rates of alcohol consumption. In response, the Thai Government enacted an alcohol control law in 2008 that included increasing the alcohol purchasing age from 18 to Women are often ignored in discussions about people who inject drugs. From the evidence available in many parts of the world, women appear to comprise only a small proportion of people who inject drugs, yet evidence suggests that women face more 4 risks and experience greater harms than male injectors. Women injectors also face more barriers to services than their male counterparts, which further entrenches their vulnerability to drug-related harms. The Egyptian Prisons Authority has embarked on a groundbreaking initiative to establish a national strategy for HIV and drug-use prevention inside prison settings, including strengthening prevention, treatment, care and support services for prison inmates, in cooperation with the competent government agencies, international organizations and civil society institutions. 09.00-10.30 Banquet Hall 1+2, Plenary Room Young people leading the drug policy revolutions Presenter: Aram Barra, Projects Director, Espolea, Mexico 11.00-12.30 Banquet Hall 4, Major Room HIV prevention and reducing negative consequences of drug use in prisons in Morocco Presenter: Fatima Asouab, Ministry of Health, Morocco From the 12 year old boy that shoots up heroin in the Ukraine, to the young indigenous coca leaf grower in Bolivia, or the 16 year old ketamine user at dance clubs in Europe, young people are involved in both the demand and supply of drugs. We are active in prevention, harm reduction and treatment responses and are relevant actors in making decisions regarding the policies that affect our own lives. health The increasing prevalence of injecting drug use in Moroccan prisons reached an estimate 6%. In response to this, the Penitentiary Administration together with the Moroccan MoH and supported by UNODC- ROMENA started a comprehensive Harm Reduction intervention in prisons settings implemented in collaboration with NGOs with long working experience with drug users. The intervention started by implementing a comprehensive harm reduction program covering access to basic health, providing sterile injection material and behaviour change communication. 09.00-10.30 Banquet Hall 1+2, Plenary Room Hard to reach communities – who do we mean and why do we talk about them? Pye Jakobsson,Rose Alliance, Sweden Often service providers express concerns and frustrations regarding working with, so called, 'hard to reach' groups. People are seen as being especially hard to reach if they belong to more than one marginalised group, for example sex workers who use drugs. It seems that if it’s not a male drug user hanging in the street or a female sex worker standing on a street corner one is hard to reach, a concept not seldom used as an excuse to avoid working with certain groups. 11.00-12.30 Banquet Hall 4, Major Room Developing harm reduction interventions in Prisons Presenter: Bahman Ebrahimi, Iran Prisons Organisation, Iran An evaluation of harm reduction practices in Iranian prisons. 14.00-15.30 Banquet Hall 1+2, Plenary Room Sacrificing harm reduction practice to moral ideology: the example of the USAID anti-prostitution pledge Presenter: Melissa Hope Ditmore, Research Fellow at the Centre for the Study of Women and Society, University of New York, USA 11.00-12.30 Banquet Hall 4, Major Room The Egyptian experience in drug-use and HIV prevention within prison settings Presenter: Atef Sherif, Deputy Minister of Interior for the Egyptian Prison Authority, Egypt 5 Since 2003 and the Bush administration, US government grants to address the HIV/AIDS pandemic have been subject to an anti-prostitution requirement that forbids the 'promotion of prostitution' by grant recipients. It has been documented that the requirement of a ‘pledge’ not to promote prostitution has diminished the efficacy of some HIV prevention efforts for sex workers. In 2010, the Obama administration extended the pledge requirement. In the context of sex work, the sacrifice of harm reduction practice to the forms of moral ideology embedded within these policies have and continue to render portions of US government aid spending both brutal and ineffective. Therefore, we aim to minimise the violence caused by the drug trade by reclaiming the favelas. If drug trading is done peacefully, we see this as a major success. UPP ensure safety within favelas so that local initiatives can work with the favela residents to provide alternatives to the drug trade, for example, to teach young people English to become tour guides, or play the drums. Without first creating safe conditions, it will be impossible for favela residents to escape the vicious circle of drugs and crime. 16.00.17.30 Rabieh, Concurrent Room Prisons as a source of tuberculosis: findings from qualitative research in a Russian city Presenter: Anya Sarang, Head, Andrey Rylkov Foundation, Russia 14.00-15.30 Banquet Hall 3, Major Room Drug policy in African countries: a concern for young people Presenter: Adeolu Ogunrombi, Community Youth Advancement Initiative Nigeria, Nigeria Issue Russia is the second leading country in the rate of incarceration. Some estimates suggest up to 80% are sentenced because of drug-related crime. Drug use is prevalent in prisons, and HIV prevention is absent. Russia has a growing problem of tuberculosis (TB), and is among the three leading countries with the highest incidence of MDR-TB. Tuberculosis is the leading cause of death among people with HIV. Africa is currently witnessing a youth bulge in population. Many of these young people are initiating drugs and consequently affected by drug policies which are punitive and lack scientific evidence. Globalization and shifts in the global drug trade have led to sharp increases in the availability of illicit drugs and increased domestic drug use across Africa. The United Nations estimated that about $1 billion worth of cocaine destined to Europe from Latin America passed through West Africa in 2008. 16.00.17.30 Rabieh, Concurrent Room Prevalence and risk factors of pulmonary tuberculosis among prison inmates in Khartoum, Sudan Presenter: Hamza Omer, Human Rights Ambassador, Permanent Mission of the Republic of the Sudan to the United Nations Office at Geneva 16.00.17.30 Banquet Hall 4, Major Room Reducing harm: innovative policing in Brazil Presenter: Leonardo Nogueira, Police Pacification Unit (UPP), Rio de Janeiro, Brazil A cross sectional study design was used to determine the prevalence and risk factors associated with TB suspicion and smear positive pulmonary tuberculosis (SPPTB) among prison inmates in Khartoum, Sudan in the year 2007. A sample of 382 prison inmates were selected from 2647 prisoners to participate in the study from Khartoum state prisons (Khartoum and Khartoum north correctional institutes, Soba prison, Omdurman Drug-related violence, rife in the favelas of Brazil, is largely fuelled by prohibitionist laws. Having worked for many years as a police officer, and for five years taking part in dramatic interventions in favelas, it is clear how ineffective and harmful such policies are. 6 men and Omdurman women prisons) according to their population proportions. 09.00-10.30 Banquet Hall 3, Major Room Will availability to Swedish type smokeless tobacco (snus) speed up quit-rates for cigarette smoking? Empirical findings from Norway and Sweden Presenter: Karl Lund, Research Director, Norwegian Institute for Alcohol and Drug Research, Norway 16.00-17.30 Hamra, Concurrent Room Lesbian, bisexual and queer women and health in Lebanon Presenter: Anthony Rizk, Board member, Helem, Lebanon It is widely believed that Sweden has the West's lowest smoking rates because of the substitution of smokeless tobacco (called "snus" in Sweden) for smoking. Elsewhere in the EU snus is banned, and opponents of lifting the ban often claim that there is no evidence that snus is useful for smoking cessation. However, in countries exempted from this ban like Norway and Sweden, snus has for some time been the preferred method for quitting among male smokers, and the method has also been adopted by an increasing number of female smokers. Helem is a non-government organisation that was formed in 2004 to lead a peaceful struggle for LGBT equality rights in Lebanon. The organisation’s work encompasses health, advocacy, media, legal representation, and awareness raising activities among others. Session attendees will gain insight into the challenges that this LGBT health and advocacy agency experiences working in a setting where both drug use and homosexuality is illegal. There will be opportunities to discuss drug use issues among LGBT people in Beirut, and how Helem responds to these issues using a harm reduction approach. 09.00-10.30 Banquet Hall 4, Major Room Implementing comprehensive case management in opioid substitution therapy in Kabul, Afghanistan Presenter: Senop Tschakarjan, Medical Coordinator, Médecins du Monde (MDM), Kabul, Afghanistan Wednesday, 6 April 09.00-10.30 Banquet Hall 1+2, Plenary Room Presenter: Maysa Kassabry, Palestinian Territory MDM is implementing a model program for comprehensive harm reduction in Afghanistan since 2006. Case Management is being implemented since the start of Opiate Substitution Therapy. Participants include 3 medical doctors, a nurse, a psychologist, a representative of the people using drugs and a social worker in charge of case management follow up. Meetings take place once a week. Two to three patients are being discussed every week. Difficult cases are being identified beforehand. After establishing a comprehensive “picture” of the patient’s history and current situation, covering somatic health, mental health and social issues (bio-psycho-social approach), a procedure plan is established for the following weeks. Approximately one month later the case is being re-evaluated. Sex workers in Palestine are defined as prostitutes or as a form of social deterioration. They may be only 40 registered cases, as sex work is hidden and impossible to announce. In addition, sex workers are deprived from access to health services since they are stigmatized and social outcasts. Only unknown small charities and social organizations provide services to them. And within the health programs developed for sex workers in Palestine like UNFPA, UNIFEM and UNDP, sex workers are not involved in the planning process or consulted in needs assessment. Responsively, Palestine Health policy, rules and regulations are weak to make advocacy for sex workers rights. There are no rules protecting them. 7 11.00-12.30 Banquet Hall 1+2, Plenary Room professional life has been devoted to drugs and health. He was also a member of the Portuguese Committee which, in 1999, prepared the report on which the first Portuguese Drug Strategy, which included decriminalisation, was based. The Portuguese experience is widely seen as the model for harm reduction around the globe- since decriminalisation in 2001 rates of HIV infection, Hepatitis, drug use and drug related crime have reduced dramatically. Global Fund Investments in harm reduction: latest data analyses and trends Presenter: Ade Fakoya, Senior Advisor HIV and AIDS, The Global Fund to Fight AIDS, TB & Malaria (GFATM). The Global Fund has undertaken a series of initiatives to promote harm reduction and support applicants, while adhering to its country-driven principles. This presentation will overview findings from in-depth grant portfolio analyses currently being undertaken. It will provide detailed assessments of how much is being spent on key harm reduction interventions, where this funding is going and what results are being achieved. This will, in turn, help inform assessments of progress being made over time and identify the gaps that still exist – informing future efforts for the Global Fund and its stakeholders. 11.00-12.30 Banquet Hall 3, Plenary Room Developing WHO guidance on viral hepatitis b and c for people who use drugs Presenter: Annette Verster, WHO/Eastern Mediterranean Regional Office In 2010, the World Health Assembly passed a resolution requesting WHO to provide support to the development of scientific research related to viral hepatitis. Over the last decade, WHO developed guidance on the prevention, treatment and care of HIV in PWID. Because PWID are most affected by viral hepatitis in many regions, there is an urgent need to develop recommendations on the management of prevention, vaccination, screening and treatment of viral hepatitis in this population. Key issues that need further guidance include surveillance of viral hepatitis B an C; effective methods of HBV vaccination in PWID and in prisons; improving access to prevention, screening, and treatment of viral hepatitis among PWID. 11.00-12.30 Banquet Hall 1+2, Plenary Room In Ukraine 60% of IDUs are reached by harm reduction programs: what is next? Presenter: Pavlo Smyrnov, Deputy Director at the International HIV/AIDS Alliance, Ukraine office, Ukraine In 2004 Ukraine started scale-up of harm reduction programs for intravenous drug users (IDUs) to address HIV/AIDS epidemic exploding in this group. The initial coverage was 8% and the main task was to increase it to 60%. The task is different now: provide services to those who were reached. 11.00-12.30 Banquet Hall 4, Major Room Piloting opiate substitution therapy in the Islamic Republic of Afghanistan - first results Presenter: Amin Zemaray, Médecins du Monde, Kabul, Afghanistan 13.00-14.00 Dialogue Space, Exhibition Area Decriminalisation in Portugal Presenter: João Castel-Branco Goulão, President, Institute on Drugs and Drug Addiction, Chairman of the European Monitoring Centre on Drugs and Drug Addiction (EMCDDA) Portugal The Islamic Republic of Afghanistan is facing a growing drug use problem and a concentrated HIV/AIDS epidemic among Injecting Drug Users (IDUs). One million Afghans are using drugs, including 120,000 regular heroin users. HIV prevalence reached an average of 7% in three cities in 2009, as compared A medical doctor by profession, Dr. Goulão has over 20 years experience regarding drug-related issues, working in this field since 1987 as general practitioner and since then all his 8 to 3% in one city in 2006.Upon request of the Ministry of Health, MdM started the implementation of a pilot Opiate Substitution Therapy (OST) program for 200 heroin users in Kabul, Afghanistan. Methadone was selected as OST under daily observed therapy. Inclusion of the first patients started in February 2010. Data was measured at baseline and after 4 months. Retention rate was evaluated after 7 months. Four options are possible: more inclusive bans (including banning e-cigarettes or even personal possession of snus); maintaining the status quo (likely in the US); fewer marketing restrictions (more likely for snus in the EU than any US product); or open endorsement of THR (unlikely). Countries lacking such strong institutions will likely mimic major changes. Will there be a race towards locking in the cigarette market share by preventing informed choice or might we see the most meaningful western public health policy of the century? 11.00-12.30 Banquet Hall 4, Major Room Methadone maintenance program in Morocco: a choice for a mixed implementation, ambulatory facility with harm reduction interventions and detoxification inpatient services Presenter: Mohammed Essalhi, Moroccan Ministry of Health, Morocco AIDS is a growing problem in Morocco among a most at risk and vulnerable populations (SW; MSM; IDUs, Inmates etc.) Morocco has been a pioneer in the region to develop since nineteenth, a comprehensive national program to tackle HIV/AIDS. The country had a strong political and financial commitment to combat HIV/AIDS and its willingness to engage civil society and work with the international development community. The Ministry of Heath (MoH) has started since 2007, the implementation of a comprehensive harm reduction program for IDUs, that includes access to basic health and social services at a drop-in -centre, outreach activities and MMT. 14.00-15.30 Banquet Hall 3, Major Room A survey of healthcare professionals in the UK, Sweden and Norway on their attitudes about the role that tobacco harm reduction can play in helping reduce public health impacts of tobacco use Presenter: Sudhanshu Patwardhan, International Scientific Affairs Manager, Medical and Public Health, British American Tobacco, UK The debate over the role of tobacco harm reduction in helping reduce public health impacts of tobacco use is dividing the public health community, pitching those in favour of a broader approach against supporters of the 'quit or die', approach (1,2). Healthcare professionals (HCPs), particularly General Practitioners, nurses and smoking cessation advisors, are at the frontline of initiatives to combat smoking. We designed a survey to find out how aware HCPs are of this ongoing debate and their views on tobacco harm reduction. 14.00-15.30 Banquet Hall 3, Major Room Tobacco harm reduction regulations in the US and the European Union: a race to the bottom or a race to the top Presenter: Karyn Heavner, School of Health, University of Alberta, Canada 14.00-15.30 Rabieh, Concurrent Room Starting comprehensive harm reduction in Temeke District, Dar-es-Salaam, Tanzania Presenter: Celine Debaulieu, Médecins du Monde- France, Tanzania Tobacco Harm Reduction (THR) is dependent on low-risk products being available, and is dramatically enhanced if they are also legal and manufacturers can make accurate claims about the reduced risks from switching. The US and European Union (EU) regulatory environments are such that either could become the leader in THR or be responsible for denying the world its benefits. Recent research has documented the increasing prevalence of injecting drug use (IDU) in Eastern Africa. In Dar-es-Salaam, Tanzania, HIV prevalence rates are estimated to be around 40% in the IDU population. Médecins du Monde France (MdM-F) has 9 started a comprehensive Harm Reduction intervention in Temeke District. This program is mainly targeting IDUs. The intervention is implemented in collaboration with the Ministry of Health and a local NGO that has worked for several years with drug users. After analysing the knowledge regarding HIV and viral hepatitis and the drug use behaviours among the drug users’ community, MDM-F has started the implementation of a comprehensive harm reduction program that includes access to basic health and social services in a drop-in centre, outreach activities, provision of sterile injection material and behaviour change communication. locations we work at include the Coast of Kenya and Dar es Salam where drug-use is most prevalent especially amongst the youth. We take the integration of legal services approach in harm reduction because drug users in the region are extremely vulnerable in the face of the law. Anecdotal evidence of this imbalance is illustrated at Shimo la Tewa Prison in Mombasa where 70% of the inmates are incarcerated on drug-related charges. Thursday 7 April 09.00-10.30 Banquet Hall 3, Major Room HIV risk environment from a rapidly modernising Malaysian fishing industry: a call for structural harm reduction intervention. Presenter: Martin Choo, Centre of Excellence for Research in AIDS, University of Malaya, Malaysia 16.00-17.30 Banquet Hall 3, Major Room Outreach workers supporting behaviour change among injecting drug users: an adapted and effective harm reduction approach in Egypt Presenter: Doaa Oraby, Family Health International, Cairo, Egypt Fishermen in Malaysia account for 3.8% of reported cases for HIV in 2009 with the main route of transmission being injecting drug use. With the objective of understanding the HIV risk environment of fishermen, this study explores the relationship between injecting drug use and the culture of fishing in Kuantan, Malaysia. Recovering injecting drug users (IDUs) are committed to carrying a message of common welfare to their peers according to narcotics anonymous which is popular accepted tradition in Egypt. Motivated male and female recovering IDUs were engaged to conduct outreach activities and peer education targeting IDUs and focusing on harm reduction. They were trained in the areas of behaviour change communication, negotiation skills, micro planning, risk reduction counselling, harm reduction and peer education. 11.00-12.30 Banquet Hall 3, Major Room Russia: new trends in drug use lead to severe health consequences and death among IDUs Presenter: Alena Vladimirovna Asaeva, Russia 16.00-17.30 Banquet Hall 3, Major Room Rabieh Concurrent Room Integration of legal support into harm reduction services to advance the health and human rights of drug users in Eastern Africa Presenter: Umra Omar, Health Program Assistant, Eastern Africa Initiative, Open Society Foundations, Kenya, Nairobi Harm reduction and drug treatment services from all over the country (Moscow, Tatarstan, Yakutia etc) report about severe health consequences caused by use of desomorphine, tianeptine, and tropicamide. Injections of tianeptine and desomorphine which home production involves the use of sulphur, benzene, iodine and hydrochloric acid lead to rapid progression of trombosis, trophic ucler, necrosis and gangrene. One of the most severe consequences of desomorphine use is bisphosphat necrosis. As a result of poor access to health care among IDUs in Russia, medical help is often offered only at the Our aim is to promote legal and human rights issues in harm reduction by issuing grants to tackle punitive laws and address violence and stigma targeted at drug users. The primary 10 late stage of disease. Specialized surgical interventions are expensive and can be performed only in several hospitals in the RF, and for many drug users use of pharmaceutical drugs ends with amputation and even death. Replacing smoking with a smokeless delivery system for the primary drug, nicotine, can reduce risks by about 99%, which is basically as good as abstinence. Because smoking is so popular, the total potential health benefits from tobacco harm reduction (THR) dwarf those from any other area of harm reduction. Substitution of oral smokeless tobacco is the only proven method of reducing smoking rates below about 20% in any population where smoking has become popular. With the creation of an increasing array of appealing smokeless tobacco products and electronic vaporizers ('e-cigarettes'), the potential appeal of substitution is increasing. 11.00-12.30 Banquet Hall 4, Major Room People who use drugs, HIV, and human rights Presenter: Joanne Csete, Associate professor of Clinical Population and Family Health, Columbia University, USA People who use drugs are being left behind in efforts to achieve universal access to comprehensive HIV prevention and treatment. Rather than relying on evidence-based interventions, many countries continue to take approaches to drug use focused on criminalization and the imposition of harsh penalties. We reviewed the evidence regarding human rights problems faced by people who use drugs, and of the implications of human rights violations on efforts to respond to HIV and related health concerns among them. Over 900 studies and other documents were reviewed. 13.30-15.00 Banquet Hall 1+2, Plenary Room The United States President’s Emergency Program for AIDS Relief (PEPFAR): progress and challenges in building country-level capacity for comprehensive HIV prevention for persons who inject drugs Presenter: Rich Needle, Senior Public Health Advisor at PEPFAR, Office of the Global AIDS Coordinator As part of the 2010 financial appropriations process, the US Congress lifted the ban on domestic funding for needle and syringe exchange programs. On July 10 2010, PEPFAR released a revised technical guidance document on Comprehensive HIV Prevention for People Who Inject Drugs. This guidance affirmed PEPFAR’s support for comprehensive, evidence-based, and human rights-based HIV prevention programs for persons who inject drugs. As part of this guidance, PEPFAR explicitly allowed funding for to be used for needle and syringe exchange programmes as one component of comprehensive HIV prevention programmes among persons who inject drugs along with medication assisted treatment, ART and other interventions. 13.30-15.00 Banquet Hall 1+2, Plenary Room Effectiveness and cost effectiveness of harm reduction Presenter: David Wilson, Global HIV/AIDS Program Director, World Bank, USA There is clear evidence that both needle syringe programmes and medication assisted therapy are effective. A growing literature also demonstrates how cost effective they are and how great the cost of inaction or ineffective action is. The evidence shows the returns on investment in effective harm reduction are amongst the highest in public health. 13.30-15.00 Banquet Hall 1+2, Plenary Room Forfeit of stand fast: human rights of people who use drugs Presenter: Irina Teplinskaya, volunteer, Andrey Rylkov Foundation, Russia 13.30-15.00 Banquet Hall 1+2, Plenary Room Tobacco harm reduction: will we see a public health triumph or a defeat for all harm reduction? Presenter: Carl Phillips 11 My life is a mirror reflecting the fate of millions of people who use drugs in Russia and most of the former Soviet countries. My beliefs have faded away by undelivered promises of the officials; I have nothing to lose as my health has gone, many of my friends have died of AIDS, TB and overdoses; I am tired of begging the authorities to fulfil their legal obligations. Drug users in Russia often suffer ill-treatment and punishment, lack of access to medical help, infringements of the right to privacy and freedom of expression, violation of other human rights and freedoms. 15.15-16.00 Banquet Hall 1+2 Closing Ceremony Speakers: Pat O’Hare, Honorary President, IHRA Elie Aaraj, Director, SIDC and MENAHRA Paddy Costall, Managing Director, Conference Consortium Rick Lines, Executive Director, IHRA Donya Aziz, Member, National Assembly, Pakistan Awards ceremony National Rolleston Award Travis Jenkins Award Film Festival Award 12