The resolution on social work in the sphere of drug use and prevention of infectious diseases in Kyrgyzstan was passed at the international conference "The role of community and social work in the sphere of drug use and prevention of infectious diseases".
The International Conference of high level was organised by CADAP-6 on behalf of the Frankfurt University of Applied Sciences in cooperation with Deutsche AIDS-Hilfe and AFEW-Kyrgyzstan in the Bishkek Humanitarian University on 24-25 of January, 2018, in order to present international standards for participation of NGOs/civil society/self-support system and social work in the sphere of drug use and prevention of infectious diseases.
80 delegates took part in the Conference, including officials from the Kyrgyz Government, Ministry of Health, Ministry of Internal Affairs, State Penal Service, representatives of service providers in the sphere of narcology, psychiatry, psychology and social work from Kyrgyzstan and Tajikistan, representatives of universities, European Union, UNODC, USAID, UNDP, Soros Foundation-Kyrgyzstan, GIZ in Central Asia.
The experience and best practices presented by the participants demonstrate considerable achievements in the sphere of drug use prevention and social work with people who use drugs (PUD), shaping the drug and harm reduction policy, rehabilitation programs. The achievements became possible due to consolidated work of non-commercial organisations, community based organisations, governmental agencies, international organisations and donors.
The participants of the conference, representing governmental organisations, science and health care, international organisations and community would like to re-assure their commitment for achievement of the Sustainable Development Goal #3 on ensuring healthy lives and promote wellbeing for all at all ages and make the following recommendations:
To the Kyrgyz Parliament:
- To review the discriminatory provisions of the Code on Offences, which lead to criminalization of drug use and decrease of HIV preventative programs utilization by drug users
To the Ministry of Health:
- to ensure universal access to prevention, early interventions, treatment, rehabilitation and harm reduction for all people who use drugs;
- to introduce mechanisms for state financial support of non-governmental and community-based organisations that work in the sphere of drug use prevention and HIV;
- to change the state system for drug addiction registration, which currently has discriminatory provisions and prevents not-registered drug users from starting OST program (stigma, labour and legal discrimination);
- to involve drug users community in shaping drug policy and decision-making at all levels (local, national, regional and international: rights advocacy, budgeting for prevention, treatment, care and support programs);
- to promote drug scene research programs in order to shape drug policy that would be efficient in responding to the majority of drug challenges;
- to develop psycho-social and rehabilitation support for people who use drugs and their families;
- to prepare regulatory framework for management of PUD and PLHIV by multi-disciplinary teams (MDT) under healthcare organisations; to ensure qualified human resources for the MDTs (infectious diseases specialist, nurse, social worker, peer consultant) and institutionalise MDTs as part of existing system of medical and social support of patients;
- to promote post-graduate education for systematic training of medical staff in order to provide continuous medical and social support, ensuring positive interactions between medical personnel, people who use drugs and people living with HIV
To the Republican Narcology Center
- to set up mechanisms for regular and consistent feedback from patients who receive opioid substitution therapy and their relatives in order to optimise the treatment process;
- to conduct campaigns for increasing treatment literacy among patients, drug users community and their families;
- to provide regular trainings for medical staff on interpersonal communication and burnout syndrome;
- to ensure that the OST treatment outcomes are widely publicized
To the Republican Health Promotion Center
- to develop and start dissemination of information materials on HIV prevention among women who use drugs (in cooperation with various stakeholders)
- to enhance cooperation with mass media in order to decrease stigma and discrimination, provide correct information about harm reduction and HIV, including routes of its’ transmission and treatment;
- to develop international partnership in the sphere of preventative programs for drug users and to find new donors.
To the Ministry of Labour and Social Development:
- to review regulatory framework on social work, include drug users to the target groups and appoint social workers responsible for supporting PUD;
- to develop regulations on the status of social worker;
- to prioritise programs for vulnerable women and women released from prisons when providing grants under state social funding;
- to enhance programs for prevention of all types of violence and providing support to the victims of violence; support specific programs and safe places (shelters, social dormitories) for women who use drugs based on their specific needs (HIV-related programs shall be accompanied by gender-based violence victims support, sexual and reproductive health services, emergency contraception, oral contraception, nutritional support and psychological counseling);
- to speed up the process of approving standards for crisis centers;
- to design and implement comprehensive system of early interventions for children of women who use drugs in order provide their psychosocial support and adaptation;
- to study experience of other countries and introduce confidential and safe system of providing social benefits for people living with HIV and children born from HIV-positive women.
To the Ministry of Education:
- to start certification of social workers using existing licensed training centers in the country;
- to develop educational programs for social workers to provide support for people who use drugs with active participation of community representatives, scientists and national universities;
- to introduce a special course (8-12 hours) on medical and social problems related to drug use and HIV in order to train social workers on relevant counseling, building adherence to treatment, communication skills, professional burnout and ensure tolerant attitude to the target group;
- to design and introduce educational programs for promoting gender-sensitivity and preventing all forms of violence.
To the judicial system, Ministry of Internal Affairs, State Penal System:
- to contribute to collecting correct and reliable data on drug use and drug scene that can be used in order to shape adequate and evidence-based drug policy;
- to review statutory documents that currently includes discriminatory provisions towards people who use drugs;
- to promote alternative punishments without imprisonment for drug users who committed minor drug-related offences;
- to train forensic experts, law enforcement officers and judges on Istanbul protocol;
- to ensure continuity of care and support for people who use drugs and people living with HIV upon release from prison and link them with public healthcare organisations;
- to ensure that the range and quality of medical services available for drug users and PLHIV in prisons is equivalent to those existing in the community;
- to engage drug users community to providing probation services
To the local authorities:
- to provide premises for social centers (shelters, rehabilitation centers) for people who use drugs;
- to provide shared funding for preventative programs for people who use drugs;
- to promote employment of people who use drugs: workshops, sewing workshops and etc.
To non-governmental organizations and community-based organisations:
- to advocate for changing the state system for drug addiction registration, which currently has discriminatory provisions and prevents not-registered drug users from starting OST program (stigma, labour and legal discrimination);
- to enhance cooperation with the law enforcement, penal and other state agencies in order ensure favourable legal environment;
- to ensure partnership and cooperation with human rights organization in order to protect the rights of OST patients, advocate for reviewing discriminatory legislation related to narcological services;
- to build capacity of drug users community through trainings, including trainings on best practices, active involvement in advocacy campaigns, decision-making, budgeting, developing regulatory framework, participating in trainings for social workers in the capacity of trainings;
- to boost action for overcoming stigma and discrimination against people who use drugs and other key populations, especially in healthcare, education and law enforcement;
- to actively participate in HIV and drug use prevention, treatment and care programs at the stage of design, implementation and M&E in order to ensure high quality of the programs by bringing unique knowledge on specific needs of people who use drugs;
- to cooperate with national, international and other partners in order to improve access to social, medical, legal and other services for people who use drugs.
- to promote application of efficient international practices for people who use drugs with special consideration of local epidemiological, economic, social and cultural specificities;
- to support efforts of governmental and non-governmental sector on protecting rights of vulnerable populations and providing access to HIV prevention, treatment and care;
- to contribute to providing adequate funding for programs for people who use drugs in the region and promote smooth transition to stable domestic funding;
- to support regional initiatives for working with people who use drugs implemented as part of international development programs.