Andrey Rylkov Foundation
for Health and Social Justice

EHRN Update on the Regional Initiative on HIV and Harm Reduction

3 July 2013

Background: On 28 February 2013, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) announced that Eurasian Harm Reduction Network (EHRN) had been invited to be an Early Applicant as part of the Global Fund’s New Funding Model (NFM) with a proposal on HIV and harm reduction for the region of Eastern Europe and Central Asia. The funding amount indicated for this regional proposal was $6 million over three years (2014-1016). EHRN formally accepted the invitation with a decision to develop and submit a Concept Note to the Global Fund, based on outcomes from an inclusive, consultative regional dialogue process.


Since accepting the Global Fund’s invitation to be a regional Early Applicant, EHRN has undertaken a regional dialogue process comprising on-line and face-to-face consultations. The aim of this regional dialogue has been to generate robust and meaningful engagement from partners in shaping the proposed goals, objectives, activities, and implementation strategies of the regional initiative for Eastern Europe and Central Asia (EECA). This update provides a brief description of outcomes of these consultations and the next steps in the regional application process.

Regional dialogue processes: EHRN started the regional dialogue process by engaging through conference calls and meetings with a wide range of technical partners including WHO, STOP TB Partnership, UNODC, UNDP, UNAIDS; partners from international and regional organizations such as Open Society Foundations’ International Harm Reduction Development Program (IHRD), GIZ BACK UP Initiative, International Network of People Who Use Drugs (INPUD), Harm Reduction International (HRI), International HIV/AIDS Alliance, International Drug Policy Consortium (IDPC), and the Eurasian Network of People Who Use Drugs (ENPUD). The preliminary consultations helped further define the overall concept for the regional EECA initiative; the initial concept was largely based on EHRN’s draft proposal to the Global Fund that was developed for Round 11 in 2011.

This consultative process then evolved into three consecutive online consultations between May and June 2013. A total of 205 people from 24 countries participated in the online consultations, with 61% representing national and local NGOs, 11% representing community based organisations, 23% from UN agencies or international/regional organizations and 5% representing other sectors (government, individual experts, etc.). Topics addressed included common regional challenges; priority goals, objectives and activities for the regional initiative; the value of a regional approach; prioritization criteria to identify focus countries and to select sub-recipients (SRs); and best practices in harm reduction service provision and advocacy.

The findings of these consultations were then shared as part of an in-person regional consultation, “Developing a Global Fund Regional HIV Initiative in Eastern Europe and Central Asia: Together,” held on 13-14 June 2013 in Vilnius, Lithuania. 76 people participated, including international partners (such as WHO, UNAIDS, UNDP, UNODC, members of the Global Fund Secretariat, HRI, INPUD, IDPC, Global Network of Sex Work Projects (GNSWP) among others), other regional networks (ENPUD, East Europe and Central Asia Union of PLWH (ECUO)), and national stakeholders—15 members of Country Coordinating Mechanisms from 10 countries of EECA representing both government agencies and civil society, 6 national harm reduction networks and organizations, 12 representatives of the community of people who use drugs and sex workers. A total of 18 countries in EECA were represented. This regional consultation generated consensus on key elements of the regional initiative including: the goal and objectives; scope of key activities; terms of reference for the governance bodies that will advise on the development of the concept note and oversee grant implementation; processes for SR selection; and next steps for consultation and engagement with CCMs in the region.

The overall goal agreed to for the regional initiative was “to increase successful advocacy driven by people who use drugs in EECA to expand domestic funding for and increased quality of basic harm reduction services, in the transition to sustainable national ownership.” The consultation also generated two objectives under this goal:

1) To increase the level of domestic funding for essential harm reduction services of appropriate quality in countries that are currently transitioning, or have recently transitioned, from international to domestic funding, to ensure sustainability; and

2) To build the capacity of the community of people who use drugs to advocate on issues of access, quality, and sustainability of essential harm reduction services.

Regional consultation participants recommended that the prioritization process for identifying target countries for participation in the regional initiative be organized through an open call for expressions of interest from civil society and community-based organizations aligned with the goal of the initiative and capable of working to meet its objectives. This “bottom up” and demand-driven process was considered superior to other country prioritization approaches that were discussed during the consultations. Prioritization criteria relevant to the two objectives will be further developed by the EHRN Secretariat and Regional Technical Advisory Group as a part of the concept note development process, and will be considered and approved by the EHRN Steering Committee in July 2013.

Governance structures: the regional consultation also defined the governance structures for the regional initiative. Three bodies will share responsibilities for concept note development, grant implementation and grant oversight. EHRN’s pre-existing governing body, a Steering Committee (SC) elected by EHRN membership and representing EECA sub-regions and the community of people who use drugs, will be responsible for the overall governance of the grant, as well as Concept Note development and implementation, including decision-making on prioritization criteria for target countries and SR selection. The SC will also play a key role in monitoring grant implementation, serving as a de facto Coordinating Mechanism. The SC will take responsibility for regular communication with CCMs in countries where regional initiative activities will be implemented. The Regional Oversight Committee (OC) will oversee grant implementation—a function that will be delegated by the SC to the OC. To increase transparency and accountability in governance, the OC will be open to non-EHRN members.  The OC will not perform any management functions or assume any management responsibilities for the Principal Recipient, but will assure effective grant implementation. The OC will not make any decisions related to its findings, but rather will make recommendations to the Steering Committee for decision and action. Finally, the SC will also establish a Regional Technical Advisory Group (RTAG). The RTAG will provide technical input from an array of partners, reflecting international and national processes under way in fields allied to harm reduction such as human rights, women’s rights, tuberculosis and hepatitis C, community and health systems strengthening, and financial management. The RTAG will provide the SC with strategic guidance on the development and implementation of the grant and will review applications from potential SRs. The RTAG will act as a consultative body and will have no decision-making authority.

Next steps: on 21 June 2013 EHRN submitted a draft project concept to the Global Fund Technical Review Panel for its preliminary review and feedback in advance to the development of the Concept Note. A call for RTAG members will be launched in early July 2013 and an RTAG meeting will take place later in July in Vilnius. EHRN will circulate announcements and updates regarding the regional initiative regularly.


Questions and further information: contact Sergey Votyagov (, Executive Director, and Ivan Varentsov (, Civil Society Action Team (CSAT) Coordinator, the focal points at the EHRN Secretariat for all matters related to EHRN’s regional application within the Global Fund NFM.

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