We believe that the end of AIDS is possible if there is more focus on key populations. Our project in South Africa addresses barriers faced by the PWUD community related to their sexual and reproductive health and rights. Driven by community champions, we work to realize sustainable funding and improved access to inclusive community-based services (including harm reduction and OST); consideration of PWUD as legitimate community members and a strong national PWUD network.
Rampant violence and limited access to harm reduction
South Africa is considered a newly industrialised country, being ranked as an upper-middle income economy by the World Bank. Despite having the seventh highest per capita income in Africa, poverty and inequality are widespread. There are still many gaps to be covered regarding the assistance for people who use drugs (PWUD) in South Africa. It is estimated that there are 67,000 injecting drug users in South Africa. Little reliable data exists on the prevalence of HIV and Hepatitis C among injecting drug users. According to the report ‘the Global State of Harm Reduction 2014’ HIV prevalence is around 19.4%. With the number of injecting drug users rising in a generalised HIV epidemic, the need for comprehensive harm reduction services are enormous. In general, harm reduction services have not yet played a significant role in South Africa’s response to drug use or HIV, since the majority of services remain solely abstinence focused. With rampant violence against people who use drugs, our project aims to both set up harm reduction services and slowly work to improving the human rights of people who use drugs.
People who use drugs claim a right-based HIV and SRHR response
Bridging the Gaps works with a Theory of Change approach. A Theory of Change is a description of a list of events that is expected to lead to a particular desired outcome. It is a visualization how change is believed to happen. In 2016, representatives of the PWUD community developed a Theory of Change that consists of short-,medium, and long term outcomes. The specified Theory of Change of the PWUD project in South Africa describes how we plan to realize sustainable funding and improved access to inclusive community-based services (including harm reduction and OST); consideration of PWUD as legitimate community members and a strong national PWUD network.
Through innovation and by building on previous work, we will strengthen civil society organisations’ ability to:
1. We facilitate community development
- Training students and healthcare professionals on harm reduction, rights and policies.
- Building national PWUD network to improve human rights and health of PWUD.
2. We advocate for the continuously strengthening of services and upholding human rights
- Documenting human rights violations and evidence-informed advocacy.
- Assessing the needs and risks of street-based PWUD to inform advocacy and programming.
3. We deliver inclusive, rights-based and gender sensitive services
- Providing accessible health services for PWUD, for example through outreach and the supply of sterile needles and syringes and other harm reduction commodities.
- Providing psychosocial services to PWUD through established drop in centres and safe spaces.
- Designing and distributing harm reduction IEC materials for PWUD, including stimulant use, smoking, snorting and injecting drugs.
- Coordinating a structural clean-up.
- Facilitating capacity building of outreach workers and knowledge exchange.
4. We foster global and in-country process and partnerships that reinforce results
- Strengthening relationships, networks and processes with government departments and the civil society drug policy network.
- Establishing and participating in a ‘Friends of PWUD’ structure that helps capacitate and support PWUD networks until they are self-sustaining.
- Establishing relationships with civil society and encouraging the development of harm reduction services and advocacy for effective rights based drug policies.
Our project builds on the strong advocacy work of our partners OUT Well-Being and TB/HIV Care to put PWUD health issues on the political agenda and provide rights-based health services. Their work is internationally supported by Mainline and INPUD.