The Global Fund is leaving Macedonia this year in June. It means that most of the services will be closed or reduced to a minimum if the government does not provide financial support. NSWP member Healthy Options Project Skopje (HOPS) started a campaign for securing sustainability of harm reduction programmes in Macedonia through various activities including a petition, meetings with Ministry of Health, press conferences, social media campaign, a video. The key focus is harm reduction programmes for people who use drugs, but they also include sex workers, MSM, and PLWHA.
Harm reduction programmes in Macedonia date back to 1996. Since then a total of 17 programmes were developed, 4 of which are in Skopje and 13 in other 13. These programmes are characterised by complementarity, offering multiple services in one place: the exchange of sterile syringes, condoms, services by a nurse, social worker, outreach, testing for HIV and hepatitis C and free legal aid. With the exception of support from the City Of Skopje to one of the programmes in Skopje, all the rest are financially supported by the Global Fund.
The Global Fund also funds 7 programmes for support of sex workers in 9 cities in Macedonia. All programmes provide outreach work with condom/lubricant distribution, peer education, medical/gynecological and social services, educational workshops and some of the programmes also offer drop in services such as laundry, shower, food, creative workshops and legal services. STAR-STAR, the Macedonian sex worker-led organisation, is among mentioned programmes funded by the Global Fund.
Thanks to harm reduction programmes, only two new HIV cases have been recorded in Macedonia in the last ten years as a result of drugs injecting, and less than 5 percent of 315 registered cases of HIV were people who inject drugs. There are zero HIV cases recorded among sex workers. These figures are far smaller than the neighbouring countries. Macedonia can boast with the lowest HIV rate in Southeast Europe, but if these programmes are not implemented, there is a risk of an HIV epidemic.
HOPS calls the Macedonian Government to financially support the harm reduction programmes through the state budget, therefore remaining a country with low prevalence of HIV and a country that cares about all its citizens.