1. Middle East and North Africa
Harm Reduction Association
Enabling the Environment for harm
reduction strategy in MENA region
The experience of MENAHRA
Elie Aaraj
Executive Director
IAS 2012
Washington D.C.
IAS 2012 - Washington D.C.

2. MENAHRA aims at
Enabling the environment through:
strengthening local and regional technical
capacity to develop, implement, monitor
and evaluate HIV/AIDS prevention and
treatment services targeted at IDUs
IAS 2012 - Washington D.C.

3. Harm reduction situation in
2008
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4. Harm reduction situation in
2012
OST-pilot
OST-scale up
NSP-pilot
NSP-scale up
HIV prevention for IDUs in NASP
HRD policy adopted
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5. Current situation in 2012
• The International Harm Reduction Conference is in Lebanon-MENA
for the first time in 2011
• OST introduced in Morocco, Lebanon and Afghanistan
• Oman is requesting assistance to establish the first OST site
• Bahrain is requesting assistance to develop a HR strategy
• Tunisia developed a HR strategy and sought its funding from the GF
• Syria requested funding for harm reduction services from the GF
• Egypt and Pakistan are piloting outreach
• NSP is scaled up in Lebanon, Afghanistan, Morocco, Tunisia, and
Jordan
IAS 2012 - Washington D.C.

6. MENAHRA’s contribution
• Grants provided to 14 CSOs to implement or pilot
Harm Reduction projects in: Algeria, Afghanistan,
Egypt, Iran, Lebanon, Pakistan, Tunisia.
• Outreach and peer education, NSP, OST, VCT on HIV
and Hepatitis B&C, Condom distribution, referral,
advocacy havebeen provided to several thousand
IDU with MENAHRA’s support.
• 4 model programs implemented with a support from
MENAHRA
IAS 2012 - Washington D.C.

7. MENAHRA’s Contribution ----
continued
• Tens of training workshops for around 2000 people
• 17 different advocacy materials
• 28 newsletter on HR in MENA
• Active Social network and interactive website
IAS 2012 - Washington D.C.

8. Reportedly by stakeholders
– CSOs that benefited from MENAHRA activities report
growth in harm reduction service provision beyond their
individual projects
– information sharing in the Region on harm reduction has
dramatically increased as a result of MENAHRA activities
– MENAHRA activities have contributed to changes that
favour harm reduction in both policies and practices
IAS 2012 - Washington D.C.

9. External facilitating factors
• Advocacy by international agencies like WHO, UNODC,
UNAIDS and other international NGOs, bilateral and
multilateral donors
• Resources made available through international partners,
particularly the Global Fund to fight HIV, Tuberculosis &
Malaria
• Drosos unprecedented interest in the civil society and key
populations at increased risk of HIV in the region
• Better understanding of harm reduction as a public health
approach by policy makers and implementers
• Good examples in the2012 - Washington D.C. Iran, Lebanon, Morocco
IAS
region from

10. Challenges
• Geographic, sociopolitical and epidemiological
context
• Low prevalence = low priority for resources?
– Global Fund prioritization of countries
• Nascent programs and new understanding =
low priority?
– Countries unable to prove their urgency to
introduce HR intervention vis-à-vis donors
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11. MENAHRA’s ambitions
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12. Conclusion
• There is a rising opportunity of an increased
acceptance of harm reduction in MENA
• It is difficult to assess the contribution of
MENAHRA to this change however;
MENAHRA’s M&E show a significant role in
inducing this change
IAS 2012 - Washington D.C.

13. Thank You
IAS 2012 - Washington D.C.