20th ERNA General Meeting Report
Luxembourg City 8-11 October 2019
The 20th General Meeting of the European Red Cross/Red Crescent Network on HIV, AIDS and TB hosted by the Luxembourg Red Cross and took place in Luxembourg city. 46 participants from 18 National Societies, as well as partners from WHO, UNAIDS, IFRC, Villa Maraini, RC/RC Partnership on Substance Abuse and 13 representatives of local partner organizations took part in the Meeting.
Objective of the General Meeting:
To increase knowledge of the ERNA Annual meeting participants on interventions for key population as well as strengthen collective response of the NSs towards HIV, Hepatitis, TB and drug abuse epidemic in the Region.
The ERNA meeting takes place under the high patronage of M. Etienne Schneider, Health Minister of Luxembourg and M. Marc Angel, UNAIDS Ambassador 90-90-90
Meeting Day 1
Michel Simonis, Secretary General of Luxembourg Red Cross and Dr. Massimo Barra, ERNA President presented welcoming words to ERNA meeting participants.
Keynote speeches were done by Marc Angel, UNAIDS Ambassador 90-90-90 of Luxembourg and Dr Davron Mukhamadiev, IFRC Regional Health and Care Coordinator to establish the framework for ERNA meeting. The importance of universal health care being a human right was stressed and it was pointed out that the UNAIDS aims of 90-90-90 can only be reached if everybody works together: politicians, municipalities, communities and social and health institutions. Especially working together with communities and training community workers needs to be a strategic action in the future. Luxembourg’s answer to fight HIV is a financial and political one. There is still a grave lack of human resources for health work all around the world. More human resources for HIV/TB activities are needed. Health care needs to be looked at from a broader perspective: it is not only about being free of disease but it’s important to support people affected by disease in having a sustainable social life and a job. Therefore, the Ambassador during his mission and meeting with the government, use to involve in the discussion also ministries of finances and employment to sensitize them also. Advocacy needs to be improved; a way needs to be found on how to talk with the decision makers: make them understand that we do not promote drug use or sex work, but we just try to help those who need help.
Dr Davron Mukhamadiev noted that Red Cross and Crescent could contribute to an overall agenda on universal health care. Main challenges remain universal access to health (mass groups still lack access) and discrimination and stigmatisation, since stigma prevents people from accessing health services out of fear of being judged. Evidence based data needs to be used to improve activities and strategies and cooperation with Global Partners.
Introduction of participants and expectations on ERNA in this meeting and in the future
Dr Massimo Barra welcomed all the participants and invited them to first introduce themselves and second express their expectations on ERNA for this meeting.
- Help people more via humanitarian approach to reach vulnerable populations
- Scale up in agenda on key issues (activities reaching target groups) and share strategies
- Share experience and strategies and increase knowledge about work in other national societies (Networking, sharing ideas and good practices)
- Inspiration: New innovative strategies, ideas and solutions to reach key populations
- In 1 year show figures about what we have done/impact we had
- Get more information on infectious disease as key indicator for monitoring drug use (Task Force on Drugs)
- Hear about ERNA work and deepen cooperation in the future (4motion)
- How to attract private sector’s or other stakeholder’s interest in health activities
- ERNA should coordinate with all national activities (network for good practice exchange)
- To see new faces, create new approaches, develop ideas on joining forces and working together
- Use ERNA for talking and lobbying with the government
Thematic Session 1: Current situation in the region + hard to reach and key population for HIV, TB, Hepatitis C
- WHO Regional Office Europe, Dr Askar YEDILBAYEV presented information on current situation on HIV, TB and Hepatitis C while focussing on key populations, such as migrants, drug users and prisoners. He noted that:
- Collaboration between TB/HIV/VHC screening and treatment is necessary in order to reach positive outcomes when addressing key populations.
- Health security is an issue for treatment, so access to medication and support for everyone needs to be improved.
- Universal Health Coverage is an important key to success and a human right for everyone around the world. Governments need to take their responsibility and show political commitment. We need to persuade them with statistical evidence that harm reduction actually works. Attachment 2 – WHO presentation
- Good practices by National Societies:
Kyrgyzstan RC – “Innovative methods in TB activities”
Presentation on monitoring adherence treatment with different digital tools (sureAdhere, Electronic dose monitors, 99 DOTS) that give support to patients in order to take their medication properly. Attachment 3 – presentation of Kyrgyzstan RC
Presentation on different outreach projects in Festival and Party Settings about safer sex, alcohol consumption and harm reduction. Attachment 4 – Finnish RC
Thematic Session 2: Current situation in Luxembourg
- National Service for Infectious Diseases of the Centre Hospitalier du Luxembourg – Dr Vic Arendt
Presentation on current situation in Luxembourg on HIV and Hepatitis C while focussing on key populations. Attachment 5 – Dr Vic Arendt
- Luxembourg Focal Point for EMCDDA, Ministry of health – Nadine Berndt and Rita Seixas
Presentation on recent data for drug use and drug addiction in Luxembourg. Attachment 6 – MoH
- Cesas, National reference center for sexual and affective education – Camille Soudeyns and Eva Maria Schmid
Presentation of the national reference center for sexual and affective education, its mission and the different educational programs in Luxembourg (UNESCO, WHO standarts). Attachment 7 – CESAS
- HIV Berodung of the Luxembourg Red Cross – Sandy Kubaj, director in charge
Presentation of the Luxembourgish HIV department, its mission and the different projects and services provided (mobile testing units). Attachment 8 – HIV Berodung
Thematic Session 3: Sharing experience among the NSs in the field of HIV, AIDS, Hepatitis C and substance abuse
- Villa Maraini and Partnership with Italian Red Cross and IFRC on Substance Abuse (Opioid overdose prevention)
Presentation of the world opioid crisis, humanitarian drug policy and harm and risk reduction activities runned by Italian Red Cross volunteers together with Villa Maraini workers, and the Italian RC strategy to engage local branches in harm reduction services with a special Task Force focused on Opioid Overdose prevention that works together with Health, Youth and Social inclusion Management. Attachment 9 – Drug Policy
A variety of useful documents and templates are available on Villa Maraini (www.villamaraini.it) and IFRC Website such as: Guidelines on Harm Reduction related to injecting drug use, Naloxone best practice tool and the draft Youth Declaration for humanitarian drug policy, Manual on Youth Engagement on Substance Absue, Meet, Test and Treat Campaign; Spreading the light of science (https://www.ifrc.org/PageFiles/96733/Red_Cross_spreading_the_light_of_science.pdf).
- HIV in emergencies and Key Population Target, Davron Mukhamadiev (IFRC ROE Budapest)
IFRC Regional Health and Care Coordinator talked about main threats, risks and challenges in emergencies concerning HIV transmission and access to treatment. He noted that the focus is set on possible contributions of Red Cross and Crescent to better access for key populations to medical treatment and testing, by offering education and information to reduce stigma and discrimination, by offering testing and counselling close to key populations and advocating for human rights with governments and political actors. Attachment 10 – IFRC
- Good practices:
Spanish RC – HCV and substance abuse
Presentation on the drug consumption room in Barcelona and all the services offered in this facility by the Spanish Red Cross of Barcelona (emergency health insurance card). Attachment 11 – Spanish RC
Ireland RC – Mass Voluntary Viral Screening in Prison
Ireland Red Cross presented their successful project of mass viral Screening in Prison based on a voluntary approach. Peer Education Works: Volunteers spread the information amongst the prisoners and convinced them to come to test and to become RC Volunteers, teaching them the 7 Principles and health good practices in prison. Attachment 12 – Irish RC
Georgia RC – HIV/AIDS, TB activities lessons learnt
Georgia Red Cross presented their work on HIV/AIDS – TB and Harm Reduction and shares good practices. They stress the importance of community based services and using an individual approach. Attachment 13 – Georgia RC
Meeting Day 2
Brief from day 1, Mr Uldis Likops – ERNA Vice-President
Acknowledgements were expressed to Luxembourg Red Cross for organizing and hosting this year’s ERNA meeting. Mr Likops also noted the importance of working together, thanked all the participants for their great work, and wished successful and fruitful meeting ahead.
Thematic session 1: Working with hard to reach and key population: role of CSOs and networks in HIV/Hepatitis/TB prevention and care (local NGOs)
- National Surveillance Committee on AIDS, infectious hepatitis and sexually transmitted diseases – Dr Carole Devaux, President
Presentation of up-to-date evidence based data on the current situation in Luxembourg for infectious and sexually transmitted diseases focusing on key populations. The national action plan on HIV, the national action plan on hepatitis and the currently ongoing HCV-UD outreach program were explained. Attachment 14 – National Surveillance Committee on AIDS
2. Suchtverband Lёtzebuerg, Federation of organizations working in the area of addictions – Jean-Nico Pierre, President
The mission and different actions and purposes of the Suchtverband Luxembourg, a federation that regroups all the organizations working in the area of addiction, were presented. In addition, different services and projects were presented, such as the heroin substitution program. Attachment 15 – Suchtverband Lёtzebuerg
3. DropIn, Dispensary for sex workers, Luxembourg Red Cross – Tessy Funck, director in charge Presentation of the the DropIn, its mission, provided services and programs. It is a low threshold centre where psychological and medical care is provided and screening test for HIV, VHC and other IST are offered in close collaboration with HIV Berodung (HIV Department) and CHL (specific Hospital) in the case of positive results. A needle exchange program is offered, where an average of 9000 needles are exchanged per month.
Street work is done almost every night to support the women on the streets, give them free condoms and inform them about the center. In the centre prevention workshops are held on a regular basis on different topics like how to use a condom properly, the different IST and their ways of transmission, how to work safely, how not to get into trouble because of money exchange etc. A program called EXIT is offered in close collaboration with ADEM (agency for employment development). It is about stopping prostitution and getting back to a “normal” life having a legal job. A new indoor project is about to start very soon in order to reach those who just do their work in apartments or hotels. This outreach work will be a huge challenge since prostitution in Luxembourg is illegal and the women are afraid of being judged or that DropIn staff may be linked to the police.
- PIPAPO: Sex, drugs and Rock’n Roll – Carlos Paulos, director of 4motion
Presentation of PIPAPO, a project that sensitizes partygoers about all the risks you can encounter while you are out partying at a Festival or in a club. This project is all about information on harm reduction, recreational drug use, ear protection, safer sex and safer use and the well-being of partygoers. Occasionally there is also a drug checking service available. Attachment 16 – PIPAPO
- CIGALE, Information Center for Gay and Lesbian – Roby Antony, director in charge
Presentation of the CIGALE, the Information Center for Gay and Lesbian, its mission, provided services, programs and different activities. Presentation of the Genderbread Person, a teaching tool to better understand the concept of gender and its particularities such as gender identity, gender expression and anatomical sex. Attachment 17 – CIGALE
Report from ERNA Secretariat, Strategic Plan
ERNA report for 2017-2019, Strategic plan and Plan of Action were presented by Azamat Baialinov, and discussed with the present National Societies.
Elections on ERNA Board and Secretariat
Participants of the General Meeting approved the current positions of ERNA Board and Secretariat as follows:
- President – Dr. Massimo Barra, Villa Maraini
- Vice-president – Mr Uldis Likops, Latvian Red Cross
- Vice-president – Mr Azamat Baialinov, Kyrgyzstan Red Crescent
- ERNA Secretariat – Ms Begimai Asanova, Kyrgyzstan Red Crescent
Proposal for next meeting
No present national society has proposed to host the next ERNA meeting. It was decided to keep this point open for later in order to give national societies who are not attending this meeting a chance to propose as well.
Suggestions for future
- Develop common tools for data collection.
- Improve communication: use social media to improve visibility à responsibility of all national societies
- Ms Keti Mindeli from Georgia RC suggested to organize joint regional training on how to write project proposals. In addition, she offered to include to ERNA budget an expert for writing joint project proposals for ERNA members.
- Ms Marija Korkut from Lithuania RC suggested to organize training for ERNA members on drug abuse issues
Thematic session related to field visit next day
- Abrigado, drug consumption room – Lionel Fauchet, deputy director in charge
Presentation of the Abrigado, its mission and different facilities, provided services and programs. It includes a drug consumption room, a night shelter, showers and a laundry room. Moreover they offer a needle exchange service, medical care and HIV/VHC/IST screening is provided in collaboration with the HIV Berodung from Red Cross Luxembourg. Attachment 18 – Abrigado, drug consumption room
- Shelter for homeless people and alcohol consumption room – Stephanie Sorvillo, Director of Emergency shelter department, Caritas Luxembourg
Presentation of the Foyer Ulysse, a shelter for homeless people, its mission and different facilities, provided services and programs. It includes the social pub Le Courage, which is a low threshold facility with an alcohol consumption room. Furthermore, clients have access to showers and laundry services and a safe place to rest during the day. HIV/VHC/IST screening is provided in collaboration with the HIV Berodung from Red Cross Luxembourg. Attachment 19 – Shelter for homeless people
- Doctors of the World Luxembourg – Dr. Yann Gorges
Presentation on the work of Doctors of the World Luxembourg, their mission, the medical care they provide and how many people they reach. HIV/VHC/IST screening is provided in collaboration with the HIV Berodung from Red Cross Luxembourg. Attachment 20 – Doctors of the World Luxembourg
- Dimps, mobile HIV, hepatitis and syphilis testing and counselling – Laurence Mortier, prevention and national HIV plan coordination
Presentation of the dimps, a mobile testing unit in form of a van for rapid testing on HIV, hepatitis C and syphilis. This project is run and coordinated by the Luxembourgish Red Cross HIV Department (HIV Berodung). Attachment 21 – Dimps, mobile HIV, hepatitis and syphilis testing and counselling
Meeting Day 3
Next steps: working group discussions on future commitments, priorities and membership:
- Working Group 1: HIV and Hepatitis
- Working Group 2: Substance abuse
- Working Group 3: TB and other infectious diseases
As a result of group work, following outcomes for each topic were offered:
- HIV and Hepatitis
- Set up more mobile units that provide healthcare in place
- Increase Quick Testing (Hiv, Hcv, Tb, Siphilis) activities to detect virus in time and ensure in the main time education on healthy life styles during Testing activities
- Organization of large-scale public events with involvement of celebrities
- Provide prevention, diagnosis and treatment activities in every region
- Healthcare provided on site
- Work with key population
- Develop partnership with governmental structures, NGOs
- Strengthen advocacy activities for better access to services
- Substance Abuse
- Promotion of services to assist drug users
- Harm reduction activities on local level
- Dissemination of free methadone therapy in prisons
- Information sessions in high schools on substance abuse
- Engage and export Villa Maraini model and services among other NSs
- Provide access to services for homeless drug users
- Create street and emergency units for drug users on local level
- Increase the number of volunteers participating in activities on reduction of substance abuse, drop-in centers, support local NGOs working with Drug Users
- TB and other infectious diseases
- Provide treatment to all infected people
- Enhance treatment and psychological services
- Mobile diagnostics for beneficiaries
Based on the group work results, Sandy Kubaj from the Luxembourg RC initiated to establish Task Force on the abovementioned topics that would help ERNA members with the technical expertise, consultative support.
Closing of the meeting
Dr Massimo Barra, ERNA President welcomed Marc Crochet, Deputy Secretary General Luxembourg Red Cross. He, furthermore, expressed the strategic involvement of the Luxembourg Red Cross in ERNA and its great work in the field of Harm and Risk Reduction in the country. Concluded that the three days of meeting were very fruitful. Marc Crochet, Deputy Secretary general Luxembourg Red Cross explained that the most important decision was not to host ERNA meeting but to be part of ERNA. He expressed his contentment hosting this meeting but also finding the way to ERNA family. He stressed the importance of networking especially with other local actors very active in the field. The Luxembourg Red Cross opened up to other NGO’s and local partners and is very proud of this. He took notice of the imbalance of western European societies and eastern European societies in ERNA network and expressed his hope that this might change with Luxembourg Red Cross being part of ERNA network and sharing this experience with neighbouring countries. Acknowledgements were expressed to Dr Massimo Barra in person and HIV Department of Luxembourg Red Cross and to all participants of the meeting for being so strongly invested in this work.