Creating a conducive environment for evidence-informed and human-rights based policies for HIV prevention
Azerbaijan's proximity to drug trafficking routes is a major factor influencing the country's growing drug problem. The number of drug users registered at narcological service in 2011 was 20,000 , with 60% of them being injecting drug users (IDU). Concentrated HIV epidemics in the country have been driven by unsafe injecting practices with 62% of all HIV cases attributed to injecting drug use.
The prevalence of HIV among injecting drug users reaches up to 20% in urban areas, and HIV prevalence among prisoners has rapidly grown from 2,9% in 2008 to 5,8 % in 2011; the prevalence of Hepatitis C virus among injecting drug users is estimated to be around 60 per cent. HIV prevention is not integrated in the state health care system, there are no professional standards for harm reduction interventions and the effective prevention interventions are not properly reflected in professional educational system.
These reasons were taken into account by the United Nations Office on Drugs and Crime (UNODC) when the "Effective HIV Prevention and Care Among Vulnerable Population in countries of Central Asia and the Republic of Azerbaijan" project, Phase I (2006-2010) was launched in this country and then continued as its Phase II (2010-2016). This multi-component project was developed in a consultative process with government agencies, UN, bi- and multilateral donors and designed to complement and contribute, through normative work, advocacy and sustainable capacity building, to the existing projects/programmes implemented by other international players with the common goal to prevent generalized HIV epidemics in the region.
UNODC provided technical assistance to the revision and amendment of the ten national laws related to health, social protection and law enforcement to include provisions guaranteeing availability and accessibility of preventive and curative interventions comprising the so called comprehensive package for IDUs (WHO/UNODC/UNAIDS, 2009). The UNODC project also supported the development of the National Drug Control Programme for the period of 2013-2017 so that this new programme includes activities aimed at ensuring accessibility to quality health and social protection services for drug users. The Project contributed to a new Law on Social Services for Vulnerable Populations which was adopted by the Milli Meclis (Parliament ) in 2011. New occupational standards with the expanded professional competencies required for health care and social protection workers involved in HIV prevention among IDUs were developed based on the UNODC recommendations and currently are in the process of their official endorsement by the respective authorities. Technical assistance was provided to the process of upgrading teaching curricula in higher education institutions such as the State Medical University (2011) and in the Academy of Justice (2012). The upgrade includes integration of socio-medical and legal aspects of HIV prevention among vulnerable population into teaching programmes of these institutions .
The credibility of work of the UNODC project enabled to mobilize decision-makers and technical experts from the various sectors such as law enforcement, health, education, and civil society and helped create a conducive environment for multi-sectoral collaboration thereby enabling major stakeholders to perceive various perspectives of and links between drug use, HIV, human rights, and most importantly, to find the "right" solutions and make relevant decisions.
To a certain extent it also helped to synchronize activities implemented within HIV-related projects supported by other international and bilateral organizations.
The technical assistance and advocacy at the policy development level proposed by the project and the focus on amending legal and regulatory framework, developing professional and education standards and contributing to the development of a comprehensive package of interventions for HIV/AIDS prevention, treatment and support among drug users and prison inmates appear to be highly relevant and appropriate in the existing national context.
The project results are characterized by a high level of national ownership as each of the outputs was achieved with the active and meaningful involvement of national decision makers and technical officers who fully shared responsibility for the products quality and suitability. Ultimately, the above results contributed to the objective of making policy and legislative environment more conducive for achieving better access of drug users and prisoners to HIV related health and social protection services.