Mobilization of people who use drugs in Afghanistan
Peer workers are widely used in Afghan NGOs, when working with PWUD. Peer workers assist in the running of drop-in centers (DIC) and the delivery of outreach services.
Médecins du Monde’s (MdM) harm reduction mission to Kabul between 2006 and 2013 placed a particular focus on community mobilisation with PWUD. The main focus of the MdM mission was to pilot Opioid Substitution Therapy (OST). In addition, clients of the OST service and DIC were taught advocacy, community organising and peer education skills. In 2010, MdM invited the International Network of People who Use Drugs (INPUD) to run a capacity building training, which led to the establishment of the Afghan Drug User Group (ADUG). The group developed a number of initiatives in partnership with MdM and helped raise the profile of the health and wellbeing of Afghan drug users. ADUG was primarily a service user group and the organisation did not have sustainable funding or exist as a formal entity beyond the departure of MdM in 2013.
Abdur Raheem Rajaey stood out as a key peer advocate and spokesperson for Afghan drug users both in Afghanistan and globally. MdM formally employed Raheem as an Outreach Worker, which also created capacity to support Raheem’s community advocacy role and ensured access to ongoing professional development opportunities. Raheem was unemployed for 18 months after the end of the MdM mission but continued to work voluntarily among active drug users. In 2014 he was appointed as a peer worker by SAF to support the new ‘safe space’ (satellite needle and syringe programme) that had been built next to Pul-e-Sokhta. This provided a formal role for Raheem to engage with the active drug scene and allow him to support an important and much needed new service function. However, there were also evident conflicts of interest between providing harm reduction services as a peer worker and acting as a community watchdog commenting on the quality of harm reduction services. Therefore, the peer worker position was a welcome stepping stone in the development of Bridge, which also highlighted the need for an independent voice for PWUD, if not wider KAPS, in the Afghanistan HIV system.
The role of the Global Fund New Funding Model:
The Global Fund New Funding Model has also shifted the dynamics of engagement with PWUD in Afghanistan. The Communities, Rights and Gender component of the Global Fund New Funding Model has been an important mechanism for setting standards for the meaningful engagement of key populations and women during the development of the Global Fund HIV Concept Note (CN). The feedback from the GF about the weak involvement of key populations, and the risk this posed to the CN being approved, provided an entry point for the dialogue around the meaningful participation of PWUD with the Afghanistan National AIDS Control Programme (NACP).
Bridge Hope and Health Organisation and Coact Partnership
Coact Partner, Mat Southwell, providing voluntary leadership coaching to Raheem in 2012 and this was described in a Memorandum of Understanding. The goal was to build Raheem’s capacity and also to look for opportunities to promote drug user organising and the meaningful participation of PWUD in Afghanistan.