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Innovations in Pakistan

Harm reduction programmes to improve the health and rights of People Who Use Drugs (PWUD) show similarities all over the world. In countries where PWUD lack access of quality harm reduction services; are being criminalised; and human rights are being violated, Mainline works hard to promote health and rights to the often ostracised and hidden populations. 

Outreach work forms an essential foundation for all harm reduction interventions and is the backbone of an organisation.

Through outreach workers – or low threshold locations – several services are delivered to those who need them, people are educated on safe drug use and, if necessary, are referred to health services as per own need.

However, experience shows different challenges in order to provide sustainable harm reduction services to this often hard-to-reach population.


Mainline believes
that quality harm reduction programmes should be efficiently targeted to the needs of the client and should be sustainable, consistent and widely available. This can only take place if services are embedded in a broader continuum of care for PWUD. However, organisations struggle to collect real-time data and assess the actual impact of their work. And with constant – political and financial – setbacks in our work, it is hard to set a quality standard.



Mainline believes that innovative solutions can overcome some of these challenges. Innovation and creativity within the harm reduction field are not only much needed, but it is the only way harm reduction can survive in the long run.

The Bridging the Gaps 2 programme fully embraces innovation and sees it as a means to sustainable solutions where current practices stop. The programme allows Mainline the unique opportunity to improve the quality of services, pilot new interventions and to learn.

By putting innovation high on our BtG2 agenda, Mainline hopes to benefit all of its partners within the programme and beyond in order to flag the importance of data collection, improve the quality standards of local programmes and increase access to harm reduction services for those who use drugs worldwide.

Mainline hopes to leave a positive mark in the harm reduction community and other key populations, such as sex workers and the LGBT-community.

Want to know more?


Our partners in Pakistan

Pilots in Pakistan

News from Pakistan


Contact

Innovation- and Country Manager Pakistan: 
Nick Veldwijk


Innovations in Pakistan

The HIV-epidemic in Pakistan is centralised and concentrated. In Pakistan, HIV mainly affects people who inject drugs. In a country where drug use – although widespread – is a huge taboo and where sexuality is not always easily discussed – you can find one of the world’s most successful harm reduction programmes.

It is in Pakistan where Mainline supports and implements most of its innovative work. Read more about our current innovative pilots in Pakistan and find out how other key populations can also benefit from successful and/or failed pilots.


Academic publications


HIV incidence and associated risk factors in female spouses of men who inject drugs in Pakistan


Adherence to antiretroviral therapy among HIV positive men who inject drugs in Pakistan

Our current projects


internationaal

Services for Vulnerable Migrants who use Drugs in the EU

Netherlands, Belgium, Spain, Greece, Germany, France

Several risk factors increase the vulnerability of (new) groups of migrants to engage in problematic drug use. These risk factors include traumatic experiences, disengagement with society, unemployment and poverty. Services and municipalities throughout the European Union are faced with the urgent challenge to address these migrants’ needs. 

> Read more

Mainline - Technical Advice

Did Mainline become a supplier? Yes: a supplier of technical advice for the Global Fund. Harm reduction organisations and networks of people who use drugs across the world can now request a Mainline training or capacity building. Read more about how this works.

> Read more
internationaal

Gender-based violence

Kenya

Women who use drugs in Kenya face violence every day: At home. On the streets. By the police. In their communities. A unique study - conducted in Mombasa, Kenya - sheds light on the tough realities these women encounter. Urgent action is needed.

> Read more
internationaal

Chemsex

Global

The use of drugs during sex is a growing worldwide phenomenon among men who have sex with men (MSM). Mainline has built a unique track record while working in the frontline of the Dutch 'chemsex' scene. Now, we also apply this expertise in an international context. The best place to start? Our chemsex e-learning.  

> Read more
internationaal

Assessing the drug scene

Zimbabwe

Mainline have been asked to assess the drug scene in five provinces in Zimbabwe. A team of three researchers are currently working in collaboration with the Zimbabwe Civil Liberties Drug Network in the first quarter of 2022. The goal: to gain an insight into which drugs are commonly used and to recommend health interventions.

> Read more
internationaal

Love Alliance

Burkina Faso, Burundi, Egypt, Kenya, Marocco, Mozambique, Nigeria, South Africa, Uganda, Zimbabwe

Mainline is a partner in the Love Alliance programme. The Love Alliance brings together organisations led by communities most affected by HIV and AIDS.

> Read more
internationaal

Mindful Muscles

United Kingdom, Finland, Greece, Estonia, Serbia, Portugal, the Netherlands

Harm reduction approaches are rarely applied in a recreational sports setting. And why would we - sport equals health, right? Not always. Research shows that the use of performance and image-enhancing drugs (PIEDs) is quite common in various recreational sport scenes. And for those people who use frequently and in high doses, harm reduction can make a big difference.

> Read more
internationaal

Stimulant Harm Reduction - Field Lab

Vietnam

In 2021 and 2022, SCDI in Vietnam and Mainline can continue to strengthen and expand the available harm reduction offer for people who use meth-amphetamines. After establishing the regional field lab in 2019 and 2020 we now have the opportunity to push this innovative initiative to the next level. One important element: to improve and expand the community mental health response. Moreover, the skills that were built in Hanoi's field lab are ready to be further disseminated across the South East Asian Region.

> Read more
internationaal

Quality Harm Reduction

Iran

Iran is renowned for its harm reduction programme. It was one of the first countries in this geographical region to adopt a harm reduction approach. Government supports and funds the programme. But the drug scene in Iran has changed over the past 20 years. More people are using stimulant drugs and, due to economic circumstances, more people who use drugs have become homeless. Mainline sets out to see whether the current programme in Tehran still fits the needs of the local people who use drugs.

> Read more
internationaal

Prison Health

Indonesia

Prisons in Indonesia are overcrowded and health services are limited. Is quality prison health too expensive? Not according to findings from Atma Jaya University, who applied the method of 'economic modelling' to prison health services, including drug dependency programmes. The findings fed important advocacy messages to improve the prison system in 2021. Moreover, Atma Jaya - via a 2021 implementation study - succesfully introduced motivational interviewing into the prison setting: an evidence-based method to assist people who are dependent on drugs and would like to reduce or quit their drug use.

> Read more

Our finished projects

Understanding the needs of women who use drugs and their HIV+ children

Tanzania

Children Education Society (CHESO) in Tanzania has requested Mainline to assess the needs of women who use drugs and their (HIV positive) children. Between September and November two Mainline staff members will speak with women to ensure their needs for services will be taken up in the new national HIV and AIDS strategic plan. 

> Read more
internationaal

Young, Wild and... Free?

Kenya, South Africa

Young people use drugs - including minors. It's an inconvenient truth: societies usually seek to prevent young people from damaging their health and there is a big taboo on drug use among young kids. But are stigma, legislation or moral judgement keeping young people away from harm reduction services? This project aims to find and improve access to services.

> Read more
internationaal

Size estimation and service mapping: introducing harm reduction

Zambia

Harm reduction is new in Zambia. Mainline was asked to estimate how many people inject drugs in the country and to map the already existing harm reduction and HIV services for people who use drugs. Based on this information, we drafted practical service guidelines. In doing so, Mainline hopes to have contributed to the introduction of harm reduction in Zambia.  

> Read more
internationaal

Reducing harms in the work environment

South Africa

Together with activists and peer- and outreach workers in South Africa, Mainline worked on a practical guide about involving peers in harm reduction work.

> Read more
internationaal

Women Who Use Drugs & Peer Workers

South Africa

Women Who Use Drugs face additional problems compared to their male counterparts. The harm reduction field far too often neglects the needs of women. To some extent, the same is true for peer workers: incredibly valuable staff in any impactful service. How can local services make sure that peer workers are valued, supported and living up to their full potential? And how can access for women who use drugs be improved?

> Read more
internationaal

Hanoi field lab for stimulant harm reduction

Vietnam

October 2019 marked the start of a cutting edge new initiative. With the support of Open Society Foundation, Mainline and SCDI in Vietnam are building expertise to support people who use stimulant drugs. The core motivation to do so is the sharp rise in the use of crystal meth in the South Asian region and the lack of a coordinated harm reduction response.

> Read more
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