Bridging the Gaps1: 2011 - 2015

Indonesia, Kenya, Nepal, Pakistan, South Africa and Tanzania (BtG2)

In the context of the Bridging the Gaps program, Mainline works with local partners in five countries to improve the health and human rights of drug users.

The program is aimed at three groups that are highly vulnerable to HIV:
lesbian, gay, bisexual, and transgender (LGBT) people, sex workers, and people who use drugs. Mainline works within this program with the project for drug users.

Bridging the Gaps

  • Associates health and human rights with each other,
  • Brings together key populations: sex workers, LGBT people, and people who use drugs, and
  • Links local work with international lobbying activity.


  • Mainline focuses on drug users as one of the target groups that run an increased risk of becoming infected with HIV.
  • Our goal is to reduce the HIV risks and improve the general health of users.
  • We do this by changing social attitudes and government policies. And by improving access to harm reduction services (such as health care).

Bridging the Gaps is a cooperative effort of:

Mainline, Aids Fonds, AFEW, COC, GNP+, INPUD, ITPC, MSMGF, NSWP and is financed by the Ministry of Foreign Affairs.

The programme continues: from 2016 till 2020! Read more

Our Bridging the Gaps projects





South Africa

Tanzania (BtG2)

In Indonesia, Kenya, Nepal, Pakistan, and South Africa, Mainline works with local partners, particularly non-governmental organizations (NGO's). We support harm reduction activities carried out by people in the field (outreach). We also help our partners to develop their organizations (capacity building).

Further, we find it important that specific services for drug users are integrated into hospitals and health care centres. This ensures that drug users will continue to have access to good care after the project has been completed.

All of the activities that Mainline carries out in the context of the Bridging the Gaps program are carried out in accordance with the prioritization of human rights. By working with a broad coalition of partners, we are also carrying out coordinated lobbying efforts vis-à-vis the authorities.

In particular, the International Network for People who use Drugs (INPUD) lobbies internationally on behalf of drug users. Together we are attempting to ensure that needle exchanges and methadone distribution are allowed and that forced withdrawal is prevented.

Project leaders

• Indonesia & South Africa: Hatun Eksen

• Kenya: Monica Carriere

• Nepal: Nick Veldwijk

• Contactperson Pakistan & Tanzania (BtG2):  Machteld Busz

Continuity of care

With our Pakistani partner Nai Zindagi, Mainline works to develop exchanges between developing countries (South-South exchange). In all of our work, we strive to achieve continuum of care.

This means that we also take into consideration the environment and socio-economic circumstances of drug users.

Read more about Bridging the Gaps?

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All the results of Bridging the Gaps 1 (2011 - 2015) are summarised in a results report

Mainline is happy to be able to continue all our international work over the next 5 years under:

Bridging the Gaps 2
(2016 - 2020)


  • Human rights situation of drug users
    For his master thesis, Leon Essink carried out his research in eight BtG countries. He also presented recommendations with regard to practical ways of preventing the violation of those rights.

  • Drug users' access tot care
    For her master thesis, T
    atiana Mouhebati also carried out her research in eight BtG countries.

Our current projects


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

Gender-based violence


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



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

Assessing the drug scene


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

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

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

Stimulant Harm Reduction - Field Lab


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

Quality Harm Reduction


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

Prison Health


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


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

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

Size estimation and service mapping: introducing harm reduction


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

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

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

Hanoi field lab for stimulant harm reduction


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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