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South Africa

The main drugs of choice in South Africa are alcohol, cannabis, heroin and methamphetamine. Methamphetamine is locally known as tik. Most heroin is smoked mixed with cannabis, a popular mix called whoonga, cocktail or nyope. Heroin injection, however, has been increasing in recent years. 



Harm reduction programmes were introduced in South Africa only in 2014, focusing on PWID. South Africa counts with a progressive legal framework around drug policies, supporting a harm reduction approach. Nevertheless, and despite being considered a middle-income country, government funding for harm reduction is still very limited. Moral issues around drugs play an important role in this disparity. 

Mainline in South Africa
With the help of Bridging the Gaps Program, in 2 years’ time 3 Needles and Syringe Programmes (NSP) for People who Inject Drugs (PWID) were built and developed in 3 key-cities (Cape Town, Durban and Pretoria).

Some of the activities offered by the programmes are HIV prevention and testing, needle and syringe distribution, drop in centres, and referral to other services.


On the advocacy side
Mainline supports the development of two recently born regional drug users’ networks, documentation of human rights violation towards PWUD, media articles on human rights for PWUD and national events to debate drug policies.

Read here one excellent example of such an event: the RUN 2016 - SA Drug Policy Week.


As a result of advocacy efforts
Three new Opiate Substitution Treatment (OST) pilots will start in 2017 in Durban (Kwazulu Natal), Cape Town (Western Cape) and Pretoria (Gauteng). To support this, Mainline recently delivered a training on OST to South African outreach workers, together with our local partners.

Training focused on understanding the medical aspects of OST and possibilities of psychosocial assistance for OST clients. Read more about the training

Our current projects


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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
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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 now.

> Read more
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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?

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Train-the-trainer programme

In 2017, Mainline launched its first international train-the-trainer (ToT) programme. The objective of the programme is to develop the in-house training capacity of local partner organisations, making Mainlines capacity building efforts more sustainable in the long term.

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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
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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
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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.

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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
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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 years: more people are using stimulants and there are more and more homeless people who use drugs due to economic circumstances. Mainline sets out to see whether the current programmes in Tehran still fit the needs of the local people who use drugs.

> Read more
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Prison Health

Indonesia

Prisons in Indonesia are often 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 treatment. The findings feed important advocacy messages to improve the prison system in 2021.

> Read more
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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.

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Our finished projects

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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.

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Harm reduction for stimulant users

A MAINLINE-GIZ STUDY

With the support of the Global Partnership on Drug Policies and Development (GPDPD), a project implemented by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, a team of three Mainline researchers conducted a study into effective harm reduction interventions for stimulant users. The study includes a review of the evidence for different harm reduction strategies for stimulants and a detailed description of seven good practices in different world regions.  

> Read more
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Bridging the Gaps 2: 2016 - 2020

Indonesia, Kenya, Nepal, Pakistan, South Africa, Tanzania and Vietnam

The Bridging the Gaps programme started its second phase in January 2016 and continued until the end of 2020. The shared goal of the Bridging the Gaps alliance: to improve the health and rights of people who use drugs, sex workers and lesbian, gay, bisexual and transgender (LGBT) people.

> Read more
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Tanzania

Heroin use has increased enormously in Tanzania and other East African countries in recent years. East Africa is situated along the heroin trafficking routes from Afghanistan to Western Europe, and this has also affected local consumption. It is estimated that there are 30,000 people who inject heroin in Tanzania wherein at least 10,000 of them live in the capital Dar es Salaam. People who use drugs in Tanzania are marginalised and cope with infectious diseases, overdose and police brutality. In 2019, Mainline partnered with Mukikute to build better health services for this vulnerable group of people.

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Multi-country study on harm reduction and community involvement

Funded by Bridging the Gaps, this study aimed to understand how involvement of people who use drugs can influence the quality and availability of harm reduction services. The study took place in three countries - Indonesia, Kyrgyzstan and South Africa.

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Vietnam

In the last decade, the use of methamphetamine – also referred to as ‘meth’ or ‘ice’ – has increased significantly throughout Southeast Asia. And Vietnam is not an exception.

> Read more
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