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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 partners in South Africa
South Africa in context
News from South Africa
E-mail: m.handulle@mainline.nl
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.
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.
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?
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.
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.
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.
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.
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.
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, we drafted practical service guidelines. In doing so, Mainline hopes to have contributed to the introduction of harm reduction in Zambia.
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.
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 dependency programmes. The findings feed important advocacy messages to improve the prison system in 2021.
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.
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.
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.
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.
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