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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.
Within the Bridging the Gaps programme, Mainline supported harm reduction projects in Indonesia, Kenya, Nepal, Pakistan, South Africa, Tanzania and Vietnam. The Dutch Ministry of Foreign Affairs funded Bridging the Gaps.
The first phase of Bridging the Gaps took place between 2011-2015. The continuity that this programme offered, running for almost 10 years, allowed us to work strategically and to build strong partnerships across the world.
The flexibility of the project made our work exceptionally effective, as it ensured we could focus on specific service gaps for people who use drugs or to address new drug trends.
We focused on people who use meth-amphetamines in Indonesia, on outreach work, human rights and opioid substitution programmes in South Africa, on women who use drugs in Kenya, on needles and syringe programmes in Nepal, on stimulant use in Vietnam and on safeguarding harm reduction in Tanzania.
The Bridging the Gaps 2 programme led to some interesting innovations. Mainline joined forces with long-time partner Nai Zindagi in Pakistan to explicitly work on innovative interventions.
Mainline provided financial support to partner organisations that were part of the Bridging the Gaps programme. In addition, we also assisted local partner organisation to build capacity. We trained and coached partners in four key areas:
Mainline offered specialised harm reduction training, ranging from basic harm reduction skills to outreach work and from women who use drugs to harm reduction for people who use stimulants (and much more). Our trainer-of-trainers programme was also initiated under the Bridging the Gaps 2 programme.
A study about community-led harm reduction work was commissioned and conducted in Indonesia, Kyrgyzstan and South Africa. This resulted in the report 'Community Matters'. Additional studies were done in Pakistan: one about the spouses of people who inject drugs and their risks to contract HIV and one about adherence to ART.
As a complementary programme, the Dutch Ministry of Foreign Affairs approved a programme that focuses on young key populations. This programme runs until the end of 2021 and is called 'Young, Wild and.. Free?.
The Bridging the Gaps programme has been evaluated by an external assessor. The report can be found here:
The website of the Bridging the Gaps programme is accessible until the end of 2021. Have a look at www.hivgaps.org.
Nepal
Mainline was asked to review the current harm reduction programmes in Nepal from the perspective of women who inject drugs. Based on interviews with women we formulated recommendations to improve service delivery.
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.
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.
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.
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.
Brazil
Mainline is starting a two-year project in Recife, Brazil, together with LANPUD, and the Free School for Harm Reduction (ELRD). The project aims to expand harm reduction and HIV care and support for young people who use crack cocaine.
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.
Zimbabwe
Mainline have been asked to assess the drug scene in five provinces in Zimbabwe. A team of three researchers worked in close collaboration with the Zimbabwe Civil Liberties Drug Network throughout 2022. The goal: to gain an insight into which drugs are commonly used and to recommend health interventions.
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.
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.
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.
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.
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?
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