people who inject drugs in Georgia
Georgia ranks third in the world for prevalence of hepatitis C
of people who use drugs carry the hepatitis C virus
Drug use developed rapidly in Georgia after the collapse of the Soviet Union in 1991 and affected up to 53,000 people in 2019. In a context where people who use drugs, the institutional response is based solely on criminalisation rather than rehabilitation.
In Georgia, 3% of people who inject drugs are HIV positive
Today, around three quarters of people who use drugs carry the hepatitis C virus (HCV) and around 3% are HIV positive (of these, the majority are co-infected with hepatitis C). Although Georgia has had a national plan for the elimination of hepatitis C since 2015, people who use drugs are still widely stigmatised and marginalised and only have limited access to treatment.
On 17 December 2019, Médecins du Monde in Georgia marked the closure of its harm reduction project originally launched in 2011. That was when MdM, working with its local partner New Vector, opened a centre for people who use drugs.
Over a period of almost 10 years a wide range of activities were organised around prevention and raising awareness of the risks of infectious diseases. This included, in particular, distributing injection kits and providing screening sessions and medical and dental consultations.
Médecins du Monde worked on a hepatitis C treatment programme
To demonstrate the value of a care and treatment model adapted to meet the specific needs of people who use drugs and their ability to take care of their own health if they receive appropriate support, Médecins du Monde also developed a pilot hepatitis C treatment programme. The success of this peer educator model enabled the work to be expanded to the regions through other harm reduction organisations, in Zugdidi in 2017 and Gori and Batumi in 2018.
Since then, with support from the Global Fund, this model has been promoted at national level to all those working in harm reduction.
In 2019, Médecins du Monde continued to support and develop the capacity of its partner, New Vector, which provides prevention services. New Vector is now able to offer direct access to hepatitis C treatment through another pilot programme. The priorities in 2019 were also to upscale the hepatitis C care and treatment model to the national level, to support community groups and to undertake advocacy work on drug policy in Georgia.
Organisations in the regions have received training and tools which have been developed to provide better hepatitis C screening and better care and treatment for patients. Médecins du Monde also supported the establishment of a self-help organisation for young people who use drugs. Extensive advocacy work has been undertaken on drug policy and hepatitis C, especially around providing treatment at centres for people who use drugs.
In 2019, Médecins du Monde also worked with young people who are increasingly using new psychoactive substances (NPS), particularly at the electronic music festivals which are becoming more widespread across the country. Lack of knowledge about these substances can lead to overdoses, which are sometimes fatal.
Contributing to harm reduction in the LGBT community
Médecins du Monde in Georgia is opening a new chapter in its history as it works to expand its harm reduction services to the LGBT community. Building on our experience in Georgia, we are also working to support new partnerships in the South Caucasus, initially in Armenia, then in Azerbaijan, where the prevalence of HCV and HIV is particularly high among people who inject drugs (the HCV rate is 53% in Armenia and 63% in Azerbaijan and HIV prevalence is over 10% in the two countries). Despite these high levels of infection, good harm reduction and HIV prevention programmes are virtually non-existent.
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