South Caucasus


of men who have sex with men in Georgia are HIV positive


of people who inject drugs in Armenia have hepatitis C


people were recorded arriving in Armenia in December 2020 in the wake of the conflict with Azerbaijan

A humanitarian emergency in South Caucasus

These figures speak for themselves: the need for a humanitarian mission in the South Caucasus is indisputable.


Our humanitarian action in the South Caucasus: harm reduction

The South Caucasus region comprises three countries – Georgia, Armenia and Azerbaijan – all of which regained their independence in 1991 after the collapse of the Soviet Union. Despite some reforms to the healthcare systems in these countries, the situation remains critical in terms of infectious disease prevention among key population groups.

An access to treatment almost non-existent and a legislation still very repressive

Although levels of HIV infection are relatively low in the general population, people who inject drugs in Armenia and men who have sex with men in Georgia are among the groups most exposed to HIV, with prevalences of 7% and 21.5% respectively.

The South Caucasus also has one of the highest rates of hepatitis C in the general population in Eastern Europe and Central Asia. People who use drugs are particularly exposed and stigmatised with hepatitis C rates of 52.6% in Armenia and 62.8% in Azerbaijan. Access to treatment is virtually non-existent and the legislation remains very repressive.

In response to these emergencies, Médecins du Monde ran a number of humanitarian assistance programmes in Georgia and Armenia in 2020 and is planning work in Azerbaijan to deliver a regional humanitarian programme focusing on harm reduction. We intend to increase our advocacy work on better access to prevention services for the groups that are most affected and marginalised.

South Caucasus: humanitarian action by Médecins du monde in Georgia

Humanitarian and medical assistance is needed in the South Caucasus and especially in Georgia.


Supporting LGBTinfo-icon+ people and young people who use drugs: key milestones in our humanitarian mission

Since 2018, Médecins du Monde has been supporting a self-help group for young people who use drugs, focusing on new psychoactive substances (NPSs). In 2020, this support was extended to an organisation active in the area of harm reduction and protecting the rights of men who have sex with men.

Through its humanitarian mission in the Philippines, Médecins du Monde also worked on developing treatment models for these key population groups. The aim is therefore to launch a pilot project to improve access for the LGBTinfo-icon+ community to innovative HIV prevention services and to develop new harm reduction services for young people who use NPSs, especially at festivals.


Advocacy developments – from the national level to the regional

As part of its humanitarian mission in the South Caucasus, MdM is continuing its advocacy work to help strengthen harm reduction services in Georgia at a time when the state is about to take over responsibility for the funding previously provided by the Global Fund. Working with several civil society organisations, four reports were produced to facilitate this transition. Position papers were sent to the national authorities, with recommendations on decentralising the country’s HIV treatment system and on funding of prevention and harm reduction services.

With a view to expanding this advocacy work to the South Caucasus regional level and enhancing its impact, we are continuing our humanitarian action in 2020 with civil society representatives in Armenia and elsewhere, with regional platforms working in the countries of Eastern Europe and Central Asia.


Responding to the impact of Covid-19


The restrictions imposed by the authorities to tackle the Covid-19 pandemic further weakened access for key groups to health services and harm reduction supplies.

MdM therefore offered support – material (personal protective equipment) and technical (training and awareness-raising for key groups) – to 25 centres and partner organisations to maintain access to health services. Our teams also ensured that healthcare staff, volunteers working at the centres and centre users were protected. These were essential safety measures to ensure continuity of care.



IN 2020

through our humanitarian action in the South Caucasus and working with our partners we achieved concrete results, we:

  • supported 25 centres and partner organisations with supplies and training
  • distributed 69,361 pieces of personal protective equipment (surgical masks and hand sanitiser)
  • met with and supported 20,924 harm reduction service users


These figures illustrate the effectiveness of the medical assistance provided by Médecins du Monde in the South Caucasus.


© Olivier Papegnies
© Olivier Papegnies

South Caucasus: Médecins du Monde’s humanitarian action in Armenia

Through our humanitarian action in Armenia we have been able to help the most vulnerable groups, such as people who use drugs and people caught up in conflict.


Protecting people who use drugs: a key focus of our humanitarian mission in the South Caucasus

Following exploratory missions in 2018 and 2019, Médecins du Monde has been working in Armenia to develop a harm reduction programme aimed at people who inject drugs and based on the model used in Georgia.

In 2020, MdM worked with the local partner we had identified to develop a suitable model to improve detection of HIV and hepatitis C and access to treatment for people who use drugs.

In response to the Covid-19 pandemic, Médecins du Monde also provided personal protective equipment to ensure the continuation of the activities and services offered by our local partners. For the first time in Armenia people who are HIV positive have been able to receive their ARVinfo-icon treatment directly at home. This is a positive development for patients, who have benefited from greater peace of mind and better quality of care.

In 2020,

we joined forces with our partners to address needs more locally. As part of our humanitarian mission in the South Caucasus we worked together to:

  • distribute 16,710 items of personal protective equipment (surgical masks and hand sanitiser)
  • meet with and support 2,477 harm reduction service users

South Caucasus: responding to the humanitarian emergency in Nagorno-Karabakh

Through our humanitarian work in the South Caucasus MdM also provided support for people caught up in the violent conflict.


Supporting Armenians hosting people affected by the conflict

After many years of tensions, the conflict between Azerbaijan and the separatist republic of Nagorno-Karabakh, supported by Armenia, erupted again on 27 September 2020, with each side claiming that it was responding to aggression from the other side.

A ceasefire was signed on 9 November 2020 in a process led by Russia. At least 5,000 people lost their lives during these clashes, many received injuries, some of them life-changing, and whole families were forced to leave their homes (mainly women and children). This amounted to around 80,000 people out of a total of 120,000 registered in the region.

Following an exploratory mission in October 2020, Médecins du Monde provided initial emergency humanitarian support to two civil society organisations receiving and supporting people arriving in Armenia in the wake of the conflict: 1,425 non-food items (winter kits) were provided for families affected.



A new longer term response is planned in 2021 to build the capacity of partner organisations, to support the volunteers welcoming and supporting the displaced families and to improve access to information, healthcare and social services.


In 2020,

the humanitarian assistance provided by MdM in the South Caucasus helped to:

  • support two local organisations in Armenia working with displaced people
  • provide 1,425 winter kits and non-food items to families affected by the conflict



our institutional support

Budget of the humanitarian mission in the South Caucasus: €343,900 in donations to the South Caucasus
L'Organisation mondiale de la santé soutient Médecins du Monde
Open Society Foundations soutient Médecins du Monde
Programme on mother-child health in the west of the country, in the area where people have been displaced.
Exploratory mission in the secessionist region of Abkhazia then in conflict with the Georgian state.
Exploratory missions on harm reduction for people who use drugs.
Opening of a programme for people who use drugs in Tbilisi.
Setting up of a hepatitis C treatment cohort for people who use drugs.
Roll-out of HCV care and treatment model to people who inject drugs in the Samegrelo region (Zugdidi).
Roll-out of HCV care and treatment model to people who use drugs in the Gori region.
Exploratory missions for the expansion of the harm reduction project in Armenia and Azerbaijan.
Work with the local partner to develop a suitable model to improve detection of HIV and hepatitis C and access to treatment for people who use drugs.

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