Bridging the Gaps: Nepal
Bridging the Gaps: Nepal
Bridging the Gaps is alliance of nine international organisations and networks and more than 80 local and regional organisations, working towards the end of the AIDS epidemic among key populations.
Supported by global and regional level work, Bridging the Gaps works with over 80 partner organisations in 15 countries in three regions:
• Sub-Sahara Africa: Botswana, Kenya, Mozambique, South Africa, Tanzania, Uganda, and Zimbabwe.
• South East Asia: Indonesia, Myanmar, Nepal, Vietnam.
• Eastern Europe and Central Asia: Georgia, Kyrgyzstan, Tajikistan and Ukraine.
We work to realize effective needle and syringe exchange policies; an improved legal context for people who use drugs; and increased access to quality, comprehensive and accessible harm reduction services in Kathmandu Valley.
In Nepal, the programme works with, and for the health and human rights of, people who use drugs, including those living with HIV.
Bridging the Gaps partners in Nepal work towards ending AIDS among key populations through (1) a strengthened civil society that holds government to account; (2) increased fulfilment of human rights of key populations; and (3) increased SRHR and fewer infections.
Through innovation, and by building on previous work in Nepal, we will strengthen civil society organisations’ ability to:
1. Facilitate community development, by:
• Building of national PWUD network;
• Facilitating community development on advocacy.
2. Advocate for the continuously strengthening of services and upholding human rights, by:
• Using evidence from the Human Rights Count (HRC) report on PWUD living with HIV (BtG 1) to build an advocacy campaign, and push for legislative and programmatic changes to ensure that the health and human rights needs of PLHIV drug users are advanced.
3. Deliver inclusive, rights-based and gender sensitive services, by:
• Implementing an efficient and high-quality Needle and Syringe Programme in Kathmandu Valley;
• Conducting size estimation of IDU’s in Kathmandu Valley and conducting effective outreach;
• Training outreach workers on thematic skills and pilot outreach methods in the field.
4. Foster global and in-country processes and partnerships that reinforce results, by:
• Improving partnerships in-country with other NGOs, government, the Health •
• Council, and organisations that can assist in (data) management systems.
People who use drugs
In Nepal, prejudice and discriminatory attitudes towards key populations hinder access to health services, especially those seeking STI treatment and ART. PWUD continue to face punitive legal environments and human rights abuses, and the right to health for many people who use drugs is impaired.
Nepal endorsed the national guidelines on Opioid Substitution Therapy in 2014, which paves the way to scale up and support OST programmes for PWUD (including methadone and buprenorphine). There are an estimated 52,174 PWID, with a HIV prevalence of 6.3%. However, these numbers are contested by civil society and there is little data on female PWID available. On average, there are 36 syringes distributed per PWID per year. Condom usage (estimated at 46,50%) and HIV testing (estimated at 21,40%) are low among PWUD. The current OST programme implemented has problems of low uptake and low retention rates. Female drug users are also common and very vulnerable to sexual violence and poverty in a male-dominated culture. Though HIV prevalence among PWID has remarkably decreased, high prevalence of viral hepatitis has been observed among PWID and in particular among those co-infected with HIV.