{"id":10749,"date":"2018-12-06T11:08:46","date_gmt":"2018-12-06T11:08:46","guid":{"rendered":"https:\/\/drogriporter.hu\/?p=10749"},"modified":"2022-07-04T14:19:32","modified_gmt":"2022-07-04T12:19:32","slug":"bulgarin-harm-reduction-drown-in-bureaucracy-interview-with-yuliya-georgieva","status":"publish","type":"post","link":"https:\/\/drogriporter.hu\/en\/bulgarin-harm-reduction-drown-in-bureaucracy-interview-with-yuliya-georgieva\/","title":{"rendered":"Bulgarian Harm Reduction Drown in Bureaucracy: Interview with Yuliya Georgieva"},"content":{"rendered":"

The news came as a shock: all harm reduction programs were terminated this year in Bulgaria, an EU member state. Why? Yuliya Georgieva, a veteran Bulgarian harm reduction activist from the Centre for Humane Policy<\/a> and the new co-chair of the Eurasian Harm Reduction Association, answered our questions.\u00a0\u00a0<\/p>\n

Drugreporter: How and why did you get involved in harm reduction?<\/em><\/strong><\/p>\n

Yuliya Georgieva<\/strong>: It was in the mid 90s during the heroin epidemic in Bulgaria. Some of my friends already used and my instinct was that I needed to help somehow. Of course, at first I tried to speak with them, to support them, but it didn\u2019t work very well. Then I started to buy some syringes for my closest friends. It was absolutely instinctive behaviour – I hadn\u2019t heard of harm reduction in those days but I felt that this was the right way to do things.<\/p>\n

Some time after that I also started to use drugs and in a few years I became one of the first clients of \u201cInitiative for Health\u201d foundation – the first harm reduction organisation in the country. Very soon after that I became a volunteer for the organisation and started to distribute syringes and information for my friends. With a colleague from Initiative for Health we had a joke that I\u2019d opened the first drop-in centre with a safe injecting room in the country in \u201997.<\/p>\n

So, the guys from the foundation helped me very much and in 2000 I\u2019d quit drugs, started my education in the university, and tried to work for the first Therapeutic Community in the country. Very soon I realised that it was not my cup of tea and quit. In this very hard moment of my life, I received a call from Elena (the director of the foundation) and she offered me a job there.<\/p>\n

Bulgaria is the poorest EU member state. Injecting drug use is mostly concentrated in impoverished Roma communities. The EU has spent a lot of money on the integration of Roma people, did it have an impact on their lives?<\/strong><\/em><\/p>\n

My opinion is that, unfortunately, the money wasn\u2019t spent in the proper way and instead of improving the quality of life of Roma people, they segregate the community even more. Some of those financial resources were stolen by fake NGOs and some were spent in an improper way.<\/p>\n

In that situation, the right wing propaganda pushed very hard for their interests and all the time published fake information about the social benefits for Roma people – claiming that the money for health, education, and social benefits were spent on the Roma community etc. The result is that now we have extremely segregated communities without any contact with health care facilities, with very poor educational possibilities, and with working potentialities only in the black market. It closes the communities off even more and exacerbates the negative attitudes against Roma people among the society.<\/p>\n

It was the Global Fund to Fight AIDS, Malaria and Tuberculosis<\/a> that introduced and funded harm reduction in Bulgaria for 14 years. What progress has Bulgaria made in this period?<\/em><\/strong><\/p>\n

In fact, Open Society Foundation introduced Harm reduction in 1997 in Sofia. Before the Global Fund program came to the country, there were already three very good harm reduction organisations, with strong advocacy positions and very good services. The Global Fund program supported those three organisations at first – they provided training for staff members. Some of them became consultants for the Ministry of Health and became part of the Ministry’s working groups. They built the skeleton of the structure.<\/p>\n

In 2004 Global Fund\u2019s Ministry of Health National HIV program supported 7 organisations working with people who use drugs in different parts of the country, to start dealing with harm reduction. Part of this programme was newly formed, whilst part was redistributed for the needs of the Global Fund program.<\/p>\n

Then came the \u201cgolden\u201d era for harm reduction services in the country. There were almost 60 organisations (among all key populations such as people who use drugs, sex workers, men who have sex with men, Roma population, young people etc), there was also a lot of funding for building the capacity of the structures of the Ministry of Health.<\/p>\n

Also, during almost the same period the National Centre of Addiction used to work very openly and introduced a lot of best practices – in 1995 the first free substitution programme was opened, whilst the first decree of the Ministry of Health on Harm Reduction was adopted in 2000 – they supported very strongly the Ministry with introducing harm reduction on the national level. \u2028\u2028And we used to have very good results. Officially Bulgaria still has very low HIV prevalence: 2.8\/100 000.<\/p>\n

Why and how things did get so bad?\u00a0<\/strong><\/em><\/p>\n

At the same time the bureaucrats from the National HIV program had all the power, all the money, and the political support, and day by day they built a \u201cone man show\u201d \u2013 making decisions without involving independent NGOs and community representatives. They made a lot of wrong or inadequate decisions regarding the everyday work; usually the financial tranches to NGOs were late by 4-5 months and the teams needed to work without salaries for long time periods. The NGOs were pushed out of the real decision making and were put in the position of \u201csub-contractors\u201d, who didn\u2019t have the freedom to explain their positions strongly and to fight for the interests of the target groups. If the NGOs wanted to work for the MoH program, they needed to be obedient and to execute the ministry’s orders.<\/p>\n

All those organisations became very dependent on the Ministry of Health and stopped adhering to one of the main functions of Harm Reduction \u2013 the advocacy for better policy and independent existence. Day by day the compromises became a systematic part of the functioning of the organisations and most of them became part of the bureaucratic hierarchy of Ministry of Health.<\/p>\n

Watch our video we produced in 2012 about harm reduction in Bulgaria!<\/strong><\/p>\n