HA-REACT Work Packages

Work package 1: Coordination

Work package lead: Mika Salminen (leader) and Outi Karvonen (project manager), National Institute for Health and Welfare, Finland, outi.karvonen@thl.fi

Work package 2: Dissemination

Work package lead: Jeffrey V. Lazarus, CHIP (REGIONH), Denmark, jeffrey.lazarus@regionh.dk

Work package 3: Evaluation

Work package lead: Marcus Martens and Heike Zurhold, Centre for Interdisciplinary Addiction Research of Hamburg University, Germany, martens@uni-hamburg.de; zurhold@uke.de

Work package 4: Testing and linkage to care

Work package lead: Alexandra Gurinova and Inna Vyshemirskaya,  Deutsche AIDS-Hilfe (DAH), Germany, alexandra.gurinova@dah.aidshilfe.de; inessa.vyshemirskaia@dah.aidshilfe.de

Work package 5: Scaling up harm reduction

Work package lead: Luis Sordo del Castillo and Ana Sarasa Renedo (ISCIII/CIBER), Spain, lsordo@externos.isciii.es; asarasa@externos.isciii.es

Work package 6: Harm reduction and continuity of care in prisons

Work package lead: ISFF, Heino Stöver, Frankfurt University of Applied Sciences, Germany hstoever@fb4.fh-frankfurt.de

Work package 7: Integrated care of people who inject drugs

Work package lead: Aljona Kurbatova,  National Institute for Health Development, (TAI/NIHD), Estonia, aljona.kurbatova@tai.ee

Work package 8: Sustainability and long-term funding

Work package lead: Jeffrey V. Lazarus, CHIP (REGIONH), University of Copenhagen, Denmark, jeffrey.lazarus@regionh.dk

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Work package 1: Coordination

Objectives

A well-coordinated Joint Action (HA-REACT) with functioning management, including timely reporting, budget control and support for successful implementation will be established.

Outputs & activities

HA-REACT involves 23 associated partners from 18 countries and 12 collaborating partners. The HA-REACT actions are organized into five core work packages (WP 4-8).

The coordinator ensures that the Joint Action’s packages (WP) pursue a coherent objective as specified by the Joint Action call. The coordinator leads the project with the support of the steering committee, oversees the execution of the WPs and may take part in their execution, as appropriate. The coordinator will facilitate the building of country ownership, together with the WP leaders.

Tasks of the coordinator:

  • Monitor activities  to determine that they are implemented properly;
  • Act as the intermediary for all communications between the beneficiaries and the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA);
  • Request and review any documents or information required by CHAFEA, and verify their completeness and correctness before passing them on to CHAFEA;
  • Submit the deliverables and reports to CHAFEA;
  • Ensure that all payments are made to the other beneficiaries without unjustified delay;
  • Inform CHAFEA of the amounts paid to each beneficiary, when required in the grant agreement or requested by CHAFEA.

The management structure of HA-REACT consists of the THL Coordination Team, Steering Committee and Advisory Board. In addition, each WP has its own leadership and internal meetings.

Deliverables

Logical framework approach (LFA) workshops will contribute to the first deliverable of the WP3 Evaluation by producing an LFA analysis of the core WPs (4-8).

The coordinator will compile two interim reports and the final report with the assistance of all WP leaders.

The coordinator, together with other WP leaders, will compile all training materials into one training package/toolkit at the end of the Joint Action:

  • Guidelines for gender-specific testing
  • E-learning tool on testing in low-threshold services
  • Harm reduction (HR) training package
  • Training on HR in prison settings, with focus on continuity of care
  • Toolkit on models of care and quality
  • Report on prevention and treatment service access barriers
  • Guidance on funding mechanisms.

Work package leads: Mika Salminen (leader) and Outi Karvonen (project manager), National Institute for Health and Welfare, Finland, outi.karvonen@thl.fi

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Work package 2: Dissemination

Objectives

During the three-year project period of the Joint Action, the coordinators and partners will share information publicly on a frequent and regular basis and link activities to the most important meetings, trainings and events of the Joint Action. The project seeks to be highly visible in its field by reporting on progress, results and deliverables to intended project beneficiaries as well as a broader specialized audience.

Outputs & activities

The Joint Action external dissemination plan to be developed by CHIP (REGIONH), the lead partner, is based on four principles:

  1. Regular communication: At a minimum, every month the project will share information with a variety of stakeholders, as per below, and seek to engage non-partner countries, like Bulgaria and Romania, as well as neighbourhood countries.
  2. Multilingual materials: The project language is English, but because it is an international collaboration, materials will be translated into at least one other language (that of the country in focus) when relevant and feasible. Additionally, the news content will be disseminated by AIDS Action Europe in English and Russian.
  3. Use of existing channels: Dissemination activities will seek to capitalise on existing communication platforms and accounts and will include promotion efforts at scheduled regional and national events, such as conferences, relying on all project partners and particularly the associate partners. These include gatherings of the European AIDS Clinical Society (EACS), the European Association for the Study of the Liver (EASL) and the International AIDS Society (July 2018, Amsterdam). All project partners, particularly the associate partners, will be engaged in these dissemination initiatives.
  4. Target audiences: National policy-makers, professional medical associations (nurses, general practitioners, specialists on infectious diseases, particularly HIV, hepatitis and TB); NGOs; CBOs and patient organisations; national and European policy organisations, security and prison health specialists; as well as drug agencies.

CHIP will lead on all dissemination initiatives and participate in the five overall project meetings. However, all Joint Action partners will be involved in dissemination and offered opportunities to contribute to specific activities, such as the blog and LinkedIn discussions, in order to share their deliverables and other activities. Associated and collaborating partners as well as European institutions—CHAFEA, DG SANTE, DG JUST/HOME, ECDC and EMCDDA—will be encouraged to join in on these endeavours.

AIDS Action Europe is the associated partner in this WP and will lead on website development, media outreach and the project blog and will contribute to LinkedIn/Liver Portal discussion posts.

All training events, conferences, network meetings and seminars implemented in other WPs will be promoted by social media (#HAREACT) and on the project website (hareact.eu).

Deliverables

The task of this work package is to ensure multi-channel, multilingual communication of HA-REACT’s progress and outcomes to a wide audience. The key deliverables to achieve this task will be promoted via the use of web resources, printed material, and publications in journals and newsletters.

Work package lead: Jeffrey V. Lazarus, CHIP (REGIONH), Denmark, jeffrey.lazarus@regionh.dk

 

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Work package 3: Evaluation

Objectives

Set up an evaluation framework to measure and monitor:

  1. The level of achievement with respect to the project objectives in line with the 2003 Council Recommendation on the prevention and reduction of health-related harm associated with drug dependence; the EU drug strategy (2013-2020) and its Action Plan on Drugs (2013-2016); as well as the EU HIV policies [COM (2009) 569] and Action Plan on HIV/AIDS in the EU and neighbouring countries [(2014–2016 ) SWD (2014) 106];
  2. Whether the Joint Action outcomes match the needs of the EU member state countries;
  3. If the project activities are implemented as intended.

Outputs & activities

  • Support the WP leaders in setting up tangible and measurable process, output and outcome/impact indicators in connection with establishing a logical framework for the WP;
  • Take an active role in the logical framework workshops which will create the evaluation framework and clearly define instruments (qualitative and quantitative) and target groups;
  • Developing standardized measurements for and monitoring in a timely manner all three indicator levels (process, output, outcome/impact)..

Deliverables

The evaluation framework for the Joint Action will be developed to enable comprehensive and unbiased monitoring and reporting of the Joint Action implementation vis-a-vis agreed process and impact indicators, and planned outputs and expected outcomes. Evaluation reports will be prepared regularly to follow up and measure the progress of the Joint Action.

The WP leads, together with the coordinator, will monitor and ensure that all project deliverables have the EU added value dimension, that they are ready to be replicated and that they are transferable to other EU countries.

Work package lead: Marcus Martens and Heike Zurhold, Centre for Interdisciplinary Addiction Research of Hamburg University, Germany, martens@uni-hamburg.dezurhold@uke.de

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Work package 4: Testing and linkage to care

Objectives

Improved early diagnosis of HIV, viral hepatitis and TB, will be ensured, as well as improved linkage to care for men and women who inject drugs.

Outputs & activities

  1. Personnel working with PWID in Hungary and Latvia, who are trained in low-threshold testing of HIV, HCV and TB;
  2. Development of an interactive training manual and e-learning package on HIV, HCV and TB testing in low-threshold settings for personnel who work with people who use drugs, with a special focus on women and peers;
  3. Improved client awareness of their infection status and prevention and treatment of HIV, HCV and TB;
  4. Access to treatment is ensured after positive test result;
  5. Development and implementation of gender-specific approach in testing services that are focused on women who use drugs.

Deliverables

The deliverables of the WP4 will enhance the competence of low-threshold personnel in awareness raising, counseling, testing delivery and patient referral. The deliverables will largely be based on existing experiences and practices collected from other projects and will include a training component, and materials to educate, guide, and inform.

The WP lead, assisted by the project coordinator and WP2 partners, will ensure that all deliverables have the EU added value dimension, that they are ready to be replicated and are transferable to other EU countries.

Work package lead: Alexandra Gurinova and Inna Vyshemirskaya, Deutsche AIDS-Hilfe (DAH), Germany, alexandra.gurinova@dah.aidshilfe.deinessa.vyshemirskaia@dah.aidshilfe.de

 

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Work package 5: Scaling up harm reduction

Objectives

Harm reduction will be scaled up in the EU, based on Latvian and Lithuanian cases.

Outputs & activities

  • Assessment of people who inject drugs (PWID) epidemiology and HR interventions, and identification of needs/barriers to HR implementation in Latvia and Lithuania;
  • Training package for care providers and policy-makers on key HR interventions, including face-to-face training, and guidelines and manuals;
  • Direct support to HR interventions in Latvia and Lithuania.

Deliverables

The scale-up of harm reduction is more effective when decision-makers and professionals actively support the outreach work being done among vulnerable groups by qualified workers equipped with proper knowledge and tools. This work package will produce reliable data and evidence-based training tools to be used with various audiences and in various contexts. The outreach work will be supported through a mobile unit demonstration project.

The WP lead, assisted by the coordinator and WP2 lead, will ensure that all deliverables have the EU added value dimension, that they are ready to be replicated and that they are transferable to other EU countries.

Additional deliverables

  • Report on the training package, including three face-to-face activities: seminars, study visits and workshops,
  • Report on the first- and second-year functioning of the mobile unit as an exportable example, including a proposal of sustainability of the initiative after the conclusion of the HA-REACT Joint Action (Latvia).

Work package lead: Luis Sordo del Castillo and Ana Sarasa Renedo (ISCIII/CIBER), Spain, lsordo@externos.isciii.esasarasa@externos.isciii.es

 

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Work package 6: Harm reduction and continuity of care in prisons

Objectives

Access to harm reduction services and continuity of care in prisons will be improved.

Outputs & activities

  1. Situation analysis / mapping of needed support in the participating countries implemented;
  2. Medical, social and other prison professionals trained to work with PWID and to provide harm reduction services (incl. OST, NSP, condom provision and psychological support);
  3. Information, education, communication (IEC) materials developed for PWID and staff in prisons;
  4. Practical toolkit created for prison staff on harm reduction in prisons (as part of the Joint Action training toolkit);
  5. Condom provision and other harm reduction measures piloted in one prison;
  6. Policy brief written based on experiences from the component.

Deliverables

The deliverables of this WP are public events in the form of trainings and meetings to share and learn experiences about HR in prison settings, and a package of learning tools for professionals and PWIDs. Findings on accessibility of harm reduction will be published in a journal.

The WP lead, assisted by the coordinator and WP2 lead, will ensure that all deliverables have the EU added value dimension, that they are ready to be replicated and that they are transferable to other EU countries.

Work package lead: ISFF, Heino Stöver, Frankfurt University of Applied Sciences, Germany, hstoever@fb4.fh-frankfurt.de

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Work package 7: Integrated care for people who inject drugs

Objectives

Provision of integrated HIV, HCV and TB treatment and harm reduction for PWID will be improved.

Outputs & activities

  1. Improved capacity of health, social and civil society professionals in providing better quality of care for PWID;
  2. Development and dissemination of evidence- and practice-based tools and instructional materials for implementation of better quality care for PWID.

Deliverables

The deliverables will comprise a report mapping the best practices to ensuring quality of integrated care in different settings and for different clientele, with emphasis on management of HIV, HCV and TB in PWID. The WP will also offer a toolkit to help establish appropriate quality-assured integrated care models which will be disseminated via various channels.

The WP lead, assisted by the coordinator and WP2 lead, will ensure that all deliverables have the EU added value dimension, that they are ready to be replicated and that they are transferable to other EU countries.

Work package lead: Aljona Kurbatova, National Institute for Health Development (TAI/NIHD), Estonia, aljona.kurbatova@tai.ee

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Work package 8: Sustainability and long-term funding

Objectives

National programmes will be updated to overcome barriers to respond to HIV, TB and HCV-related needs in the EU, specifically in the focus countries.

Outputs & activities

  1. Strategies suggested for national programmes to be used in planning, resource allocation and resource mobilisation activities that address the HIV, hepatitis and TB-related needs of PWID, with long-term financial sustainability recognised as a key strategic consideration;
  2. Strategies mapped, analysed and proposed for removing provider-dependant barriers in implementing acceptable and accessible high-quality HIV, hepatitis and TB services to PWID who are living with or at risk of contracting these infections;
  3. Strategies mapped, analysed and proposed for removing customer-dependant barriers in implementing acceptable and accessible high-quality HIV, hepatitis and TB services to PWID who are living with or at risk of contracting these infections;
  4. Strategies mapped, analysed and proposed for removing structural barriers in implementing acceptable and accessible high-quality HIV, hepatitis and TB services to PWID who are living with or at risk of contracting these infections, with a special focus on mobilising resources and the use of EU structural funds, and possibly the Joint Procurement agreement (http://ec.europa.eu/health/preparedness_response/docs/jpa_note_scope_en.pdf), drawing on the work of previous European Commission supported projects. Although no longer an outbreak, HIV and hepatitis can be serious cross-border threats, (Decision1082/2013/EC http://ec.europa.eu/health/preparedness_response/docs/decision_serious_crossborder_threats_22102013_en.pdf ) and indeed, HIV and hepatitis have been addressed in earlier projects as such. The Joint Procurement agreement states that “Member States are treated equally and can benefit from correct contractual conditions”—this is particularly relevant at present with reference to HCV treatment and can be further investigated in the spirit of ensuring the best (i.e., lowest) prices for EU Member States, as a part of the sustainability of hepatitis funding.

Deliverables

The deliverables of this WP will give stakeholders a clear picture of existing barriers in terms of harm reduction, HIV, HCV and TB services and offer strategies and actions to overcome such barriers, including pooling and efficient management of resources to explicitly target the groups in most need. The deliverables will be produced in the form of action-oriented, guidance papers.

The WP lead, assisted by the coordinator, will ensure that all deliverables have the EU added value dimension, that they are ready to be replicated and that they are transferable to other EU countries.

  • An action-oriented report (with annexes for each focus country) in non-technical language for stakeholders, such as policy-makers and NGOs, on PWID barriers to accessing HIV, HCV and TB services and on strategies for overcoming these barriers;
  • Tailored guidance document on the utilisation of funding mechanisms for actions on HIV/AIDS hepatitis and TB, specifically addressing resource allocation and mobilisation and the use of diversified funding approaches to reach priority groups, particularly PWID. The document will be piloted in the focus countries.

Work package lead: Jeffrey V. Lazarus, CHIP (REGIONH), University of Copenhagen, Denmark, jeffrey.lazarus@regionh.dk

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