Terms of Reference
HRI seeks an independent consultant to document
community-based harm reduction programming models
in India
Consultancy:
To document selected components of the community based TI Plus programme in
India
Background:
Transmission through injecting drug use is a major driver of India’s HIV epidemic.
Although the Indian government adopted a harm reduction strategy as part of the
National AIDS Control Programme since 2007, its response to drug injecting and HIV
has continued to include punitive approaches. Despite the scale up of essential harm
reduction programmes, such as needle and syringe programmes and opioid
substitution therapy, the quality and coverage of existing services remains
fragmented, and varies widely among different states.1
Large numbers of people who inject drugs in India experience forced detention in
unauthorised “de-addiction” centres that do not employ public health principles or
evidence to address drug dependence. Detention in these centres has been reported
to involve human rights violations and abuses, including torture, corporal
punishment, chaining, caging, forced detention, and death.2 While there are over a
100 de-addiction centres in district hospitals and medical colleges across the
country, 3 most remain non-functional. In addition there are over 400 de-addiction
centres run under the Ministry of Social Justice and Empowerment.4 Weak regulation
of treatment centres, and the lack of monitoring from central and state governments
continue to aid the proliferation of such abuses despite increasing local and
international opposition.
Within Indonesia, Vietnam, Malaysia, Cambodia, India and China, civil society
organisations provide a range of community-based services to people who use drugs
that are accessed voluntarily and are evidence-informed and rights-based. Between
1
Harm Reduction International (2012) Global State of Harm Reduction 2012: Towards an Integrated Response.
London: HRI.
2
Harm Reduction International (2013) Support Don’t Punish: Experiences of community advocacy and harm
reduction programmes. Available at: http://www.ihra.net/files/2013/06/07/SDP_REPORT_FINAL_07.06_.13_2_.pdf.
3
4
Ministry of Social Justice and Empowerment (2014) Assistance for the Prevention of Alcoholism & Substance
(Drugs) Abuse Available at: http://socialjustice.nic.in/revisedschsd.php?pageid=4.
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2014-2015, Harm Reduction International (HRI) will work with local civil society
researchers and partners in these six countries to document community based harm
reduction models employed by civil society. In India, the documentation will focus on
two selected components of the TI Plus programme, a comprehensive set of targeted
interventions originally implemented by the India HIV/AIDS Alliance which are aimed
at reducing HIV and supporting a better quality of life for people who inject drugs.
This comprises the peer counselling 5 and crisis response 6 components of the
programme.
This work forms a component of Asia Action, a three-year European Commissionfunded harm reduction policy and advocacy project coordinated by the International
HIV/AIDS Alliance.
Consultancy details:
HRI is seeking an independent consultant to document community-based harm
reduction programming efforts in India, particularly focusing on the peer counseling
and crisis response components of TI Plus programme. Data collected will be used
by HRI and local civil society partners to promote voluntary, community-based harm
reduction programming models in India and across Asia. The consultant should be
familiar with harm reduction programming in India, have experience with primary data
collection within health programmes (preferably HIV or harm reduction), and have an
understanding of the information that needs to be gathered in order to inform
advocacy on community-based harm reduction programmes.
The research should focus on answering the following core questions:
1. What models of treatment and harm reduction programming operate in India?
What are the relevant policies, guidelines and frameworks that relate to these
programmes?
2. What are the key features of the community based programme being
documented (TI Plus package), with particular attention to:
(a) The available interventions provided as part of the programme;
(b) The extent to which this programme applies a comprehensive harm
reduction approach, including any links or referral systems to other health
and social care;
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Peer counselling in the context of the TI Plus programme refers to the training of current or former beneficiaries of
needle syringe and/or opioid substitution therapy programmes to assist counsellors and nurses in their activities at
drop-in centres. Peer counselors are responsible for following up OST clients that drop out, demonstrating safer durg
use and injecting practices, conducting preliminary counselling at the field level, facilitating the formation of peer
support groups, assisting in peer outreach, and linking clients to services.
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The use of “crisis response teams” is a community-led approach to addressing and resolving issues of violence,
abuse, harassment, discrimination and other health and human rights concerns that affect communities at risk of HIV
and other blood borne viruses. Crisis response teams are usually comprised of staff of community-based
organisations, members of the community, and medical and legal professionals.
2
(c) Key features that make it effective (e.g. results, documented impact);
(d) Key features that make it community-based;
(e) The extent to which people who use drugs are involved in programme
implementation, monitoring and evaluation.
(f) Estimated costs of programme implementation.
3. What are the barriers to implementing and scaling up this model? How can
these be addressed?
4. In the local country context, what key information/evidence do we need on
community based models in order to advocate for them more effectively?
The local consultant will be managed by HRI, in close collaboration with the Asia
action Policy Manager at the India HIV/AIDS Alliance. Excellent language skills in
English writing and communication are required for this consultancy.
The findings from the 6 countries above will then be compiled by HRI in a policy
report in English and local languages with the aim of providing an insight into the
varying approaches taken and promoting them as community-based alternatives to
managing drug use and related health and human rights concerns.
Deliverables:
The consultant will be required to provide the following:
Deliverable
1. Strategy and timeline
collection, to include:


Deadline
for
data 16 January, 2015
Initial mapping of what information is
already available on the programs that
will
be
documented,
and
methods/tools by which information
will be gathered;
List of programmatic and other
features that will be documented, in
line with the core questions listed
above (e.g. program effectiveness
indicators such as client uptake and
follow up, range of services provided,
voluntary/compulsory status, etc.);
3


Key information sources and relevant
in-country contacts;
Schedule of site visits, consultation
with local stakeholders, and methods
for data gathering.
2. Narrative overview of available 27 January, 2015
treatment models within the national
context and policy context under which
they operate (approximately 1000
words).
3. First draft of findings, including 19 February, 2015
summary of each programme and ways
in which it is effective, existing barriers to
implementation, and recommendations
for policy.
4. Final draft of narrative overview and 6 March, 2015
findings from data collection, following
feedback from HRI and local Policy
Manager.
Place of Work: New Delhi, India, with availability to travel.
Reports to:
Head of Advocacy and Policy, Harm Reduction International, London, UK and
Public Health Analyst, Harm Reduction International, Jakarta, Indonesia
Duration of Consultancy:
The work comprises approximately 15-20 work days between October and
December 2014, at the global fee of 2,250 Euro. Basic travel costs are provided for.
The work should be completed by 6 March, 2015.
How to apply:
Please send a CV and a cover letter detailing what you would bring to this
consultancy to claudia.stoicescu@ihra.net by Sunday, 21 December, 2014 (deadline
extended).
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