In 2016, some 275 million people worldwide used drugs at least once, or about 5.6% of the global population aged between 15 and 64 years, 11 million of whom used injectable drugs. Around 10% of people who use drug have some drug-related disorders and an estimated xx are dependent on opioids.
It is estimated that of the people who inject drug, 1.3 million are infected with Human Immunodeficiency Virus (HIV), 5.5 million with Hepatitis C Virus (HCV) and 1.0 million are co-infected with HCV and HIV.
Throughout the world, between 2000 and 2015, deaths caused directly by drug use rose by 60%. According to the World Health Organization (WHO), in 2015 some 450,000 people died as the result of drug use. Of these, 167,750 deaths were directly associated with drug use disorders (mainly overdoses) and the remainder were indirectly attributed to drug use, including deaths related to HIV and HCV, due to unsafe injection practices.
In Mozambique in 2016, there were 5,641 registered patients with mental and behavioural disorders due to the consumption of psychoactive substances. They were predominantly male and in the 20 to 30 age group.
The Integrated Biological and Behavioural Survey (IBBS) of People who Inject Drugs (PWID) conducted in 2014 in the cities of Maputo and Nampula/Nacala, found that heroin was the most consumed injectable drug (82.2% of all injecting drug use in Maputo and 73.3% in Nampula/Nacala) followed by cocaine (17.8% in Maputo and 12.7% in Nampula/Nacala). The survey showed that, of the 1,684 people who inject drugs covered by the study in Maputo City, 50% were infected with HIV, 32% were infected with the Hepatitis B Virus (HBV), 44% with HCV, and 36% were co-infected with HIV and HC. In the cities of Nampula / Nacala, of the 52 PWIDs involved in the study, 19% had HIV, 36% HB, 7% HC and 4% were co-infected with HIV and HCV.
Injecting drug use related harm includes the risk of (i) an overdose; (ii) the transmission of HIV and hepatitis viruses due to sharing potentially contaminated needles and syringes; (iii) harm caused by the inappropriate disposal of used syringes in public places; (iv) as well as harm and problems closely linked to the policy of criminalising psychoactive substances as well as their use and possession for personal use.. This situation requires renewed efforts to support the prevention and treatment of drug related harms and the delivery of services aimed at reducing the consequences for health, in line with targets 3.5 and 3.3 of the Sustainable Development Goals. Harm reduction is an evidence based approach to HIV and hepatitis prevention and other drug related harm, recommended by WHO and which includes needle/syringe programming, opioid substitution therapy and overdose prevention using naloxone.
Consequently, Mozambique, through the Ministry of Health (Ministério da Saúde – MISAU), in collaboration with the Central Office for Drug Prevention and Combat (Gabinete Central de Prevenção e Combate as Drogas – GCPCD) and other relevant actors, intend to hire an international consultant to prepare the National Harm Reduction Plan (Plano Nacional de Redução de Danos – PNRD) to guide interventions that target public health and human rights, to be implemented in an inter- and intra-sectoral manner, in order to reduce the harms associated with the use of drugs in the country.
The preparation of the PNRD must be based on a detailed and programmed work proposal that itemizes the activities to be carried out.
The work methodology should include, among other actions:
A comprehensive desk review, including legislative output, elements and analysis of the health sector in Mozambique, government policy documents, as well as statistical or other information and studies produced in the period, relevant to this exercise;
The various documents to be consulted include, in particular, the following:
Holding individual and/or group interviews with key implementation institutions and partners involved in the process;
Facilitating technical meetings to validate documents or ensure consensus
The technical assistance must:
Excellent skills in written and spoken Portuguese and fluency in English.
The Technical Assistance will last three (03) months from the date the contract is signed.
Home based with occasional travel to Mozambique (if necessary).
Consultant rate of P3.
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