YouthRISE Nigeria is implementing an advocacy project titled ‘‘Sustainability of Harm Reduction Program in Nigeria (SHaRP) 2024–2026’’. The project is funded by the Elton John Foundation (EJAF) and focuses on ensuring coordinated and strengthened multi-sectoral efforts to ensure the availability of legal and policy frameworks for the sustainability of investment in harm reduction programs in Nigeria. Also, it is aimed at generating and documenting evidence through research that will serve as a tool for advocacy and policy engagement with stakeholders in a bid to advance legal/policy reform. This document guides the development of researched advocacy documents on the health and socioeconomic benefits of harm reduction & HIV Programs for People Who Use Drugs (PWUD) in Nigeria.
The drug control response in Nigeria is known for its punitive provisions, marked by the criminalization of people who use drugs and personal drug use/possession. In recent times, the drug policy landscape in-country has experienced development, with the most notable being the government’s approval of the implementation of comprehensive harm reduction in 2019. This led to the formation of a National Technical Working Group (NTWG) on drug demand and harm reduction and the subsequent implementation of a pilot NSP.
The initial results from the pilot NSP provided the required evidence base for the value of harm reduction, thereby strengthening the growing impetus for drug policy reform. Parallel to these developments are the misinformation on drugs, the National Drug Law Enforcement Agency’s (NDLEA) campaign tagged ‘’War Against Drug Abuse’’, arbitrary arrest and raid of bunk injecting sites), the violence related to by law enforcement agents and the attendant human rights violation and loss of lives. The negative perception of drug use and harm reduction also fuels the drive for the continued criminalization of drug use in Nigeria.
Criminalizing laws on drug use has socioeconomic and health implications for PWUD. The Integrated Behavioural and Biological Surveillance Survey (IBBSS 2020) documents HIV prevalence of about 11% among people who inject drugs and UNODC Survey 2018 reported a drug use prevalence of 14.4% which translates to 14.3 million drug-using population aged 15-64 years. The HIV and drug use epidemic remains a daunting challenge in achieving sustainable development goals by 2030.
Thus, it is important to re-think our national drug control efforts and strategy by recognizing the current drug epidemic as a developmental challenge and deploying public health and rights-based approaches to drug control rather than relying on the drug enforcement approach. The criminalization of drug use and the current drug control approach continue to threaten the gains recorded in HIV & harm reduction service provision in Nigeria. Therefore, to sustain the gains of harm reduction & HIV programs for PWUD and its decade-long advocacy efforts, there is a need for a legal or policy framework backed by evidence in support of harm reduction investment, increased government commitment, and funding for program scale-up. To this end, there is a need to
generate and document evidence, which will serve as a tool for policy advocacy with stakeholders to
address these challenges in the harm reduction & HIV spaces in Nigeria.
Hence, the need to engage a consultant to develop empirical evidence on the health, social, and economic benefits of harm reduction, especially as it relates to the reduction in crime, and social unrest, as well as how the program facilitates access to gainful employment, HIV and Hepatitis services, retention, and improves health outcomes for PWUD in care in Nigeria.
A key outcome of this research is to generate evidence (an advocacy tool) to support advocacy engagement with policymakers in particular and other stakeholders at large in Nigeria for the improvement of national harm reduction policies in the country. YouthRISE Nigeria will support the dissemination of the research work. To achieve this, the consultant is expected to conduct a country-level study in selected states where harm reduction & HIV programs are being implemented to ascertain the health, social, and economic benefits of the program on PWUD and the community in which they live. A mix of qualitative and quantitative research methods will be preferred.
i. Conduct of cost-benefit analysis and; ii. The consultant is expected to adapt available standardized tools and indicators used in conducting cost-benefit assessments focused on the health and socioeconomic impact of harm reduction & HIV programs in the past. iii. Other tasks to be prioritized include conducting a scoping review of other African countries where the same research has been replicated, conducting interviews and facilitating discussions with stakeholders, as well as reviewing and analysing available data and information products. Critical consideration is to also gather the perspectives of stakeholders who are not already supporters of harm reduction/policy reform to have a diversity of opinions. The evid ence generated will inform the final report.
As a deliverable, we will be expecting, among others, the following key products:
i. A comprehensive report on the health and socioeconomic benefits of harm reduction & HIV
programs that contain: Cost-benefit analysis: savings in monetary and social cost for every investment in harm reduction programs for PWUD.
ii. A light-touch evidence of a few case studies on the health and socioeconomic benefits of harm reduction & HIV programs conducted in West Africa or other African countries.
iii. Detailed recommendations for policy action based on savings or benefits in line with the following thematic areas: health, social justice, employment, education, family, & community.
iv. A work plan and concept note detailing the methodology of the study and data analysis, as well as tools developed for the research.
v. Data, information, and other work products related to the consultancy engagement.
The research and all work products are expected to be completed in 25 work days, effective from the day of the official engagement. This is a fixed contract, meaning a fixed amount of funds is allocated for the task and it is the
responsibility of the consultant to work with the available budget to achieve the deliverables. The available budget will be made available only to successful consultants/consortiums.
YouthRISE Nigeria’s team will also be available to provide support during the project’s implementation.