Methadone is a narcotic mainly used to treat heroin and other drug addicts. In terms of its chemical composition, this substance is practically identical to morphine, acting on the same receptors and with positive effects.

This medicine is indicated for detoxification treatment in medical services, as well as for temporary maintenance therapy for People Who Inject Drugs (PID) and/or People Who Use Drugs (PUD), thus contributing to harm reduction.

In addition to relieving the acute and chronic pain caused by drug absence, methadone is seen as an alternative for HIV prevention in this target group, since its administration reduces the desire to consume drugs, which in some situations is done by injection. Often, if not most of the time, the syringe used to inject the drugs is used by several people, making this group one of the most vulnerable to HIV transmission.

In this context, civil society wants to advocate for the extension of methadone distribution to cover more areas of the country and, in this way, ensure that PID/PUD give up their addiction and consequently their exposure to HIV transmission.

To this end, the Citizen Observatory for Health (OCS) has begun implementing a series of activities with the aim of advocating for the extension of methadone distribution to more areas of the country. Until now, methadone has only been distributed in one health centre in the whole country, specifically the Alto Maé Health Centre in Maputo city. There is therefore a need to reverse this scenario, bearing in mind that the multisectoral and combined interventions of various players could provide a window of opportunity to change the current situation in favour of this group, while simultaneously considering that this is a problem of public health, which has become increasingly worrying in Mozambique.

One of the main activities planned is to train journalists, including those from community radio stations at national level, on the importance of methadone for people who use/inject drugs, while ensuring that the media promotes informative messages with a positive impact on the challenges faced by this key population in Mozambique.

It is also planned to articulate, coordinate and dialogue with the main decision-makers in the health sector, namely donors, international agencies, cooperation partners, as well as the Ministry of Health (MISAU) itself and other government actors, in order to influence public policies and health reforms that protect and guarantee the human rights of this group in terms of access to new technologies in the field of HIV prevention. These actions are in line with the National Human Rights Plan, the Charter of Rights and Duties of the User, PEN V, international conventions and protocols ratified by the country.

These activities are part of the United For Prevention (U4P) project, which aims to ensure that by 2025, civil society and the communities most affected by HIV have helped to achieve a political increase and financial support for key HIV prevention milestones in seven countries: Kenya, Malawi, Mozambique, Nigeria, Tanzania, Uganda and Zimbabwe.

The aim is also to bring the countries closer together, considering their HIV prevention objectives and to ensure a reduction in the incidence of this disease, especially among the most marginalized.

The overall results are expected to be that civil society organizations (through their involvement in the National HIV Prevention Accountability Coalitions) will be able to influence the development and implementation of national HIV prevention roadmaps in each country.

It is also hoped that governments and donors will be held accountable by CSOs for the delivery of national roadmaps and the achievement of the 2025 Targets for HIV prevention, as well as hoping that the Global Coalition for HIV Prevention will increase its advocacy and leadership in support of national CSOs working to influence the implementation of their national HIV prevention roadmaps and the achievement of the Global Prevention Plan 2025 targets.

In Mozambique, the project comprises a coalition of Civil Society Organisations made up of LAMBDA, ABEVAMO, TRNSFORMAR, Citizen’s Observatory for Health, UNIDOS, AESMO, KUTENGA, HIXIKANWE, NWETI, REPSI, REAJUD, PAAJ+ and KUYAKANA, with technical support from REPSI and funding from FRONTLINE AIDS.

The activities began to be implemented in the second half of February 2024, when strategic meetings were held with the coalition’s member organisations to define action and engagement plans to articulate and improve coordination aimed at informed advocacy on the major challenges that key populations, people living with HIV and vulnerable groups face in accessing health services, especially with regard to new mechanisms in HIV prevention in Mozambique, namely: methadone, Prep, injectable Prep, Dapivirine Ring.

According to research by some organizations working on harm reduction issues, the prevalence of HIV in people who use drugs is around 45.8%, while Hepatitis C and C are around 22.6% and 5. 9%, respectively. (OCS)

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