24-25 February 2006
ECAD Advisory Board Meeting in Istanbul

ECAD Advisory Board´s spring meeting took place in Istanbul last weekend. Please have a look at some of the picturesque outskirts of this vivid city, which will host ECAD Annual Mayor`s Conference in 2007.
A few flashbacks and the main events from the Board meeting follow.

The view over Istanbul	Famous Blue Mosque with its six minarets
Paula Kokkonen, Deputy Mayor of Helsinki, sings Youth in Europe agreement with ECAD director Tomas Hallberg. Margareta Olofsson, Stockholm Deputy Mayor and Dagur B. Eggertsson on behalf of the Youth in Europe Steering Group witness.	During the visit at the Alcohol and Drug Addiction Research Treatment Center in Istanbul: Dr. Birim Danismant, Ass. Prof. Duran Cakmak, director of the Center and Tomas Hallberg, ECAD director.
Dr.Muammer Erol, Vice-Secretary General of Istanbul Municipality signs Youth in Europe agreement together with the Deputy Mayor of Stockholm, Margareta Olofsson and ECAD director Tomas Hallberg. One of the chair pesrons of Youth in Europe Steering Group, Dagur B. Eggertsson witnesses.	Left to right:Dr. Mehmet Yildirim,the head of the Istanbul Health Department,Dagur B. Eggertsson, Youth in Europe project key figure ,Dr.Muammer Erol, Vice-Secretary General of Istanbul Municipality, Dr. Mustafa Güveli,the coordinator of the project on the side of Istanbul,Mrs. Kristin Arnadottir, key figure for the Youth in Europe programme, and Dr. Nalan Engin, the contact person for Youth in Europe in Istanbul.

The cities of Istanbul, Helsinki and Stockholm joined the pan-European ECAD project Youth in Europe – a drug prevention programme. Deputy Mayors of Stockholm and Helsinki, Mrs. Margareta Olofsson and Mrs. Paula Kokkonen, and Vice-Secretary General of Istanbul Metropolitan Municipality, Dr. Muammer Erol signed the agreement at ECAD Advisory Board meeting in Istanbul. Ten cities have already signed and more are expected to join in the coming weeks and months. Actavis Group is the main sponsor of the programme, which includes a special contribution for research and social action in Istanbul as well as in the cities of St. Petersburg, Vilnius, Belgrade and Sofia. The cities will carry out three surveys among 15-16 year olds on lifestyle, aspirations and drug use in the next five years and also work towards mobilising society against drugs according to the programme outline.

23 January 2006
Three more cities, Vilnius, Kaunas and Klaipeda in Lithuania signed Letter of Intent to join
ECAD`s new project "Youth in Europe".

Left to right: Algimantas Shventickas, Director of Department of Culture, Education and sports, Vilnius Municipality, Kazimieras Kuzminskas, Kaunas Vice-Mayor and Dr. Saulius Chaplinskas, Director of Lithuanian AIDS Centre	Tomas Hallberg and his Lithuanian colleagues Algimantas Shventickas, Kazimieras Kuzminskas and Saulius Chaplinskas are ready to start working on the project Photo © Audrius Žygavičius

The municipalities of Vilnius, Kaunas and Klaipeda alongside with Lithuanian AIDS Centre and ECAD are to cooperate together in the International Drug Prevention Programme. Appropriate cooperation agreements were signed January 23, 2006. "15 European cities are joining the project for the time being", says ECAD Director Tomas Hallberg. "The project is aimed at influencing both mentality-change (by raising awareness of drug, marihuana and tobacco use related risks) and behaviour change among the young. This knowledge- and experience-based project is to be implemented through combined efforts of different cities", says Dr. Saulius Chaplinskas, member of ECAD Board and the Director of Lithuanian AIDS Centre. (www.aids.lt) "After the similar project was started in Iceland, drug use among 15-16 year-old youth decreased by 15%", says Dr. Chaplinskas. International Organisation European Cities Against Drugs unifies more than 250 cities in Europe in their efforts to decrease drug use and drug related negative effects on society.

19-20 December 2005
WHO report on needle exchange likely to be revised

Geneve expert panel		During an expert meeting organised by Institute of Medicine in Geneva on December 19-20, 2005, Alex Wodak, the author of the WHO report on the effect of needle exchange on HIV among intravenous drug addicts,admitted that mistakes might have been made, and that he would go over the report again.
- There were many reports to read, over 200 of them, there may be errors, and if that is the case, I will come back with corrections, said Wodak. This took place after the Swedish scientist Kerstin Käll, herself co-author of a study on the same subject, passed devastating criticism on Wodak`s report. In her address, Käll dealt with some of the conclusions Wodak made of the materials he and his co-author gathered, and pointed out the incongruities of the same. - There errors are easy to find for anybody, who reads the report, said Käll. For example, Wodak had included in his report a study as evidence of needle exchange programs` effectiveness on HIV prevention, which did not measure this factor, but only HIV prevalence in the returned syringes. From Kerstin Källs speech: ”I see the following problems with the Australian studies: Since the stage of the epidemic is not stated for the different cities you will not know if you are measuring during the rapid phase of increase or on the downward slope or if there was an epidemic in the city at all. It is not unreasonable to suspect that most countries react slowly and introduce NEP (Needle Exchange Programmes) after the rapid phase, which would tend to bias data in favour of NEP. Cities not hit at all by the epidemic may not be included in the study unless they have a NEP, which would bias in the same direction. In cities hard hit by the epidemic it is likely that frequent measurements will be done during the initial rapid phase because of the alarm raised by the outbreak, which would bias against cities without NEP. It is also noteworthy that as many as 48% of the cities with NEP studied by Hurley and co-workers had an increase of HIV seroprevalence in spite of NEP. With these serious limitations it seems to me that it is not possible to draw any conclusion about the effectiveness of NEP from these two studies”. Wodak had also included the needle exchange programme in the Swedish city of Lund. Lund has never experienced an HIV epidemic in the first place, and the Swedish experts agree on that there is no scientific evidence of the programme’s HIV-preventive effect. Käll criticised Wodak further for the incorrect methods he used when comparing HIV prevalence in various cities around the world. For example, cities were compared at different time periods. There are great risks involved if results of needle exchange programmes are compared without controlling whether the interventions were effectuated during different stages of the epidemic. From Kerstin Källs speech: In review by Dr. Wodak and his co-workers looking at NEP:s effect on HIV prevalence and incidence they end up with a case of 6 to 5 in favour of NEP (6 positive, 5 inconclusive or negative). First: The study by Monterosso and co-workers is misclassified as positive for NEP, whereas in fact the result is non-significant, which is correctly stated in the table. Number two: the study by Heimer and co-workers also listed as positive does not measure HIV prevalence among IDUs (Injecting Drug Users), but HIV prevalence only in returned needles, which cannot be directly translated into population. This study should not have been included at all. And finally, the study by Ljungberg and co-workers is used to compare the HIV prevalence in the south of Sweden, which was not hard hit by the epidemic and had NEP introduced 1987/1988, with Stockholm that had a rapid phase 1983 to 1985 with a prevalence of about 50% of heroin injectors. Wodak and his co-workers ignore that the authors point out that in Stockholm by the time of the study the incidence was already down to about 1%. If this study should be included it should be moved to the inconclusive. With these corrections the case of NEP is reversed to 3-7, thus no longer in favour of NEP. The scientific data do not support the idea that NEPs in and by themselves are effective in preventive the spread of HIV among IDUs. By putting so much faith and emphasis on this isolated measure, other important and well established tools, like HIV testing and counselling, contact tracing etc. may have been neglected in the strategy to combat the spread of HIV among IDUs in many places. I think this is particularly unfortunate for the countries that have the biggest problems today, where limited resources must be used where they are most effective. If you have to choose between NEP and HIV testing and counselling, it is crucial that you choose the most effective strategy." Alex Wodak was during many years leader of the international harm reduction movement. He launched both needle exchange programmes and injecting rooms in Australia on his own initiative, before these became legal in the country. Wodak has also taken active part for legalising cannabis. The complete version of Kerstin Källs speech is available at ECAD Office: Phone: +46 8 508 29 362 e-mail: ecad@ecad.net You may find Alex Wodak`s report "Effectiveness of Sterile Needle and Syringe Programming in Reducing HIV/AIDS among Injecting Drug Users" (Geneve, 2004)(pdf-format) here!

14th of December 2005
St.Petersburg - first to sign Letter of Intent to join "Youth in Europe"

Standing from left to right: Kristin Arnadottir, Dagur Eggertsson, Robert Wessman, Olafur Ragnar Grimsson, Tikhonov Valery V., Prokhorenko Alexander V., Sherstniov Sergej Y., Kramarev Arkady G. Sitting: Tomas Hallberg and Valentina Matvienko.		After some continuous preparatory work the agreement to take part in Youth in Europe, Drug Prevention Programme was signed on the 14th of December, 2005 by the first city outside Iceland. The president of Iceland Olafur Ragnar Grimsson was present at the signing ceremony in St. Petersburg, Russia. A lot of profound work has been done on the part of St. Petersburg’s state lawyers and one of the project’s key figures – Kristin Arnadottir. Thanks to their efforts, the governor of St. Petersburg city, Valentina Matvienko and ECAD director Tomas Hallberg could put their signatures on the document that became the starting shot for the launch of many practical tasks to be performed by the participating cities.
The president of Iceland, who is also the patron of the project, stressed the importance of St. Petersburg becoming the first city to sign the Letter of Intent. There is a great symbolic meaning in St. Petersburg being the first to enter this international cooperation, since this city was one of ECAD`s prime members and among most active ones. During the visit to St. Petersburg His Excellency Mr. Grimsson read a lecture about Icelandic drug preventive experience at St. Petersburg State University, that was very much appreciated by the students. St. Petersburg is one of the five cities that the project sponsor, Actavis Group, supports financially to make their participation in the Drug Prevention programme easier.

 
 
 
 
 
 
[Articles July 2005- May 2002]