Good practice examples
GREECE – Hellenic Liver Patients Association “Prometheus”
Vast-network-of-hepatologists-network-of-collaboration; prison-work; patient-association; advocacy-for-evidence-base-policies;
TEST; LINK; LTA; OUT; PWUD; PEER; MULTI;
Where – Services provided:
screening; psychological support; linkage to care; drop-in centre; outreach/street-work; mobile unit; prison work.
Who – Target groups:
liver patients; people who use drugs (PWUD) or inject drugs (PWID); people in prisons; Roma; migrants.
How – Team composition:
project coordinators; peer workers (paid and volunteer); communications officer; fundraiser; psychologist; secretariat.
Prometheus is the first association of liver patients in Greece, based in Athens and founded in 2012. From the beginning, they have adopted an holistic approach and operating through a harm reduction framework. They are committed to providing information about hepatitis, offering general and psychological support to PWUD and liver patients, reducing associated stigma and organising regular advocacy activities to promote patient rights at administrative and political levels.
A significant impetus for the organisation has been collaboration with the ARISTOTLE HCV/HIV programme. This community-based, fast-track, seek-test-treat programme aims to reduce the transmission of HCV/HIV and to enhance access to treatment with an holistic package of screening and linkage to care for PWID living with HCV and HIV in Athens.
Awareness & Prevention
Besides contributing to international campaigns such as World Hepatitis Day, European Testing Week, International NASH Day, and the NOhep movement, the organisation is active through their website, social media accounts and the press and also in public spaces – such as advertisements in subways, at bus stops – as well as on television.
Their actions include meetings/conferences in which new information and developments regarding access to treatment are discussed as well as harm reduction policies. When it comes to their staff members, Prometheus organises specific meetings and trainings to build their capacity and knowledge.
Prometheus offers on-site hepatitis B and C testing on a regular basis. The main methods employed by the organisation include dried blood spot testing (finger prick) at Athens and Thessaloniki “Checkpoint” (a structure of ‘Positive Voice’) , antiHCV, PCR, RNA, HCV core antigen assay, and liver elastography (fibroscan) testing in prisons and other settings (e.g. ARISTOTLE, as well as fibroscan screening in hepatology clinics. The tests are confirmed within a vast network of hepatologists to ensure that if a person is positively diagnosed, s/he can be properly linked to health care.
Complementing the testing activities, Prometheus provides pre- and post-test counselling. This activity is carried out by certified counselors who follow a protocol. Importantly, peer workers are also involved in these activities. The organisation conducts interventions in prison settings – in which the PWID population is over-represented – together with partners of the ARISTOTLE HCV/HIV initiative’.
Treatment & Care
Prometheus successfully collaborates with other stakeholders. For example, their free liver elastography programme is entitled “I Deserve to Know” with approximately 11,000 tests conducted across Greece, in addition to collaboration with the ARISTOTELIS HCV/HIV programme.
Support is provided by Prometheus for people with chronic HCV infection by enabling access to HCV treatment. In addition, their beneficiaries can receive disease self-management support (e.g. alcohol consumption, healthy diet, etc.) and liver health monitoring/assessment (e.g. Fibroscan, blood test).
The success of their treatment and care services is built upon a strong network of collaborators. Beside working with other NGO’s and scientific associations, the organisation has a formal referral agreement with local hospitals and medical facilities.
Although the organisation is fully equipped to deliver an holistic hepatitis programme, Prometheus still requires further funding for equipment and services. As a means towards overcoming this barrier, they recently focused on acquiring private funds and grants, both nationally and internationally. Ensuring such economic sustainability will give Prometheus the opportunity to hire, train and support more peer workers as this is a priority investment of the organisation.
Advocacy, Sustainability and Transferability
Prometheus monitors and evaluates the impact of its harm reduction work and participates in stakeholder collaboration and discussions on drug user health, as well as the development of drug policy advocacy activities at the local and national level. Building upon the results generated by their projects, the organisation aims to make an impact through evidence-based good practices.
In addition, Prometheus has organised – in collaboration with Positive Voice and the National and Kapodistrian University of Athens – a high-level meeting aimed at improving harm reduction coverage and policies at a national level.
In addition to this policy dialogue, Prometheus has been actively raising awareness through press releases and by publishing articles. As a result of the collective effort, on 7th March 2019, the Greek Parliament endorsed the opening of drug consumption rooms (DCR’s).
The success of Prometheus is built upon their collaboration network. Additionally, it is important to highlight how their monitoring activities – conducted both internally and externally – allows the organisation to remain up-to-date with local, national and global trends and supports its evidence-based advocacy activities.
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