The increasing prevalence of HIV among people who use drugs by injection in Eastern Europe has made it imperative to move to these countries the skills acquired by Villa Maraini Foundation in thirty-five years of activity. In mid 2004, thanks to a special fund made available at the International Federation of Red Cross and Red Crescent NSs (IFRC) by the Italian Red Cross to support harm reduction activities. The VM Foundation began the training program “To build up harm reduction capacities in Eastern Europe and Central Asia”. The involved RC/RC National Societies declared their commitment to begin in their territory activities inspired by the experience gained from training at Villa Maraini, obviously in a manner consistent with their capacity and need.

THE TEAM
The team consists of professionals, doctors, psychologists and social workers who work within the Foundation for many years plus expert from the Health Department of the IFRC and Croatian RC. The organizing staff of this training Unit is composed by a psychotherapist, founder of Villa Maraini and a clinical psychologist.

THE COURSE
The course is in English. To enable the participation of National Societies where English is not widespread, simultaneous translation into the language required is organized: courses have been conducted in Russian, Chinese, Spanish and Parsis. The training, that lasts five full days, presents the Harm Reduction as a way of action which not only reduces the risks of taking drugs, but facilitate and enable access to treatment programs and rehabilitation people who otherwise there wouldn’t be approached. The "harm reduction"  performs a function of "latch" to open a therapeutic relationship with people outside of treatment, when they are still fully enmeshed in the drug world. The mode of action proposed is guided by the fundamental principles of the International Movement CR, in particular that of "humanity."

Topics covered

•	Harm reduction, AIDS, tuberculosis, sexually transmitted diseases
•	The commitment of the Italian Red Cross, the ERNA (European Red Cross Red Crescent Network on HIV and AIDS and TB) and the International Federation (IFRC) in assistance to people with drug problems.
•	The role of advocacy for human treatment of people with drug problems: the Rome Consensus and the involvement of the International Movement of Red Cross and Red Crescent.
•	What is addiction. Drugs and particularly the street drugs.
•	Villa Maraini, his philosophy of action and its services:
	- The system-service network.
	- The street units, the in-take, the drop-in-center, the night shelters,
	- The emergency service.
	- The prison project.
	- The outpatient treatment services.
	- Treatment with drug-substitution; insights on the use of methadone.
	- The HIV unit.
	- The Orientation service and the Therapeutic community.
	- The community-as an alternative to detention.
	- The Help-Line
	- The Social Labour Cooperative.
	- The Service for families and friends
•	The burn out.
•	Stigma and prejudice against people with drug problems.
•	Analysis of the relationship "therapist-client": a comparison between the "traditional method" and the method of "harm reduction".
•	The importance of an individualized treatment based on understanding and open-mindedness of the therapist.
•	The prevention material.
•	The informative materials.
•	Governmental difficulties to organize harm reduction activities.
•	What can push a drug injector to use and exchange used syringes already used?
•	How to reduce the risk of infectious diseases transmission among injectors.
•	The different experiences in the countries participating in the course.

The presentation of these issues occurs in a context that includes both the use of visual aids that the active involvement of participants through exercises, role play, brainstorming. The training also includes participation in the field, in the role of observers / participants, in the activities of some services such as the out-clinic Centre, the street units of Termini and Tor Bella Monaca, the Emergency Unit.

The timing of the courses played
In July 2004 it was made the first course, with four representatives from National Societies of Belarus, Lithuania and Ukraine, and two representatives of the "International Federation of Red Cross and Red Crescent Societies (IFRC), one responsible for the activities of health 'Europe and the other responsible for the regional delegation of Alma Ata, in Central Asia. Following sixteen more courses were done. From the 7th course on professionals coming from National Societies outside the ERNA regional area were included. A total number of 33 different RC/RC National Societies have been involved in this programme till present with 10 people per course as an average number.

List of courses with dates and participating National Societies and IFRC regional delegation.

1st Course, July 2004
Belarus, Lithuania, Ukraine, Alma Ata IFRC, IFRC Geneva
2nd Course, February 2005
Armenia, Croatia, Estonia, Macedonia, IFRC Budapest,
3rd Course, April 2005
Armenia, Bulgaria, Latvia, Moldova, Russia, IFRC Geneva
4th Course, October 2005
Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, IFRC Geneva
5th Course June 2006
Macedonia, Romania, Serbia, IFRC Budapest
6th Course, October 2006
Armenia, Russia, Georgia, Ankara IFRC, IFRC Moscow
7th Course, December 2006
Afghanistan, Syria
8th Course, January 2007
China, South-East Pacific IFRC
9th Course, August 2007
Georgia, Azerbaijan
10th Course, October 2007
Uruguay, Argentina
11th Course, April 2008
Ukraine, France
12th Course, October 2008
Botswana, Kenya, Mauritius, Uganda
13th Course, December 2009
Cambodia, Thailand, South-East Asia IFRC
14th Course, March 2010
Armenia, Belarus, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Moscow IFRC
15th Course,  June 2010
Tajikistan, Turkmenistan, Russia, Kazakhstan, Belarus, Armenia, Ukraine, Azerbaijan  1
6th Course, July 2010
Representatives of the Governmental Health System of Georgia.
17th Course, November 2010
Representatives of the Governmental Health System of Georgia.
18th Course, May 2011
Tajikistan, Georgia
19th Course, June 2011
Representatives of Argo (Special Psychiatric Hospital of Thessaloniki). Greece
20 th Course, October 2011
Laos, China, Cambodia, Thailand, Kenya
21st Course, October 2011
Representatives of Argo (Special Psychiatric Hospital of Thessaloniki). Greece
22 th Course, November 2011
Armenia, Kazakhstan, Lithuania, Turkmenistan, Belarus, Ukraine

Three more courses will be developed during the 2012 with participants coming from every part of the world.
During the year a Guideline on best practices developed under the frame of the contents of the course will be developed and published by the International Federation of RC/RC Societies. Contents and methodology offered by Villa Maraini during the courses will be enlightened in this manual.

Following the course several National Societies have started or expanded activities to assist people with drug problems. The experience at Villa Maraini makes it clear that the adoption of a harm reduction comprehensive approach makes it possible the hosting and the inclusion of all people most affected by drug abuse. Each RC/RC participants discover have already at disposal key elements for an effective process of reception and treatment, consisting it by the seven fundamental principles of the Movement. Hoping that the result of this effort will soon got by the rest of the world, not just by those who live and work within the "drug problem context".