 Obviously we're in a situation right now globally where harm reduction is a contentious thing. We have lots of environments where just the term harm reduction is a problematic term. We have other environments where harm reduction is very much a fledgling thing. It's a new process, it's a new ideology in some kind of context, so although of course some harm reduction discourse positions itself as being very pragmatic, a lot of harm reduction discourse is very much aligned with narratives of human rights and respect for human rights and specifically the right to the highest attainable standard of health. So in terms of what we're going to be hearing about today, we're going to be hearing about some harm reduction interventions and harm reduction processes that are very new. And what's happened in terms of those new processes and very new ideas, although maybe the harm reduction process is a few and far between, these new initiatives are very compelling and very important for us to learn from. We're also going to be hearing about some contexts where there's big opposition to harm reduction and there's big opposition to interventions, initiatives, service and healthcare provision that's pragmatic, that focuses on human rights and services that respect the human rights of our communities and communities of people who use drugs. So in these contexts we're going to hear about opposition to harm reduction and reducing harm reduction interventions. We're also going to be hearing a little bit about contexts where narratives of human rights and narratives of service and healthcare provision for marginalized, criminalized and socially excluded communities where those narratives are somewhat incompatible with historical narratives in these contexts. And so we're going to be hearing about the difficulties in terms of aligning human rights narratives and aligning narratives of the right to the highest attainable standard of health for marginalized communities, the difficulties of aligning those discourses and narratives with historically entrenched ideas. And we're also going to be hearing about service and healthcare provision in areas and contexts historically and contemporarily considered to be somewhat conservative and how even in this sort of context of conservatism and increasing moves towards populism and this sort of thing that harm reduction and a focus on service and healthcare provision and human rights pragmatism can actually to some extent prevail. So I'm sure you all join me in welcoming our speakers and enjoy the session. Good evening, everyone, everyone and everyone. I am very happy to be among you tonight. I'm going to share with you an experience of a foot by my other foot, which is a political one, a socio-cultural context, which doesn't really allow us to evolve in the context of policies that cover human rights and that protect vulnerable populations. In Morocco, a few years ago, we were no longer talking about the reduction of risks, but about other policies that take into account the populations of the users. And there was the total absence of policies and strategies related to drug use, the total absence of specific services to people who had problems with the use, the only available load was within the psychiatric hospital, in very vulnerable and inhuman conditions. There was also the lack of information regarding the situation of the users and the consumer profile. The only available data was a single survey in 2003 that aimed to measure the passage of drug consumption in the occasional phase, depending on the Moroccan general population. There was also the lack of information related to epidemics, especially about the use of drugs. Only in 2004, we started talking about an initiative for specific interventions for drug users. In 2004, there was the creation of a psychological medical center that is always administrative related to the psychiatric hospital, but which developed a different approach to the use of drugs that respects the most or less the international standards of the reduction of risks. This experience of the Psychological Medical Center allowed us to create an association in 2006 with the aim of supporting the work that is done within the Psychological Medical Center and allowing the access of maximum drug users to its services. It was the Hasnuna Association that held on to drug users and was created in 2006. It was considered the first initiative of the Moroccan civil society. It was a desire to go beyond mental health concerns and allow a fund for public health and human rights. Since December 2007, the Hasnuna Association was able to mobilize the Ministry of Health in the first place and other partners to develop the first program of exchange of drugs in Tangier. It allowed us to have a structure of the intervention of the reduction of risks through a mobile unit, a charging station and a reception center within Hasnuna. This pilot experience showed the feasibility and acceptability of a reduction of risks in the Moroccan context. This experience led the decision-makers at the national level and the main partners to adopt the reduction of risks and to define, since 2007, a national intervention framework was established in 2007-2008 with a national action plan for the reduction of risks in 2008-2011. Of course, it began the opening of three centers of substitution treatment at the Metadone in Tangier, Salé and Casablanca. The Hasnuna experience and the evaluation that was conducted in 2012 by the Ministry of Health and the positive results that showed the utility of the intervention of proximities within the population of drugs. This experience encouraged the decision-makers at the national level and the technical and financial partners in Morocco to expand the device in other regions, especially in the north of Morocco, as a priority site, because the rate of consumption of heroin is mainly concentrated in the north of Morocco. In Tangier, Nador, Chosima and Tito. At the initiative of the Hasnuna team, there was the creation of a national reduction of risks that currently works on the eight sections at the national level. Hasnuna, from 2012, changed its name. At the beginning, it was Hasnuna de Seutien, a psychological medical center. Currently, it is the Hasnuna association supporting drug users. The NGOs managed to convince the Ministry of Health and other partners to ensure financing for the implementation of programs of risk reduction at the level of Morocco. Today, the strategic and operational framework for the reduction of risks is organized around this main intervention. It is the need for users to use the materials of consumption that are smoked, sniffed and injected, but unfortunately only the materials of smoke and injection that are available in Morocco. The prescription for the replacement treatment in the Middle East, the only replacement treatment available currently in Morocco. The access and treatment of people is positive, treatment and hepatitis treatment. There is also the change of norms and culture within the community of drug users by the creation of support groups. There is also all that is socio-psychological and professional insertion program spread at the national level. There is also the change of social representation linked to drug use and the defense of the rights of users especially women who are double stigmatized as women or as drug users through drug use at the national level. The offer of the reduction of risks in Morocco is summarized in the seven components and offered in three to four. There are programs for the reduction of the risks managed by the associations and there are centers of addictology managed by the Ministry of Health and of course the role and structure of HIV prevention, managed by the associations and by the Ministry of Health. This experience of 10 years needed in the context of the implementation of the RDR programs more human resources in terms of structures managed by the associations and by the Ministry of Health to be able to provide services in the context of the national strategic plan which can push the Ministry of Health with partners to create a center of resources and training at the level of the Tanger whose role is to put at the level and in quantity and quality the interventions and services dedicated to drug users the harmonization of principles and the modalities of interventions of the RDR programs the distribution of the approach of the reduction of risks in the region and also the mobilization of local actors and decision makers for the creation of a favorable environment for the interventions of the RDR and the promotion of rights through drug users. Currently in Morocco we have more than 2,500 people who benefit from the substitution treatment of methadone in the context of 5 methadone programs we will see 10 million people benefit from programs of exchange of syringes of psychosocial support this center of mobile support and units we will see 5 million people benefit from programs of professional insertion the most important on the access of users to their rights at the level of the Tanger to contribute to the improvement of the conditions of drug users Currently the arrest results of consumption are no longer at the level of the Tanger and the people incarcerated have access to methadone even within the presence Beyond Morocco Today, Morocco is a country particularly advanced in the framework of programs of risk reduction at the regional level of the MENA region at the African continent The Tanger training center is also designed as a regional platform to strengthen the RDR capacities in order to pay our colleagues at the Tunisia the Senegal, the Libya come to Morocco to ensure a theoretical training and a practical internship on the field Despite these results despite the effort that has been carried out by NGOs and militants of the civil society the program of risk reduction in Morocco is therefore required of several difficulties and challenges There is really the insufficiency of human resources in the media body under the responsibility of the Ministry of Health There is the list of waiting of methadone who surpasses 1,000 people in the three cities at the northern level Tanger, Titouan and Nador It is a program that has just been launched There is a financial challenge of intervention of risk reduction in the long-term There is a rate of mortality related to overdose especially in Morocco where there is the consumption of opiacs The naloxone in Morocco is not available The rate of hepatitis is very high near the population of drug usage It surpasses 82% in Nador 64% in Tanger There is a lack of treatment and access to hepatitis treatment There is also the evolution of the legal framework on drug consumption in Morocco Thank you for your attention I hope that I have managed to give you an image of the program of risk reduction in Morocco