 I'm standing in the historical museum of Bosnia in Sarajevo, a city that was devastated by a war 20 years ago. The city has almost fully recovered after the war, but a lot of people were traumatized and became drug dependent. Several NGOs are providing services for these people, but these services, which were previously funded by the Global Fund to fight AIDS to wear clothes in Malaria, recently lost their funding because the Global Fund is leaving the country. There are concerns that if the government does not provide funding for these programs, then the country can experience the same outbreak of HIV and hepatitis, which for example Romania experienced a few years ago. PROE is the NGO that operated the first and only program in Sarajevo that distributed clean needles to people who inject drugs to prevent infections. It was funded by the Global Fund. Samir Ibizevich, the head of the NGO told us that they had to close down the outreach and the dropping center. Of course it was a big disappointment in terms of breaking these ties because it's 10 years, it's a long time. As a result, we see many people get recovered, their families finally unify with them. At the same time, we reach many people who didn't want to go for go drug free. We provide them with harm reduction services, with needles, syringes. I believe that we prevent many deaths, we prevent many diseases. Some dropping centers in the country are still open. We visited the dropping center of the NGO Marginna in Zenica, an industrial town near Sarajevo. This center provides social and health support for drug users, including clean needles and syringes to prevent HIV and hepatitis C infections. This is one of the centers that have lost their funding from Global Fund, so now they are struggling to survive. Unlike in Sarajevo, the town of Zenica provided a free rent-off site for the organization so they could stay open. The head of the center, Deniz Dedaic, told us that the center shares a building with an unusual neighbor, a kindergarten. For all this year we don't have any problem and incident with regarding the kids and our clients. Our service is free of charge for everybody and our service is saving money and saving lives. It's a friendly atmosphere and a friendly place for these people. It's a classical needle exchange program. You look at equipment, different types of needles and syringes. The cookers, insulin syringes, alcohol pads, citric for the cooking room, heroin, water, distillate water. And all this wouldn't be possible without Global Fund money? Yes. And do you have any numbers? Like how many people from your clients live with HIV and hepatitis? We don't have any clients with HIV. But they have a specific situation regarding hepatitis C. It's the lowest percent of hepatitis C in the whole country. Incidents of hepatitis C in the population injecting drug users less than 22%. In Sarajevo we have an incidence of more than 40%. In Banyaluka we have an incidence of more than 60%. Do you think it would be possible without needle and syringe program? No. Definitely. We have started first, like the first program in the country from 2002. So you can very easily argue that there is an evidence that in cities where you introduced last year in needle and syringe program you have low level in other cities? Absolutely. How do you get salary? Where do you get salary from? We don't have salary from this moment. All staff in Margina in our three centers Tuzla, Zenica and Mostar working voluntarily. So people work for free? Yes, absolutely. It's our mission. Our first obligation is to our clients. In our organization working voluntarily, working for society, it's a second side of our obligation. Then it's also explained that there are not only public health benefits of the program but positive impact on public safety. When the program started more than half of their clients were involved in criminal activities and now their numbers are cut in half. They carried out a cost-effectiveness study which showed that they saved 2.5 million euros annually for the taxpayers. For annually saving, every year you'll be able to build new kindergarten or new school or whatever for the society. The dropping center has stored clean needles and other equipment enough for one year. After that they will run out but they have good chances for government support because they are the only harm reduction service in Bosnia that has been accredited. Then it's said they have good cooperation with the police. However, a client at the center told us drug users do have problems with them. So if the police finds a syringe in your pocket then they will take you and arrest you. Here in Zenica first they beat you and then they ask you for a name. Name of the dealers? No, no, your names. The dealers are after. He explained that he tried to stop using drugs several times but has been unsuccessful. This dropping center is the only place where he could get the proper syringes he needs. Do you think if there is no center here then you would get infected with hepatitis? It's 100%. If these problems stop here in Bosnia then there will be an epidemic. Now he has prescribed a subscription drug called Suboxon which can substitute the street heroine so he doesn't have to engage in criminal activity to buy his drug. Clients like him are referred by NGO Margina to a local clinic to receive opiate substitution treatment in addition to other therapeutic programs. The head of the center showed us around in the clinic. Our treatment is not only OST. We have individual and group psychotherapy, sociotherapy, sociorehabilitation treatment and education treatment. And this is room for distribution of opiate substitution therapy, table for distribution therapy and space for patients is here. Its methadone is juice. Service is financial, financial free. No cost for any kind of treatment. Unlike needle and syringe programs the funding for opiate substitution programs seem to be secured for the near future. Not only in Zenica but also in Sarajevo where a brand new clinic provides substitution treatment. This is the largest number of opiate substitution programs in Bosnia-Herzegovna which have around 100,000 in the whole of Bosnia-Herzegovna. Now we have a variety of conditions for work. We have all the forms of treatment from hospital treatment or detox program for heroin, for detoxification. We also created a part for treatment of acute alcohol conditions for those who take alcohol. Do you have patients with hypotipacy? Yes. If they can get treatment here or how do you solve it? They can get treatment in an infective clinic and clinic via pathology. And we have cooperation in Zenica. I would like to say that we are very sorry that Global Fund has finished its program but we have a promise that they will be partners in the next four years with our local and health and political authorities in maintaining this program with the help of local representatives and in their technical support. So we think that these programs will continue to live in the future. The primary recipient of the Global Fund grants in Bosnia-Herzegovna was the local office of the United Nations Development Program. They distributed the funds to the harm reduction NGOs in the past decade and they are pleased with the results. The estimated injection drug user in Bosnia-Herzegovna is 12,500. We actually reached by the end of December and the project more than 8,000 people. So we distributed more than 2 million needles in syringes within the program. We are quite happy and quite satisfied with the results of this decade. All together, $40 million entered this country in the last decade, which resulted with the fact that we have the lowest prevalence of HIV in the region. It is three times less than in Montenegro and four times less than in Croatia and Serbia, number of HIV positive on 100,000 citizens. We strongly believe that therapeutic centers by themselves are necessary and working a good job. But without outreach, I'm afraid that we will not have an inflow of these populations towards the institutions which could offer opiate treatment. Now we are coming to a period when the country should take over responsibility. Sridan Kukoyl, president of an HIV prevention NGO based in Banyaluka, pointed out that the sophisticated political system of Bosnia-Herzegovna is a real challenge because it is hard to identify and reach officials who are responsible and also because the government officials are frequently changing, so they have to start explaining everything all over again. Many people from the global fund are talking about the sustainable transition to domestic funds, but does it really happen? Is it really a sustainable transition that we see now in Bosnia and in Albania and other countries? It's not really going on. It's hard to explain that something that you had for 10 years, it will be stopped in one minute, you know. I think that the hundreds, maybe thousands of people will going to stay on the street without our support. What do you think will be the consequence if these programs close down? Looking at other countries, we can expect that the number of new HIV cases among ejecting drug users will going to increase. Some year thinks NGOs working in the field should do more to make their voices heard by the general society and find supporters for the cause of harm reduction, which should be framed not only as a health problem, but a broader social issue. I think we still have some space or some time to act properly. We are not losing the battle at this moment. So if funding would be available, you would start again dropping something? Of course. I would be the most happiest person in the world if we could continue.