HCV Treatment - Afghan Hero

My name is Mat Southwell. I am a drugs and HIV technical advisor and advocate. I am a Partner in a technical support agency called Coact. We help Governments, Non-Governmental Organisations (NGOs) and the UN collaborate and partner with people who use drugs effectively in tackling the health and rights challenges faced by people who use drugs. 

In 2010, I went to Afghanistan for the first time to help people who use drugs mobilise as a community in response to drugs and HIV.  On this trip, I met an extroadinary and courageous peer leader called Abdur Raheem Rajaey (Raheem). Raheem was found by Médecins du Monde (Doctors of the World) living homeless in the burnt out shell of the infamous Russian Cultural Centre in Kabul. Raheem says of this time that "I had two abcesses in my groin and no hope in my heart". 

Raheem went on to be the first person on Methadone in Afghanistan, then he volunteered as a peer educator before being appointed as an Outreach Worker. Harm reduction and opioid substitution therapy (OST) gave Raheem the stability and opportunity to step up for his community. He acted as the voice for the drug using community living in ground zero of the war on drugs, in the country with the world's highest opiate overdose rate, and with people who inject drugs being at the centre of a concentrated HIV epidemic. On top of this  methamphetamine arrived in Afghanistan last year bringing new health and social challenges for Afghan drug users.  

Raheem has become the champion of Afghan drug users. He is known by his peers as DOCTOR RAHEEM - Raheem protests that he has no medical training but the honourary title reflects the respect and high esteem with which Raheem is held by his peers. 

For the last two years, Raheem has been working with Coact, the UN, Global Fund, Afghan NGOs and the Afghan National AIDS Control Programme and Ministry of Public Health to secure the funding and working relationships so that people who use drugs could have their own community organisation.  With the help of the NACP, Bridge Hope and Health Organisation was registered with the Ministry of Economy. Bridge will represent their interests of drug users in policy and planning - Raheem already sits with other Bridge members on the Country Coordinating Mechanism for the Global Fund. In addition, Bridge will deliver outreach, needle exchange, peer education, overdose management, drop in services, advocacy and human rights abuse monitoring to drug users in Kabul.

In 2015, Bridge developed a team of peers to deliver a community consultation with over 400 people who inject drugs (PWID). As this process unfolded, Bridge were asked to also interview female sex workers, the wives of PWID, women drug users, men who have sex with men and people living with HIV (PLHIV).  Bridge is now being developed as a network founded by people who use drugs but representing the interests and mobilising in solidarity across all the key populations and PLHIV.  

The findings of this community consultation have informed the planning of the HIV and drugs response in Afghanistan. Bridge is on the verge of being funded and a team has been trained and stands ready to be launched. Raheem has been Bridge's Development Worker for the last two years. He is the national leader who has worked tirelessly for his community and country. When many other people are understandably fleeing Afghanistan as refugees, Raheem continues to return home after his international trips, because, as he says, "if I leave who will stand up for the rights and health of my brothers and sisters". 

 Raheem is an inspirational leader who is on the verge of launching a key community organisation for PWID, key populations and PLHIV in one of the most challenging settings in the world. However, Raheem has Hepatitis C (HCV) and he urgently needs to undertake life saving HCV treatment. The new HCV treatments are effectively a cure with over a 90% success rate. The HCV drugs are sold in the West for $1000 per tablet but generic treatments are thankfully available in India and it is legal to purchase a personal set of medications. 

Afghanistan does not have HCV treatment but we have arranged with our friends in India (Charan Sharma and Loon Gangte) for Raheem to visit Delhi. First he will have a range of different tests in a medical clinic, which will tell us which drug treatment regimme Raheem will need. Dr Niklas Luhmann from MdM is providing virtual medical support alongside the peer support coming from India. An immunologist in Kabul will monitor Raheem during his treatment ensuring that Raheem will be well looked after and teaching the first doctor in Afghanistan about the management of HCV treatment. This means that Raheem's treatment will benefit him directly and it will skill up a local doctor. In addition, Coact will write up Raheem's story as an advocacy case study for HCV treatment in Afghanistan. However, we need help funding Raheem's treatment. The costs are as follows:

Visa      -   $100
Return Flight Kabul to Delhi -  $300
HCV medical tests  - $300
Accomodation for 15 days - $500
Living expenses for 15 days - $500
Land travel costs - $150
HCV high quality generic medications - $750

Total Cost in USD - $2600

Total Cost in Pounds Sterling - £2000

With support from friends in Coact, MdM and the UN, we have raised $700 to pay for Raheem's visa, flight and tests.  We need to raise another $1900 or £1320 as soon as possible.

We are waiting to go live with Bridge and we are in the final stages of planning for the launch. We want to send Raheem to Delhi as soon as possible so he can complete the tests over a 15 day period and settle on his treatment before Bridge goes live.

Raheem has stood up again and again for his peers in the face of incredible adversity. Please stand up for Raheem so he can become the first person to complete HCV treatment in Afghanistan. In 2015, Raheem won the Travis and Carol Jenkins Award that is given to the international drug user activist of the year by Harm Reduction International. Please join with me in celebrating and rewarding a true HIV and drugs and human rights hero. 

If we raise more than the target amount of funding, monies will be diverted to the planned Bridge Hope and Health Organisation crowdsource fundraising campaign, which will include advocacy and access to HCV treatment in Afghanistan. 

If you can't afford to give personally then please help us by sharing and spreading news of this campaign to those who can afford to give. No donation is too small or too large.