Legality Review of Needles Syringe Programs under Thai Law

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Organization : มูลนิธิรักษ์ไทย : CARE Thailand

Contracting Authority: Raks Thai Foundation

Terms of Reference (TOR) for

Legality Review of Needles Syringe Programs under Thai Law

Under the Program Title

Stop TB and AIDS through RTTR 2018-2020 (“STAR-2”)

Funded by

The Global Fund to fight AIDS Tuberculosis and Malaria

Requisition number	PG # 91/2563
Issued dated	25 June, 2020
Purpose	The purpose of this Terms of Reference (“ToR”) is to hire a national consultant to work together with an international consultant to 1) conduct a review of legal system as on Thai juridical system that would allow the re-interpretation of NSP as possible for the greater value of saving lives of people who inject drugs and reducing spread of harmful diseases; 2) conduct studies on the Thai legal system that is related to issue on NSP and 3) produce a comprehensive report that can be presented to Ministry of Public Health and CSOs and also a separate paper that can be presented to the Office of the Council of State and other national and international agencies that are related to the legal interpretation of NSP or to human rights or health for PWID.
Program Title	Stop TB and AIDS through RTTR 2018-2020 (“STAR-2”)
Funding Source	The Global Fund to Fight AIDS, Tuberculosis and Malaria
Require for competitive bidding	Yes

Contents in the TOR
1. Purpose	7. Deliverables
2. Background	8. Payment and Consultant Fees
3. Objectives of the TOR	9. Rights and Properties
4. Expectation	10. Qualifications and Required Documents
5. Scope of Work	11. Key Contacts
6. Duration and Duty Station

1. PURPOSE

The purpose of this Terms of Reference (“ToR”) is to hire a national consultant to work together with an international consultant to 1) conduct a review of legal system as on Thai juridical system that would allow the re-interpretation of NSP as possible for the greater value of saving lives of people who inject drugs and reducing spread of harmful diseases; 2) conduct studies on the Thai legal system that is related to issue on NSP and 3) produce a comprehensive report that can be presented to Ministry of Public Health and CSOs and also a separate paper that can be presented to the Office of the Council of State and other national and international agencies that are related to the legal interpretation of NSP or to human rights or health for PWID.

Raks Thai Foundation (“Raks Thai”) is responsible for the ToR under the Stop TB and AIDS through RRTTR 2018-2020 (“STAR-2”), which is funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (“The Global Fund”).

2. BACKGROUND

Raks Thai, a member of CARE International, has been working in Thailand since 1979 in the area of emergency relief, community natural resources management, micro enterprise promotion, education, health and HIV/AIDS prevention and care for affected families.

Raks Thai, as Principal Recipient of the Global Fund to Fight AIDS, Tuberculosis and Malaria for STAR-2 (2018-2020), implements activities targeting several key affected populations, and builds on the success of the previous STAR-1 (2015-2017) phase. The program focuses on an acceleration to end AIDS and TB in Thailand by harnessing public-sector and civil-society partnerships to improve early and sustained access to diagnosis and treatment among people who inject drugs (“PWID”), migrant workers (“MW”), men who have sex with men (“MSM”), and transgender (“TG”). Intervention strategies emphasize prevention and transmission of HIV (PWID, MSM, TG, and MW), HCV (PWID), and TB (MW) by sustaining intensive behavior change activities, appropriate use of prophylaxis and strategic use of anti-retroviral drugs. The emphasis includes ensuring early and accurate diagnosis of HIV, HCV and TB diseases by improving diagnostic capability, and reducing turn-around time by using rapid HIV testing.

As part of the STAR-2 project, Raks Thai and partners also implement a Harm Reduction strategy for PWID that includes advocacy to remove harmful policy, and the distribution of clean needles and syringes. The expansion of needle and syringe programming remains a critical priority among PWID in Thailand. Access is disproportionately constrained among PWID who are not already accessing clinical services and among those who reside remotely from these services. With Global Fund support, Thailand has re-established partnerships and pursued social marketing for sterile injecting equipment while supporting distribution of sterile injecting equipment as a part of community outreach, secondary distribution in PWID-friendly community and clinical sites, and expanded access to naloxone as opioid overdose prevention in the community.

Thailand’s first case of HIV was identified in 1984. Since then up to 2005 or 18 years later did the first harm reduction project addressing the prevention of HIV started with the funds from the Global Fund. In fact that project. “Care and Support for Injecting Drug Users (CASIDU)” was one of the few non-CCM projects to be approved by the Global Fund as there was lack of government support. The CASIDU project supported the Thai Drug Users network, Alden House and Raks Thai Foundation to implemented reach and prevention activities among people who inject drugs (PWID), but it did not have a Needle and Syringe distribution component due to the legal sensitivity attached to drug/substance use in Thailand. In fact, this was the same period as the War on Drugs led by the Taksin Shinawatra, the Prime Minister at that time that resulted in 2,873 deaths under the label “extra-juridical killings”.

It was only in 2010, the Global Fund supported program of the Champion PWID, under the Principal Recipient Populations Services International (PSI) that through civil society organizations began to support needle and syringe programs. The program by then had been supported by the Country Coordinating Mechanism (CCM) and was seen as a priority in control HIV among key populations hard to reach.

In 1990 methadone that was redefined to allow its use for on a long-term basis. Furthermore, methadone treatment was added in the list of drugs included under the social security scheme for employees.

During this period the Office of Narcotic Control Board (ONCB), under the Ministry of Justice also opened to concepts of harm reduction that led to the first “Harm Reduction Policy” announced 2010 by the Ministry of Justice that focused on coordination of harm reduction activities between government and civil society at the provincial level in 19 provinces. The policy was renewed in 2013 expanding the coverage to 31 provinces but was discontinued in 2019.

It is also noted the Department of Disease Control use the Department’s budget to procure Needle and Syringe sets for harm reduction in 2016.

However, the drawback to this gradual progress in promoting harm reduction happened in 2009 when the issue on needle and syringe programs formally presented for the interpretation of the Office of Council of State in 2011 that the distribution of needles and syringes to people who infect drugs is an act illegal act. This has become a serious barrier to the promotion of NSP to reduce the spread of HIV, HCV and other diseases.

The purpose of this study is conduct a legal system as on Thai juridical system that would allow the re-interpretation of NSP as possible for the greater value of saving lives of people who inject drugs and reducing spread of harmful diseases that affect people both those are using drugs and those who are not and would also result in the costs to the health system.

The legal research team should conduct studies on the Thai legal system that is related to issue on NSP and also conduct a compassion with other countries both in the Southeast Asia region and internationally on how different countries NSP have allow the NSP to be conducted as a health practice that is not criminalized.

The legal research team must produce a comprehensive report that can be presented to Ministry of Public Health and CSOs and also a separate paper that can be presented to the Office of the Council of State and other national and international agencies that are related to the legal interpretation of NSP or to human rights or health for PWID. The presentation should produce the cases where government has approved NSP by interpreting the legal frameworks to realize the importance of NSP.

The legal research team will conduct serious of strategic meetings either via zoom or in person with key stakeholders.

3. OBJECTIVE OF THE TOR

The purpose of this study is conduct a review of legal system as on Thai juridical system that would allow the re-interpretation of NSP as possible for the greater value of saving lives of people who inject drugs and reducing spread of harmful diseases that affect people both those are using drugs and those who are not and would also result in the costs to the health system.

The legal research team should conduct studies on the Thai legal system that is related to issue on NSP and also conduct a comparison with other countries both in the Southeast Asia region and internationally on how different countries NSP have allow the NSP to be conducted as a health practice that is not criminalized.

The legal research team will conduct serious of strategic meetings either via zoom or in person with key stakeholders.

4. EXPECTATIONS

The expectations of these ToR are:

List of discussions and procedures of legal system as on Thai juridical system that would allow the re-interpretation of NSP as possible for the greater value of saving lives of people who inject drugs and reducing spread of harmful diseases;
Full report on legal research results on legal areas on the case of Thailand and countries in the region and beyond that can be used to allow NSP as part of Thailand’s health program particularly in reference to the legality of needle and syringe distribution to people who inject drugs.
A comprehensive report that can be presented to Ministry of Public Health and CSOs and also a separate paper that can be presented to the Office of the Council of State and other national and international agencies that are related to the legal interpretation of NSP or to human rights or health for PWID.
Precise report to be presented to relevant officials who are members of the Office of Council of State, the Minister of Justice, ONCB, Ministry of Public Health, UNODC, UNAIDS, media making the case on why NSP should be decriminalized and what steps have to take place.
Presentation of papers presented in #1, #2, #3 and #4 above to relevant stakeholders.

5. SCOPE OF WORK

Expectation 1: List of procedures of legal system as on Thai juridical system that would allow the re-interpretation of NSP as possible for the greater value of saving lives of people who inject drugs and reducing spread of harmful diseases;

Identify appropriate approaches and procedures of legal system that would allow State Council Committee to re-interpret the proposal of NSP distribution.
- What, when, where, who, and how to effectively reconsider the NSP distribution for PWID with the State Council Committee

Expectation 2-5: Full report, brief report and presentation on legal research results on legal areas on the case of Thailand and countries in the region and beyond that can be used to allow NSP as part of Thailand’s health program particularly in reference to the legality of needle and syringe distribution to people who inject drugs.

Conduct desk review and interview relevant key stakeholders on NSP policies in Thailand and other successful countries those legally distribute NSP for PWID.

Raks Thai will be responsible for:

Providing the Consultant with all necessary background documentation;
Suggesting the Consultant with relevant government officials and CSO staff including representatives of PWID (if necessary) for qualitative interviews/focus groups.

6. DURATION & DUTY STATION

Duration
The period expected for methodology and analysis framework design, data collection (including travel), data analysis and report is between 1^st August to 20^th December, 2020.

Activity	Location	Time Period
Develop methodology including tools, analysis framework and data collection plan with a national consultant in collaboration with Raks Thai staff	Bangkok (if national consultant based outside of Bangkok, Zoom meeting to be organized)	August 2020
Desk review on laws and legislations related to NSP in Thailand and write findings to a national consultant and share with Raks Thai	Home	September to 20^th December 2020
Write up a report, papers and presentation in English and collaborate with Thai national consultant to translate the above-mentioned documents into Thai version	Home
Present an overview of findings and recommendations to Raks Thai and implementing partners at stakeholder meeting	Bangkok (if national consultant based outside of Bangkok, Zoom meeting to be organized)

All materials associated with this consultancy process should be submitted along with the final report.

7. DELIVERABLES

Deliverables expected for this TOR align with the scope of work, above, and detailed again below:

Deliverable	Description	Due Date
1	Full methodology including analysis framework and data collection plan, agreed by Raks Thai Foundation	15^th August 2020
2	List of procedures of legal system as on Thai juridical system that would allow the re-interpretation of NSP as possible for the greater value of saving lives of people who inject drugs and reducing spread of harmful diseases	15^th September 2020
3	Preliminary report on legal research results on legal areas on the case of Thailand and countries in the region and beyond that can be used to allow NSP as part of Thailand’s health program particularly in reference to the legality of needle and syringe distribution to people who inject drugs in Thai and English	25^th November 2020
4	A preliminary comprehensive report that can be presented to Ministry of Public Health and CSOs and also a separate paper that can be presented to the Office of the Council of State and other national and international agencies that are related to the legal interpretation of NSP or to human rights or health for PWID in Thai and English	25^th November 2020
5	A preliminary precise report to be presented to relevant officials who are members of the Office of Council of State, the Minister of Justice, ONCB, Ministry of Public Health, UNODC, UNAIDS, media making the case on why NSP should be decriminalized and what steps have to take place in Thai and English. Facilitate a high-level presentation with key persons who may be able to take the issue forward for legal review and possible re-interpretation.	25^th November 2020
6	Presentation of findings in Bangkok in Thai and English. Also, with a communications paper/PDF for a broader audience.	First week of December 2020
7	Final technical report in Thai and English	20^th December 2020

8. PAYMENT AND CONSULTANT FEES

Consultant Fees

The total lump sum amount proposed for this ToR is between 500,000 to 800,000 Thai Baht for the selected Consultant.

Transportation cost is included in the ToR

Instalment	Conditions
1^st instalment, corresponds 30% of the agreed amount	Signed contract by Raks Thai and the Consultant prior to first day of consultancy Submission and verification of deliverable 1 and all associated documents 1^st payment invoice from the Consultant
2^nd instalment, corresponds to 30% of the agreed amount	Submission and verification of deliverables 2, 3, 4 and 5, and all associated documents 2^nd payment invoice from the Consultant
3^rd instalment, corresponds to 40% of the agreed amount	Submission and verification of deliverable 6 and 7, and all associated documents Final payment invoice from the Consultant

Remarks: Instalment payment is subject to satisfactory receipt of the deliverables within the STAR-2 program timeframe and pending review of the deliverables by Raks Thai Director, the Director and designated staff of the Program Quality Department, Raks Thai Foundation. Each payment will be made in Thai Baht to the bank account designated by the Consultant.

9. RIGHTS AND PROPERTIES

Raks Thai Foundation own the data, rights and property for all products under these Terms of Reference. Dissemination of products and services owned by Raks Thai Foundation are subjected to a written permission from an authorized person of Raks Thai Foundation. The sharing or distribution of products or any other contents or documents produced under these ToR without permission from Raks Thai is not allowed.

Raks Thai will not be responsible for any harms or claims, liabilities, suits, actions (including charges, disbursements and reasonable fees of counsel), proceedings, damages, expenses and obligations of any kind that be incurred by the Consultant or asserted against the Consultant, its officers and employees, by or on behalf of any person on account of, based or resulting from, arising out of (or which may be claimed to arise out of) the willful acts or omission of the Consultant and its agents, employees, research sites, assignees, transferees, delegates or successors, for which the Consultant retains responsibility.

10. QUALIFICATIONS AND REQUIRED DOCUMENTS

Technical requirement:

A Consultant must have skills and able to demonstrate evidence of experience in:

Advanced degree in Law, International Law, Harm Reduction, Human Rights, development studies or public health which included components on both quantitative and qualitative research methods;
In-depth understanding of the concept of harm reduction and the challenges faced by people who inject drugs (PWID);
At least 5 years’ experience with quantitative and qualitative research, including methodology design, focusing on law, health, social protection and inclusion, or behavioral sciences;

Contact : humanresource@raksthai.org / 02 014 7322 ต่อ 103 สำนักงานกรุงเทพฯ 185 ซ.ประดิพัทธ์ 6 ถนนประดิพัทธ์ ใกล้ BTS อารีย์ , สะพานควาย (ลง BTS อารีย์ สามารถเดินทางเข้าซอยพหลโยธิน 11 ได้) รถเมล์ที่ผ่านหน้าซ.ประดิพัทธ์ 6 สาย 52,524,97,3,117,90 ID Line : hrraksthai

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