The funding crisis for harm reduction

Date: 10 July 2014

Funding report front cover 1

Harm Reduction International, the International HIV/AIDS Alliance and the International Drug Policy Consortium have launched a ground-breaking study highlighting the funding crisis in harm reduction.

Funding for HIV-related harm reduction programmes globally is in crisis. There can be no ‘AIDS free generation’ without targeted efforts with and for people who inject drugs. Yet funding for harm reduction falls dangerously short of estimated need. While this has been the case for some time, the situation looks set to deteriorate with changing donor policies and national government neglect.

This failure to invest will bring an exponential rise in HIV transmission which in turn will cause additional costs to government health sectors.

This report investigates international donor commitments, both multilateral and bilateral, as well as national investments in harm reduction. It calls on international donors, national governments and UN agencies to take concrete actions to address the funding crisis.

The report highlights that:

  1. Current investment in harm reduction falls far short of need. US $2.3 billion is needed in 2015 alone to fund HIV prevention among people who inject drugs, according to UNAIDS, but only US $160 million was invested by international donors at last count – approximately seven percent of what is required.
  2. The majority of people who inject drugs (around 75%) live in middle-income countries and over 40% of new HIV infections are due to unsafe injecting in many of these countries.
  3. Changes in Global Fund funding policy threaten to significantly reduce allocations for harm reduction, particularly in middle-income countries.
  4. International donors such as the UK and the US are withdrawing aid from some of the most affected countries due to ‘middle-income’ status and an emphasis on disease-burden and related treatment services.
  5. National governments are neglecting HIV prevention for people who inject drugs – domestic investment in HIV responses is increasing, but governments are not allocating money to harm reduction, even where HIV transmission rates are high among people who inject drugs.
  6. Instead, governments spend vast public sums on ineffective drug law enforcement – just one tenth of one year’s drug enforcement expenditure (estimated to exceed $100 billion globally) would fund global HIV prevention for people who inject drugs for four years.
  7. To sustainably fund harm reduction in low and middle income countries, we must:
  • Keep the global fund global
  • Invest strategically in harm reduction
  • Increase national harm reduction investment
  • Rebalance existing resources in favour of health and harm reduction.

The report is available to download here: The funding crisis for harm reduction (PDF, 1 MB)(PDF, 1 MB), and will be launched during the International AIDS Conference in Melbourne, Australia on Monday 21 July.