FDS Insight Magazine Nov - Dec 2022

15 Continued crisis for harm reduction funding Harm Reduction International has been monitoring investment in harm reduction for more than a decade. Findings have been consistently dire, and this remains the case in the latest research. Still, only a few international donors fund harm reduction, and their investment appears to be shrinking. In low- and middle-income countries, funding for harm reduction is only 5% of the level needed to meet the estimated service needs for people who inject drugs by 2025. Sadly, the gap between the funding that is required and the funding that is available has only grown wider in recent years. In September 2022, the seventh replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) took place. The replenishment raised USD 14.25 billion, falling short of the target of USD 18 billion. Eighteen donors increased their pledge by 30%, including the European Union and Germany – a testament to sustained civil society advocacy. There was outstanding leadership from 13 African governments, which together pledged more than USD 50 million. With 60% of harm reduction funding in low- and middle-income countries coming from the Global Fund, it is essential that harm reduction funding is protected from the shortfall in the replenishment. Research by Harm Reduction International in 2016 found that fully funding an effective harm reduction response would be achievable by redirecting just 7.5% of the funds spent on drug law enforcement towards harm reduction. Six years later, funding for drug law enforcement still dwarfs investment in harm reduction. Globally, USD 100 billion is spent on drug law enforcement, and just USD 131 million is spent on harm reduction. Of particular concern is the shrinking investment in advocacy for harm reduction. Community-led advocacy is particularly underfunded. Opportunities for funding of harm reduction advocacy via multi-country grants from the Global Fund have significantly reduced, despite their positive impact. Without advocacy for national investment in harm reduction, services in low- and middle-income countries will continue to be reliant on a shrinking pool of international funding. Adding to this, Open Society Foundations, a key funder of drug policy reform and harm reduction advocacy, has undergone structural and organisational changes which could have implications for its funding in this area. Some donors have slightly increased their funding for harm reduction. These include the Elton John AIDS Foundation, the Robert Carr Fund and ViiV Healthcare Positive Action. Human rights and harm reduction Harm reduction is a human right. It is recognised as a vital component of the right to the highest attainable standard