The lost decade: Neglect for harm reduction funding

View the report's press release here.

Harm reduction interventions for people who use drugs—such as needle and syringe programmes (NSP) and opioid substitution therapy (OST)—are cost-effective, protect against HIV and hepatitis C, and save lives. 

Despite the potential for these interventions to contribute to healthier communities, funding for harm reduction in low- and middle-income countries (LMICs) has flat-lined over the past decade. Harm Reduction International's report, 'The lost decade: Neglect for harm reduction funding and the health crisis among people who use drugs,' found that in 2016, US$188 million was allocated for harm reduction – the same amount as in 2007 and just 13% of the US$1.5 billion that UNAIDS estimates is required annually by 2020 for an effective response in LMICs.  

The report also found (view full briefing here):

  • International donor funding - which accounts for two-thirds of all harm reduction funding - fell by almost one-quarter from 2007-16.
  • Global Fund allocations for harm reduction appeared to decline 18% in 2016 compared to 2011. The Global Fund is the largest donor for harm reduction in LMICs.
  • PEPFAR was the second-largest donor, but contributes a fraction of its overall HIV budget and doesn’t fund procurement of needles or syringes because of a US federal ban. 
  • Sizeable domestic funding was identified in only a small number of countries, and this still remains inadequate. Furthermore, it is under threat because of a lack of political commitment.

Harm reduction is integral to the world’s HIV response and cannot be ignored. People who inject drugs are among the most vulnerable to contracting blood-borne viruses. Globally, new HIV infections among people who inject drugs increased by one third from 2011-15 and coverage of OST and NSP is critically low. Asia and Eastern Europe are home to some of the highest burden HIV epidemics among people who inject drugs.

Unless the funding landscape for harm reduction changes urgently, the goal to end AIDS by 2030 will be missed and the pledge to leave no one behind will ring hollow. People who use drugs are being forgotten - with dire public health and social consequences.

Download the Lost Decade report

Lost decade report 2018

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Lost decade report graphic 1

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Lost decade report graphic 3

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