20 Sep 2010

The Global Fund is underperforming when it comes to support for HIV-related harm reduction programmes. The Fund urgently needs to increase the amount that is spends on harm reduction, and encourage applicants to build harm reduction into their proposals. These observations and recommendations come from a report recently released by the International Harm Reduction Association (IHRA), entitled "Three Cents a Day Is Not Enough."

The IHRA said that all applications for funding from the Global Fund should be required to state whether and how they have addressed drug use issues; and if they have not, to explain the reasons why. The IHRA also stated that the Global Fund must also take measures to ensure that NGOs and organisations that represent drug using populations are properly involved in proposal development, and to facilitate more NGO-led applications.

The IHRA said that although it is difficult to measure how much of global HIV spending actually goes into harm reduction, there is no doubt that the amounts are very small. According to the IHRA, a generous estimate for 2007 is that approximately $160 million was invested in HIV-related harm reduction in low and middle income countries. This spending equates to $12.80 for each injector each year in low and middle income countries, or just three cents per injector per day. To put this $160 million in context, the IHRA said, UNAIDS estimates that the resources needed for harm reduction were $2.13 billion in 2009 and $3.2 billion in 2010.

The IHRA report said that the Global Fund invested $45 million in harm reduction in 2007, and a total of $180 million in the three-year period from 2007 to 2009. [The source for these figures is an article by R. Atun and M. Kazatchkine, "The Global Fund's leadership on harm reduction: 2002-09," International Journal of Drug Policy 21(2).]

The IHRA said that resources for harm reduction and HIV services for people who use drugs should be proportionate to the need within countries. The IHRA recommended that, globally, 20% of

prevention funds be allocated to harm reduction.

"Three Cents a Day Is Not Enough: Resourcing HIV-Related Harm Reduction on a Global Basis," is at www.ihra.net/reports.

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