By Catherine Cook / Harm Reduction International and FCAA 

What are the possible reasons a donor might begin/enter into funding harm reduction work?

Donors choose to fund harm reduction because it is evidence based, cost-effective, and has been proven to reduce HIV transmission. We will not end AIDS by 2030 without a significant scale-up of harm reduction programming:

  • Evidence: There is an abundance of scientific research showing the effectiveness of harm reduction interventions in preventing HIV infection. The priority interventions for people who inject drugs – as outlined in World Health Organization, United Nations Office on Drugs and Crime, and UNAIDS technical guidance – are needle and syringe programmes and opioid substitution therapy. However, only 1% of people who inject drugs live in countries with high coverage of harm reduction interventions. Consequently, HIV infections among people who inject drugs continue to rise in many countries in the world, particularly in Eastern Europe and Central Asia, and the Middle East and North Africa. Funding for harm reduction in low- and middle-income countries falls far short of need. Harm Reducation International (HRI) research found this to reach only 13% of the $1.5 billion that UNAIDS estimate is required to cover 90% of people who inject drugs with services by 2020.
  • Value for money and cost-effectiveness Harm reduction has been demonstrated to be a high impact, “value for money” investment for donors. Harm reduction interventions are relatively inexpensive to implement and are proven to be cost-effective HIV prevention measures. HRI summarised some of this evidence in our report The Case for a Harm Reduction Decade: Progress Potential and Paradigm Shifts (p.11). It is becoming increasingly important for civil society and community advocates to be able to convey cost-effectiveness evidence when advocating for harm reduction funding.