History was made last week in Lyon, when governments, philanthropic donors and the private sector pledged US$14 billion for the Sixth Global Fund Replenishment, more than any other global health institution has ever raised. Harm Reduction International, Eurasian Harm Reduction Association, International Network of People Who Use Drugs and the India HIV/AIDS Alliance congratulate the Government of France, the Global Fund to Fight HIV, Tuberculosis and Malaria (Global Fund) and the broad network of health advocates, academics and policy makers on this tremendous success.

Recognising that a strong and fully-funded Global Fund is vital to the harm reduction response, over 150 organisations and parliamentarians around the world signed on to the Call to Action on harm reduction funding earlier this year.

However, US$14 billion was the minimum amount required for the Sixth Replenishment and will not be enough to meet 2030 targets. The Global Fund also assumes a very ambitious 48% increase in domestic resources from low- and middle-income governments between 2021-2023. Yet, most governments have not prioritised harm reduction in their spending to date, even where the epidemic is concentrated among people who use drugs.

A seismic change is needed if we are serious about achieving Sustainable Development Goals and ending AIDS and combating viral hepatitis among people who use drugs by 2030. Much more is needed to address the funding and political crisis for harm reduction around the world.