European harm reduction is facing a funding crisis

Harm reduction has long been a cornerstone of European public health, minimising drug use risks like overdose deaths or preventing the spread of infectious diseases. These interventions have been instrumental in improving the health and wellbeing of people who use drugs (PWUD).

However, in the last few years, the financial sustainability of many harm reduction initiatives has been under serious threat. A growing funding crisis, driven by shifting political priorities and a fragmented approach to drug policy within the European Union (EU), is threatening to dismantle decades of progress. 

The current funding challenge

This shifting landscape in harm reduction funding has hit at a critical time. Europe is facing an increasingly complex drug landscape, with hundreds of novel psychoactive substances (NPS) and synthetic opioids increasingly circulating in drug markets. 

Speaking to TalkingDrugs, Alexei Lakhov, Executive Director of the European Network for People Who Use Drugs (EuroNPUD) highlighted that “this complexity often increases the demand for specialised harm reduction services”, further straining service providers.

European harm reduction has historically been financed through national health funds, international aid and EU-wide grants. Yet, a 2024 report from Harm Reduction International (HRI) into harm reduction funding has underscored how national and international donors have scaled back many of their financial commitments to harm reduction. European countries, particularly those classified as high or upper-middle income, are no longer eligible for key international funding sources such as the Global Fund to Fight AIDS. While understandable, this shift has left critical harm reduction programmes struggling with severe budget shortfalls.

Political shifts toward right-leaning governments across Europe have further amplified this crisis, as policymakers shift their focus to drug-related security concerns and supply side interventions over harm reduction. While the EU’s official drug strategy continues to support harm reduction, national concerns around drug-related insecurity have prioritised law enforcement-based approaches, leaving many harm reduction services with reduced resources.

Critical dependence on public funding

The Netherlands, a pioneer of European harm reduction since the 1970s, is one of the many countries facing funding cuts that threaten its services’ stability. For over 35 years, Mainline has played a key role in conducting research on harm reduction and providing updated information on drug trends and alerts to PWUD across the Netherlands through their magazine. Now, however, they are facing serious cuts.