Global Fund HIV projects have been implemented in Bulgaria since 2003. At the moment Bulgaria is technically eligible for funding under the Global Fund’s NGO rule, which allows for non-governmental organizations in countries with political barriers to service provision to apply for Global Fund funding without CCM approval. However Bulgaria was not allocated any HIV funding for the period 2014 – 2017 under the Global Fund new funding Model (NFM) as the Global Fund decided there was insufficient evidence of political barriers to implementing HIV prevention activities in-country.

Global Fund support of harm reduction programs in Bulgaria has been essential to the country’s HIV response. But HIV prevalence among PWID in Bulgaria has grown substantially over the last decade, and the Global Fund’s withdrawal of funding for HIV activities in-country threatens the sustainability of Bulgaria’s HIV response.

Despite increased coordination in civil society advocacy for harm reduction and greater representation by civil society in planning the next HIV strategic plan, the government has not committed to providing sufficient resources for HIV prevention activities following Global Fund withdrawal. Since the National Program for Prevention and Control of HIV/AIDS and STI 2016-2020 still remains to be drafted, there is no transition plan in place or adequate resource needs estimate for harm reduction activities.

In that context, EHRN decided to develop a case study examining the situation in Bulgaria and making recommendations to the Global Fund, national governments, civil society, and other donors for easing the transition and safeguarding previous gains in HIV prevention in Bulgaria.

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