Where there is fruit, there is seed: Scaling up community involvement for integrated, responsive, and sustainable harm reduction

Drug use cuts across all demographics, but its harms are exacerbated among marginalized populations due to punitive drug laws that amplify inequities. This includes women, LGBTQI+ individuals, Indigenous communities, migrants, and incarcerated populations, all of whom face compounded barriers to accessing harm reduction services.

The bold targets of the Global AIDS Strategy 2021–2026 are supported by evidence that shows the peer-led and peer-to-peer harm reduction initiatives as effective. The Strategy underscores the critical need to apply an inequality lens to bridge gaps hindering progress, with the Sevilla Declaration6 advocating for the integration of community engagement commitments into local TB and viral hepatitis responses alongside HIV efforts.

Current funding for community-led organizations falls short of the commitments outlined in the Strategy and although domestic HIV expenditure has increased in some cases, only a small fraction of these funds is allocated to community-led organizations.