This report examines the impact of the cancellation of
Global Fund Round 11 funding and subsequent changes
in Global Fund policies and practices relating to HIV and
drug use programmes. It focuses on how future HIV and
harm reduction programming will be affected by the
Global Fund’s current funding crisis given the very low
existing levels of funding for such programming.
This issue has particular significance for Eastern
European and Asian countries where HIV epidemics are
largely shaped by injecting drug use.
A forthcoming report by the Eurasian Harm Reduction
Network will focus on the dynamics of HIV, drug use and
Global Fund funding in those countries.
This report is a follow-on to Don’t stop now: how
underfunding the Global Fund to Fight AIDS, Tuberculosis
and Malaria impacts on the HIV response, produced by
the International HIV/AIDS Alliance earlier in 2012. The first
Alliance report discussed the impact of the cancellation
of Round 11 on HIV programmes generally, and also
highlighted impacts in Bangladesh, Bolivia, South Sudan,
Zimbabwe and Zambia.
The sharing of injecting equipment is a major driver of HIV
transmission globally. Yet historically resources have been very
low for HIV and harm reduction programmes targeting people
who inject drugs, with the underfunding of needle and syringe
programmes and opioid substitution therapy being especially
notable. The result is insufficient coverage to halt or reverse
HIV epidemics and, worse, the continued spread of HIV
epidemics in some regions due to unsafe injecting practices.
The stigmatisation of people who use drugs and the resulting
controversies surrounding harm reduction services create
obstacles for the funding of interventions proven to reduce
the health and social harms associated with such behaviour.
People who use drugs are an unpopular target for national
and global health care spending.
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