HIV, Drug Use and the Global Fund: Don’t Stop Now!

As stated in the Executive Summary: "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 report cites injecting drug use (IDU) as a driver of HIV infection and discusses the problems of underfunding of treatment programmes and the stigmatisation that invokes controversy around treatment programmes.

The report finds that 14 of 15 countries, where IDU is a driver of HIV infection, are middle income countries that are affected by Global Fund policies to reduce funding to middle income countries. It finds that reduction of bilateral funding in scaling up harm reduction programmes puts these programmes in jeopardy. "Programme quality, innovation to address changing drug use practice and the needs of different sub-populations, technical support, drug user participation, community mobilisation, advocacy and legal services are essential features of harm reduction programmes and need support."

The report includes an example of a harm reduction programme in Ukraine, a case study of the impact of the removal of Global Fund resources in community-based harm reduction in China and in Vietnam. The report concludes with recommendations for a more nuanced approach to Global Fund disbursement for the scaling up of harm reduction interventions, including calling on bilateral donors to honour programme commitments. The document recommends strengthening funding for peer education and community-based outreach, along with strengthening legal and policy interventions and, especially, focusing on an evidence-based and a human rights-based approach.