ID: HR19-425
Presenting author: Emily Rowe
Emily Rowe
A reduction in international donor funds, coupled with unsupportive political and legal environments pose a threat to harm reduction and HIV services for people who use drugs in many lower middle-income countries. While inherently challenging, assessing current investment in harm reduction is necessary to inform advocacy for domestic investment and responsible transition away from international donor support. Harm Reduction International (HRI) developed research tools which were applied by national civil society partners to assess harm reduction investment in India, Thailand, Nepal, Cambodia, Vietnam, the Philippines and Indonesia. Using pre-developed criteria countries were ranked on four categories: harm reduction service coverage; transparency of spending data; government investment; and sustainability of funding. Tools evaluating law enforcement expenditure were also developed and data collected in Thailand and Indonesia. Findings indicated that in addition to an ongoing focus on punitive drug control approaches there is an improbability of continued funds in the next two years for harm reduction services across the 7 sites, particularly in transition countries. The study showed that harm reduction funding in all seven countries is precarious or already in crisis, and that increased national government investment into and mainstreaming of harm reduction services will be crucial for sustaining national responses. HRI modeling projections demonstrate that re-directing a small proportion of drug control funds to harm reduction could end injecting-related HIV infections by 2030. Greater transparency around harm reduction, HIV and drug policy spending is necessary to inform strategic investment in effective and cost-effective responses to HIV and drugs.