Assessing harm reduction investment in the European Union – Harm Reduction Works!

Catherine Cook

Harm reduction investment is not systematically tracked in any European Union (EU) member state. Ensuring the sustainability of harm reduction and the optimal allocation of limited funds requires an accurate understanding of current expenditure. The global economic crisis and resulting austerity measures, as well as limited political support for harm reduction continue to affect the sustainability of harm reduction in some states. Successful practice from countries where harm reduction receives consistent domestic support should be shared.

HRI adapted a methodology for tracking harm reduction investment for the European context, developed in conjunction with the Kirby Institute, Australia. In seven EU states, HRI worked with consultants to implement the research methodology and establish national harm reduction investment in needle and syringe programmes, opioid substitution therapy and antiretroviral treatment for people who inject drugs between 2010-2014. Survey responses were solicited from civil society to investigate existing and future funding levels, gaps and challenges and related advocacy activities in all EU states.

Common challenges in establishing harm reduction expenditure across all EU states included poor transparency and limited disaggregation of data on harm reduction related spending. While funding in several countries is considered to be relatively stable and sustainable, civil society consistently reported that investment could be more strategic. In at least four countries, funding levels were alarmingly low, or under serious threat, warranting fears of rapid increases in HIV infection among people who inject drugs.

This is an initial investigation into harm reduction funding within the EU. Systematic efforts to track annual investment in programmes will be necessary to monitor progress and inform strategic allocation of funds. Urgent action to increase funding for harm reduction in a small number of countries is necessary. Recommendations for EU institutions, national governments and civil society for securing sustainable harm reduction funding will be presented.