Special Report: Harm Reduction and the Global HIV Epidemic

September 3, 2015

A new report from amfAR, The Foundation for AIDS Research, assesses the state of harm reduction worldwide by focusing on the steps that five sample countries—Kenya, Kyrgyzstan, Nigeria, Ukraine, and Vietnam—have, or have not, taken to address the HIV epidemic among people who inject drugs (PWID). The report, titled Harm Reduction and the Global HIV Epidemic: Interventions to Prevent and Treat HIV Among People Who Inject Drugs, also examines the role of international donors, such as the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria, in funding and implementing HIV services for PWID.

Achieving an AIDS-free generation requires that all populations have access to HIV prevention and treatment services. Unfortunately, when it comes to people who inject drugs, access is often denied. The approach of many countries is to criminalize PWID instead of providing or supporting harm reduction services that are highly effective at preventing the spread of blood-borne infections such as HIV and hepatitis C. As a result, in many low- and middle-income countries, the limited harm reduction services that are available are primarily supported by international donors.

While the Global Fund has been the world’s largest funder of harm reduction for PWID to date, recent changes to its funding model may disadvantage these programs in middle-income countries—some of which have HIV epidemics driven primarily by injecting drug use. And while PEPFAR has been enormously successful in expanding access to HIV treatment and prevention in low- and middle-income countries, its effectiveness has been undermined by the U.S. Congressional ban on the use of PEPFAR resources for the collection and distribution of clean syringes.

The report concludes with a series of recommendations to help civil society, donor organizations, and national governments improve their response to HIV among PWID in the current funding climate.

The report is available here.