Harm reduction funding is a small proportion of the Global Fund investment portfolio, but it is a lifeline for harm reduction programmes in many low- and middle-income countries. For example, in 2022, Global Fund grants enabled programmes to reach 1.1 million people who use drugs with HIV prevention services. The latest data shows that harm reduction’s reliance on the Global Fund has increased. The Global Fund’s role in scaling-up harm reduction interventions is more crucial than ever. Decisions made at the 52^nd Global Fund Board Meeting on the new allocation methodology 2026-2028, the eligibility policy, catalytic investments and the Sustainability, Transition and Co-financing policy will disproportionately influence the lives of people who use drugs and their access to harm reduction programmes.

This briefing draws upon recently published flagship civil society monitoring reports on harm reduction programming, policy and funding around the world. We call on the Global Fund Board delegations to consider this evidence in discussions and decision-making at the upcoming 52^nd Global Fund Board meeting.

• Harm reduction funding amounted to USD 151 million in 2022- just 6% of the USD 2.7 billion needed annually by 2025, leaving a funding gap of 94%, which compares to a funding gap of 29% for the overall HIV response.
• Bilateral funding has reduced substantially, and harm reduction is more reliant on multilateral funding than ever before. The Global Fund accounted for 73% of all donor funding for harm reduction in 2022, compared to just 31% in 2007.
• Any reduction in catalytic investments threatens the delivery of the Global Fund Strategy on maximising health equity, gender equality and human rights.
• The Global Fund should step up to safeguard HIV and harm reduction services in Lebanon and Palestine.