Harm Reduction has been long underfunded. Harm Reduction International’s most recent findings show that harm reduction funding is meeting only 6% of the estimated necessary need in low- and middle-income countries. This research came before the United States pulled Official Development Assistance (ODA) funding through projects like PEPFAR, USAID, or pledges to the Global Fund. The situation we now face is undoubtedly more stark, with numerous low- and middle- income countries having been heavily reliant on US funding for harm reduction. Before this year, domestic funding for harm reduction had been decreasing, leading to an over-reliance on bilateral and multilateral donors to fill the gap.

UNAIDS estimates that the permanent discontinuation of this important source of HIV funding will lead to an additional 6.6 million new HIV infections and 4.2 million AIDS-related deaths between 2025 and 2029.  Amid this funding crisis, we must reassess our priorities and focus our efforts to retain vital and life-saving harm reduction services. The World Health Organization, along with The Global Fund, has stressed the importance of maintaining and sustaining the continuity of life-saving harm reduction interventions that are under threat. While the guidance is clear about the importance of maintaining these services for sustaining the life and health of people who use drugs, what does it mean for civil society advocacy?

The 2025 Update to the Global State of Harm Reduction allows us to take stock of major changes to harm reduction programming at the national level, providing general insights between editions of the more comprehensive biennial Global State. In the current context, the 2025 Update takes stock of the impact of these US funding cuts, providing an initial overview of the countries most harshly affected, while highlighting mitigating factors protecting other countries, such as those with existing domestic funding for harm reduction. 

The webinar also allowed us to view the current situation through an opportunity lens, presenting findings from evaluations conducted in Indonesia and South Africa, with case studies highlighting mitigation efforts in each country and opportunities for advocacy moving forward. These case studies led us into an open discussion, where participants were welcome to adapt the findings and recommendations to the specificities of their own context.

1. Facilitator: Ailish Brennan
2. Opening: Catherine Cook -Slides available here
3. Update to the Global State of Harm Reduction: Paulina Cortez Licona -Slides available here
4. World Health Organisation Guidelines: Antons Mozalevskis -Slides available here
5. Indonesia Case Study: Suny Adam -Slides available here
6. South Africa Case Study: Stacey Doorly-Jones -Slides available here
7. Closing Remarks: Anton Basenko