Statement on behalf of Harm Reduction International delivered at the Multistakeholder Hearing for the UN High-Level Meeting on HIV/AIDS on May 14th 2026.

Thank you Chair. I am speaking on behalf of Harm Reduction International.

In 2024, 8% of all new HIV infections globally were among people who inject drugs. HIV prevalence among people who inject drugs is ten times higher than in the general population. Despite this disproportionate burden, harm reduction services are being weakened. Instead of scaling up this effective and cost-effective response, we are watching harm reduction systems collapse. Even before the cuts in 2025, funding for harm reduction in low‑ and middle‑income countries stood at just US$151 million, barely 6% of what is needed. Harm reduction must be recognised as an essential part of the HIV response in the new Political Declaration.

A sustainable HIV response cannot exclude key populations, particularly in contexts where adequate policies and enabling political conditions are lacking. Where drug use, sex work, or same-sex relations are criminalised, national systems are less likely to fund the peer-led organisations best placed to reach those most affected. Without adequate mechanisms for meaningful community participation in decision-making, key populations risk being “left behind” in any rushed shifts to domestic financing. The Declaration must therefore commit to ensure explicit protections, ring‑fenced funding, and explicitly name key populations, including people who use drugs.

Communities must continue to be central to the HIV response. Community‑led services are often the only trusted entry point for people who use drugs to access HIV prevention and treatment. They have been hardest hit by recent funding cuts, and their sustainability is under threat. Cuts to wider health services, legal aid, social support, and human rights advocacy are compounding this loss. The Political Declaration should commit to ensure direct, flexible, long‑term financing for community‑led and civil society organisations, including through social contracting. Finally, it must enshrine community leadership in governance, monitoring and accountability at all levels of the HIV response.

Thank you.