Theme: Social Science & Policy Research Year: 2024
Background: People who use drugs are at increased risk of hepatitis C infection and yet have minimal access to testing and treatment. Funding has largely been within the context of HIV co-infection. Understanding the current state of funding for harm reduction and how this sits within the broader funding landscape is crucial to ensuring sustainable funding for the elimination of hepatitis by 2030.
Methods: Harm Reduction International carried out a desk review, surveys and key informant interviews between November 2023 and March 2024 to gather data on the state of harm reduction funding in low- and middle-income countries for 2020-2022. Data was collected from both international donors and national governments. Qualitative information was also collected for 2023 onwards. Data verification was undertaken through follow-ups with implementors and community partners in key countries. Key thematic areas that characterize the funding landscape were identified.
Results: The number of donors providing harm reduction funding has reduced and reliance on the Global Fund and PEPFAR has increased. Limited funds have supported hepatitis programming in the context of co-infection within broader HIV grants. Qualitative information indicates a shift with greater standalone hepatitis programming funding becoming available from 2023 onwards. Data on domestic investment in hepatitis programming for people who use drugs is poor.
Conclusion: The funding gap for harm reduction remains vast. Historically, international donor support has come within the context of the HIV response but is increasingly precarious in the face of shrinking overseas development assistance. Hepatitis specific funding streams have increased since 2023, indicating growing donor attention, but remain insufficient to address need. Meeting global goals to eliminate hepatitis by 2030 requires new and innovative approaches. Governments should divest for punitive drug policies and invest in integrated services that provide hepatitis testing, diagnosis and treatment for people who use drugs.