It is estimated that only 7% (or US$ 160 million) of the US$ 2.13 billion needed for harm reduction services is available, the bulk of which has been provided by the Global Fund. About 70% of the funding for HIV programs for the most vulnerable populations, including people who inject drugs, comes from donor organizations and global health initiatives.
The governments in EECA do not allocate sufficient financial resources to ensure the effective scale up of HIV programs and most of the countries have failed to fund harm reduction programs. Current financial HIV investments in EECA are disproportionate to the burden of HIV among people who inject drugs. According to UNAIDS, only 15% of financial resources directed at HIV prevention among people who inject drugs in EECA come from public sources. Despite the inclusion of harm reduction in national HIV or drug strategies in 26 countries, the majority of governments in EECA do not finance harm reduction programs. Five countries reported non-governmental and non-Global Fund funding sources for harm reduction, while another 11 reported some governmental contributions toward the delivery of harm reduction programs.
Many of the countries in the region are becoming ineligible for donor funds due to increasing income levels. Only two countries in EECA - Kyrgyzstan and Tajikistan – are classified as low-income countries. To address the HIV epidemic in EECA, public sector investments in EECA countries must be strategic and focus on interventions for people who inject drugs. This funding should be commensurate with disease prevalence and incidence.