Global Fund and Harm Reduction

Over the last decade, the Global Fund has played a unique and indispensable role in responding to the HIV epidemic among people who inject drugs in Eastern Europe and Central Asia (EECA), where national governments are still either reluctant or outright resistant to invest in harm reduction programs.

In EECA, needles and syringe programs (NSP) have been designed and implemented primarily by NGOs. Most have had to obtain financial support from outside the region, and the Global Fund has been by far the most important funder.  From 2002 to 2009, it approved $263 million for harm reduction in EECA alone —more than all other international sources combined. This enabled the steady expansion of harm reduction programs in the region.  The Global Fund’s direct involvement is a key reason that the number of NSPs increased steadily after 2002.  In 2003, a total of 213 NSPs reportedly existed across 25 EECA countries, and just seven years later there were more than eight times that number in Ukraine alone.  Notably, in Round 10 (2010) the Global Fund announced a dedicated funding reserve for most-at-risk populations including people who inject drugs (“MARPs reserve”), and a further $152 million was approved for programs targeting people who inject drugs – including $109 million (64%) for new grants in five EECA countries.The Global Fund’s beneficial influence has often been very clear: in several EECA countries (e.g. Belarus, Kazakhstan and Tajikistan), OST pilots were first introduced within the implementation of the HIV prevention programs supported by the Global Fund.

In EECA, frequent political opposition to harm reduction, along with laws that directly or indirectly criminalise people who inject drugs, makes it imperative to provide support for community strengthening, advocacy capacity, and work toward the inclusion and human rights of people who use drugs. Through its Community Systems Strengthening (CSS) Framework, engagement of people who inject drugs in some CCMs, and emphasis on human rights, the Global Fund contributed significantly to building civil society capacity to advocate effectively for policy reform.




A three-year Regional Program “Harm Reduction Works – Fund It!” (supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria) was launched by EHRN on 1st of April 2014.

Community, Rights & Gender Technical Assistance (CRG TA) Program (supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria) was launched by EHRN in October 2016. A small-scale focused study conducted in Georgia in the framework of CRG TA Program: Civil Society Organizations on Georgia’s Transition Plan.


"Fund Harm Reduction" video
UNION 2014 Plenary Session
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