The urgent need for harm reduction funding: Scaling up evidence based interventions for people who use drugs

23 March 2018 - Vienna, Austria - "The urgent need for harm reduction funding: Scaling up evidence based interventions for people who use drugs" was the title of a side event, chaired by Anne Skjelmerud, Government of Norway. It took place during the 61 st Session of the Commission on Narcotic Drugs.

The event was organised by the Strategic Advisory Group to the UN on HIV and Drug Use, which comprises UN agencies, key donors and civil society partners, and exists to advise the UN and others on overall global policies and strategies, research and development in relation to the global HIV/AIDS response among people who use drugs.

The current state of the HIV epidemic among people who inject drugs, including the glaring gap in service coverage and need for sustainable, predictable funding to scale up HIV services for people who inject drugs, was the focus of this session.

Anne Skjelmerud described harm reduction as an "ethical principle" that emerged out of concern for public health as well as concern for the individual. Shifting from an approach of wanting to control the epidemic, as well as individuals, in HIV programmes to strategies of cooperation and empowerment of the most affected groups was key in Norway. Inclusion of marginalised groups enabled these groups to reflect on risk and "protecting oneself and others".

Dr Monica Beg, Chief of the HIV/AIDS Section and Global Coordinator for HIV/AIDS, UNODC presented an overview of the progress made in HIV prevention, treatment and care among people who inject drugs since the adoption of Resolution 60/8.

"Globally, people who inject drugs account for 8% of all new HIV infections according to the latest estimates", she said and added, "In Eastern Europe and Central Asia unsafe drug injection even accounts for over 65% of cumulated HIV cases."

Referring to the WHO/UNODC/UNAIDS Technical Guide to reduce HIV infection among people who inject drugs, she highlighted that "we have the most effective HIV harm reduction interventions: needle and syringe programmes (NSP), opioid substitution therapy (OST) and antiretroviral therapy, HIV testing and counselling. We know that if they are implemented the right way, in the right scale, the epidemic can be controlled. Yet less than 1% of people who inject drugs live in countries with high coverage of both NSP and OST."

Among the successes of the UNODC Global HIV Programme, she mentioned the brokering of strategic alliances between Drug control, Law enforcement, Justice, Prison administration, the Health sector, civil society organisations and community based organisations, as well as technical support, most notably in Kenya, where 6788 people who use drugs have access to comprehensive HIV services, and Vietnam 's scale up of OST services in prison.

Speaking at the side event, Aljona Kurbatova, National Institute for Health Development in Estonia, stressed the advantages for governments that invest in sustaining evidence based HIV services. There is strong evidence that these services work and are cost‐effective.

Also participating, Valentin Simionov, International Network of People who Use Drugs (INPUD), presented the strategic plan of INPUD, including a human rights centred approach to drug use. He highlighted the importance of community involvement in the HIV response.

Fionnuala Murphy of Harm Reduction International stressed that donor withdrawal from states with the most urgent need was one of the biggest problems and recommended a balanced approach to allocation of funds.

The panellists reiterated that reaching the SDG target of ending AIDS by 2030, leaving no one behind, was stressed in the Outcome Document of the 2016 UNGASS on the World Drug Problem, and ensuring access of people who use drugs to evidence based and human rights centred  HIV prevention, treatment and care is key in working towards this goal.