1. Global Fund Investments in Harm Reduction Washington, July 2012 Global Fund Investments for People Who Inject Drugs 23 July 2012 Professor Jeffrey V. Lazarus Copenhagen HIV Programme, Copenhagen University Jamie Bridge, Benjamin Hunter, Rifat Atun

2. Global Fund Investments in Harm Reduction Washington, July 2012 The Global Fund is an international financing institution mandated to: - Raise and invest substantial new funds - Operate transparently and accountably - Achieve sustained impact on HIV, TB and malaria - Invest in country-driven proposals Raise it Invest it Prove it BG/290607/1 What is the Global Fund?

3. Global Fund Investments in Harm Reduction Washington, July 2012 BG/290607/1 What is Harm Reduction? The UN Comprehensive Package: 1.Needle and syringe programs 2.Opioid substitution therapy 3.HIV testing and counseling 4.Antiretroviral therapy 5.STI services 6.Condoms 7.Information and education 8.Hepatitis services 9.TB services (+much more!...)

4. Global Fund Investments in Harm Reduction Washington, July 2012 Analysis Aims Identify how much the Global Fund invests in programs that target people who inject drugs (“harm reduction”) Create baseline for future analyses of trends and progress Provide open access information to support advocacy by donors, partners, recipient countries and the Global Fund itself Create a robust portfolio analysis methodology that can be used for other strategic priorities, MARPs and/or interventions

5. Global Fund Investments in Harm Reduction Washington, July 2012 Analysis Methodology Harm reduction activities are not readily defined or disaggregated in Global Fund information systems We searched all Global Fund HIV grants to find those that contain interventions targeting people who inject drugs We analyzed the final “detailed grant budgets” that are held by the Global Fund Secretariat We recorded all budget entries for people who inject drugs, categorized by the intervention type

6. Global Fund Investments in Harm Reduction Washington, July 2012 Results: Rounds 1 (2002) to 9 (2009)

7. Global Fund Investments in Harm Reduction Washington, July 2012 Results: Rounds 1 (2002) to 9 (2009) TOTAL BUDGETED:BUDGETED & PROJECTED TOTAL: US$ 361 millionUS$ 430 million (Average US$ 48 million each Round)

8. Global Fund Investments in Harm Reduction Washington, July 2012 Round 10 (2010) Dedicated “MARPs Reserve” created Global Fund releases first Harm Reduction Information Note 32 HIV proposals: 12 in MARPs Reserve 14 proposals included harm reduction: 7 in MARPs Reserve First grants for Malaysia and MENAHRA

9. Global Fund Investments in Harm Reduction Washington, July 2012 Results: Rounds 1 (2002) to 10 (2010) TOTAL BUDGETED:BUDGETED & PROJECTED TOTAL: US$ 81 million in Round 10US$ 152 million in Round 10 = US$ 442 million overall= US$ 582 million overall

10. Global Fund Investments in Harm Reduction Washington, July 2012 Where the Money Goes: Countries 139 grants 58 countries (excluding MENAHRA multicountry grant)

11. Global Fund Investments in Harm Reduction Washington, July 2012 Where the Money Goes: Principal Recipients Total = 139 grants

12. Global Fund Investments in Harm Reduction Washington, July 2012 Where the Money Goes: Interventions 67% of the budgeted investments for people who inject drugs goes on the WHO/UNODC/UNAIDS “comprehensive” harm reduction package 100% = US$ 442 million

13. Global Fund Investments in Harm Reduction Washington, July 2012 Conclusions 139 Global Fund HIV grants included activities for people who inject drugs, with a total projected investment of US$ 582 million Global Fund is the leading international donor for harm reduction Investments still fall short of the resource needs for harm reduction (estimated at US$ 2.3 billion annually by 2015) The Round 10 MARPs Reserve was successful in increasing funding for this population: should be continued More analysis needed: Other MARPs; Other Donors; and the submitted ‘Transitional Funding Mechanism’ proposals

14. Global Fund Investments in Harm Reduction Washington, July 2012 Thank You Jamie Bridge: bridgejamie@hotmail.com Ben Hunter: ben_hunter@hotmail.com Rifat Atun: r.atun@imperial.ac.uk Jeffrey Lazarus: jla@cphiv.dk www.theglobalfund.org