Statement by Rick Lines, Executive Director
Harm Reduction International
The world is going to miss the 2015 target of reducing HIV among people who inject drugs by 50%. In fact we’re going to miss it by 80%. Making among the worst performing targets of all those set in 2011. This is staggering. We must acknowledge that the world has failed people who use drugs and we must refocus our efforts. We need leadership on harm reduction. Harm reduction leadership means increasing political support and funding for harm reduction. Currently, harm reduction investment is just 7% of what is needed and the situation is getting worse. And that’s not because money isn’t available and being spent, indeed wasted, on drugs. We estimate that just ten cents of every dollar spent on drug enforcement and interdiction could fund the global HIV response among people who inject drugs globally twice over. A 10% reinvestment of current drug enforcement spending by 2020, or 10 by 20, must be the collective demand of the HIV movement. Harm reduction leadership means ending the criminalisation of people who use drugs, and the punitive legal frameworks that fuel HIV transmission, overdose, mass incarceration and human rights violations worldwide. Harm reduction leadership means halting moves by bilateral donors and the Global Fund to restrict support for harm reduction in middle-income countries. More than 3/4 of people who inject drugs live in these countries, and they are where the epicentres of the injecting driven HIV epidemics are located.
The HIV response prides itself on being evidence-based and human rights compliant. Donor withdrawal from middle-income countries, without proper planning or agreements to maintain funding for services, meets neither of these criteria. The evidence is clear that middle-income countries will not automatically step in to keep harm reduction services open, which represents a collective denial of the rights of people who use drugs by both donors and national governments. And harm reduction leadership means renewing efforts to truly know the injecting-driven HIV epidemic. Harm Reduction International produces the Global State of Harm Reduction report, being launched this evening. We know better than most that the data on which the response is based is often outdated, incomplete, politically manipulated or of questionable quality. To redress this gap in evidence, the UNAIDS family must reinstate and fund the Reference Group on HIV and Injecting Drug Use. UNAIDS should amend the National AIDS Spending Assessment and Global AIDS Response Progress Reporting tools to accurately capture disaggregated data to track national level financial investments for HIV interventions for key populations, and should provide technical support to ensure implementation of such systems. Harm reduction saves lives, improves health, saves money and promotes human rights. Yet many governments, including governments around the table this week which have made otherwise lovely statements on HIV, continue to block official recognition of harm reduction in UN resolutions. This is the opposite of leadership on harm reduction. Without harm reduction leadership, we will never achieve the goal of reducing and ending HIV among people who inject drugs.