Global Fund Investments for People Who Inject Drugs 23 July 2012

1. Global Fund Investments for People Who Inject Drugs 23 July 2012 Professor Jeffrey V. Lazarus Copenhagen HIV Programme, Copenhagen University Jamie Bridge, Benjamin Hunter, RifatAtun

2. 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 Prove it What is the Global Fund? Invest it BG/290607/1

3. What is Harm Reduction? • The UN Comprehensive Package: • Needle and syringe programs • Opioid substitution therapy • HIV testing and counseling • Antiretroviral therapy • STI services • Condoms • Information andeducation • Hepatitis services • TB services (+much more!...) BG/290607/1

4. 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. 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. Results: Rounds 1 (2002) to 9 (2009)

7. Results: Rounds 1 (2002) to 9 (2009) TOTAL BUDGETED:BUDGETED & PROJECTED TOTAL: US$ 361 million US$ 430 million (Average US$ 48 million each Round)

8. 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. 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. Where the Money Goes:Countries 139 grants 58 countries (excluding MENAHRA multicountry grant)

11. Where the Money Goes:Principal Recipients Total = 139 grants

12. 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. 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. 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