Aid Cuts, Community Resolve: Unveiling the New Harm Reduction Funding Map

An unexpected pause in US foreign aid has rippled through harm reduction efforts from South Asia to southern Africa, shifting our shared landscape in profound ways. Harm Reduction International’s latest interactive overview brings together both published and behind-the-scenes data from the 2024 Cost of Complacency and Global State of Harm Reduction reports. It reveals how the Global Fund picks up a large share of support and how PEPFAR’s USD 7.9 million in 2022 drove HIV prevention and opioid agonist therapy for 27 000 people across seven key countries.

Behind the numbers lie communities adapting on the fly. In South Africa, a USD 1.3 million boost in opioid agonist therapy in 2022 contrasted with abrupt clinic closures in Kenya and Zambia when funding halted overnight. Needle and syringe programmes funded in partnership had to pause, leaving gaps in services that once helped thousands avoid overdose. Domestic investments show promise in some regions, but sustaining those gains demands more than numbers on a page—it requires the voices, insights, and creativity of people most affected.
 
This ever-evolving page shines a light on ten countries with the most significant PEPFAR investments, mapping where domestic funding stands beside big-ticket donors and where the next wave of support must arrive. It highlights mitigation measures on the ground, peer-led monitoring efforts, and partnerships that refuse to stand still. As cuts reshape HIV, HCV, TB, and harm reduction services more broadly, this resource will grow too—adding new country profiles and fresh data as developments unfold.
 
Dive into the full funding landscape, explore interactive maps, and see how community-based programmes are rising to the challenge. And if you have updates or local insights to share, reach out to [email protected] and help keep this critical resource as dynamic as the communities it serves