International donor funding comprised 67% of total harm reduction funding in 2022. Most of the money went towards HIV prevention programmes for people who inject drugs. The US President’s Emergency Plan for AIDS Relief (PEPFAR), a decades-long initiative, supported opioid agonist maintenance therapy to 27 000 people in seven countries (India, Kenya, Kyrgyzstan, South Africa, Tajikistan, Tanzania and Uganda). In many cases these were and are the only services available. They also supported harm reduction programmes in Mozambique, Myanmar and Kazakhstan.
Kenya has been a major partner of the US President’s Emergency Plan for AIDS Relief (PEPFAR) and a beneficiary of the USAID grant that has been supporting HIV and TB response. The US government funding freeze had resulted in the closure of over 150 clinics, adversely affecting more than 72,000 people who rely on antiretroviral therapy. Drop-in centres for key populations including sex workers and people who use drugs have shut down, along with HIV prevention services for adolescent girls and young women. Communities most at risk are paying the price. People living with HIV and key populations such as sex workers are facing increased persecutions in many PEPFAR-supported countries as governments chose the funding freeze as cover to crack down on human rights.
Sex workers in South Africa say they are devastated following the closure of US-funded clinics.
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