Western nations' 'neglect' eroding fight against Aids

The global attempt to end Aids is being undermined as western countries, including the UK, pull funding in the places that need it most, according to leading health groups.

On the eve of the 20th International Aids Conference, held in Melbourne, experts are warning that funding for HIV prevention for people who inject drugs is in crisis. They say that achieving an "Aids-free generation" will be impossible without concerted action.

Harm Reduction International, the International Drug Policy Consortium and the International HIV/Aids Alliance – which is mourning the loss of several colleagues who died in Thursday's Malaysia Airlines jet crash – will publish a report that confirms HIV prevention services for drug injectors are losing out due to "changing donor policies and national government neglect". The report warns that a failure to provide funding will bring a huge rise in HIV transmission, which in turn will cause additional costs to government health sectors.

UNAids, the joint UN programme on HIV/Aids, claims that $2.3bn is needed in 2015 alone to fund HIV prevention among people who inject drugs. But international donors have invested only $160m – approximately 7% of what is required.

The Department for International Development has been pushing for the Global Fund, the main distribution mechanism for HIV treatment programmes, to focus on low-income countries. However, the report shows that 75% of people who inject drugs live in middle-income countries.

"The cost effectiveness of harm reduction interventions in preventing new HIV infections is well documented," said Catherine Cook, senior research analyst at Harm Reduction International. "In many middle-income countries, more than two-fifths of new HIV infections are among people who inject drugs. But donors are nonetheless withdrawing due to their middle-income status without responsible exit strategies in place."

As a result of the reprioritisation, half of the 58 countries that have previously received harm reduction funding are now either ineligible for support or have not been assigned any "new" HIV money.

"We're facing a perfect storm of donor retreat, national neglect and massive overspending on ineffective and often counterproductive drug enforcement," said Susie McLean, senior adviser on drug use and HIV at the International HIV/Aids Alliance.