The Global Fund to Fight AIDS, Tuberculosis and Malaria's investments in harm reduction through the rounds-based funding model (2002-2014)
The Global Fund to Fight AIDS, Tuberculosis and Malaria's investments in harm reduction through the rounds-based funding model (2002-2014)
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DOI：
10.1016/j.drugpo.2015.08.001
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发表时间：
2016-01-01
影响因子：
4.4
通讯作者：
Wolfe, Daniel
中科院分区：
文献类型：
--
作者：
Bridge, Jamie;Hunter, Benjamin M.;Wolfe, Daniel
背景资料：减少伤害是一种以证据为基础的有效应对艾滋病毒传播和注射毒品者面临的其他伤害的措施，并得到全球抗击艾滋病、结核病和疟疾基金的明确支持。尽管如此，注射吸毒者仍然很难和不公平地获得这些服务，并面临普遍的耻辱和歧视。2013年，全球基金推出了一种新的供资模式，标志着自2002年成立以来一直运作的以回合为基础的模式的结束。本研究更新了先前的分析，以评估全球基金在2002年至2014年基于回合的模型期间对减少危害干预措施的投资。方法：审查了2002年至2014年全球基金艾滋病毒和结核病/艾滋病毒赠款文件，以确定包含注射吸毒者活动的赠款。从详细的赠款预算中收集数据，并记录和分析相关的预算项目，以确定分配给不同干预措施的资源，这些干预措施是专门针对注射吸毒者的。结果：58个国家的151笔赠款，加上一项区域提案，包含针对注射吸毒者的活动，总投资为6.2亿美元。这一预算数额的三分之二用于联合国界定的“综合一揽子”措施。结论：本研究是对全球基金从成立（2002年）到新资助模式开始（2014年）在减少危害方面的投资进行的最新、全面的评估。报告还强调了减少危害资金的总体短缺，估计仅在2015年全球就需要23亿美元用于减少危害。利用这一基线，全球基金必须认真监测其新的供资模式，并确保维持或扩大对减少危害的投资。人们普遍担心从中等收入国家撤出，因为这些国家的减少危害工作仍然至关重要，而且没有其他来源的资金：例如，已确定的投资中有15%用于现在没有资格获得全球基金支持的国家。(C)2015作者出版社：Elsevier B. V.
Background: Harm reduction is an evidence-based, effective response to HIV transmission and other harms faced by people who inject drugs, and is-explicitly supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. In spite of this, people who inject drugs continue to have poor and inequitable access to these services and face widespread stigma and discrimination. In 2013, the Global Fund launched a new funding model-signalling the end of the previous rounds-based model that had operated since its founding in 2002. This study updates previous analyses to assess Global Fund investments in harm reduction interventions for the duration of the rounds-based model, from 2002 to 2014.Methods: Global Fund HIV and TB/HIV grant documents from 2002 to 2014 were reviewed to identify grants that contained activities for people who inject drugs. Data were collected from detailed grant budgets, and relevant budget lines were recorded and analysed to determine the resources allocated to different interventions that were specifically targeted at people who inject drugs.Results: 151 grants for 58 countries, plus one regional proposal, contained activities targeting people who inject drugs-for a total investment of US$ 620 million. Two-thirds of this budgeted amount was for interventions in the "comprehensive package" defined by the United Nations. 91% of the identified amount was for Eastern Europe and Asia.Conclusion: This study represents an updated, comprehensive assessment of Global Fund investments in harm reduction from its founding (2002) until the start of the new funding model (2014). It also highlights the overall shortfall of harm reduction funding, with the estimated global need being US$ 2.3 billion for harm reduction in 2015 alone. Using this baseline, the Global Fund must carefully monitor its new funding model and ensure that investments in harm reduction are maintained or scaled-up. There are widespread concerns regarding the withdrawal from middle-income countries where harm reduction remains essential and unfunded through other sources: for example, 15% of the identified investments were for countries which are now ineligible for Global Fund support. (C) 2015 The Authors. Published by Elsevier B.V.