 Thank you, my name is Maria, I work for Harm Reduction International, we're an NGO based in London, and one of our key issues at the moment is funding for harm reduction. And we know that there isn't enough funding and we know that there are major problems in getting funding, but we wanted to try and do a report to really highlight how big an issue is this. Where is funding coming from? Where could it come from? And maybe some potential ways to solve what is essentially a crisis situation for harm reduction. So I'm going to talk to this very briefly for five minutes. The report is behind you on the table, so do take a copy if you want more information. Okay, so in terms of harm reduction, David will allude to the effectiveness of the intervention, but we know it's very effective. So what is the situation in terms of coverage? We know that many countries implement harm reduction, we know that many countries have a harm reduction approach, they have services, but what does this mean for people who use drugs? Well, globally, per month, just two needles and syringes are distributed per person who uses drugs per month. Now we know that we need at least three a day. So this is hugely low, so low that it's almost, well it is disgraceful, in fact, that we cannot scale this up further. In terms of opioid substitution therapy, in the same year that we did this study, we discovered that just 8% of people who inject drugs have any access to opioid substitution therapy. This is a hugely low number given the effectiveness of OST, we know it works, we know it has huge benefits to people who use drugs and communities, yet 90-something percent of people have no access. In terms of antiretroviral therapy, and we've heard a lot of talk at this conference about treatment and around access to treatment and around the need for treatment as prevention and all of the big stories that are going on in this area, we have to remember that in terms of a key effective population, in terms of people who use drugs, only 4% of people who use drugs who need ART have ART. So really, when we have all these discussions about treatment and the treatment revolution, let's not forget that we haven't even touched, we haven't even scraped the surface of what we need to do in terms of access for drug users. And a key problem for all of this is money. How much money do we need to get harm reduction scaled up to where it has to be? Well, the Strategic Investment Framework was launched three years ago in a big flurry with a fanfare and it said, this is what we need to do. We invest strategically, we invest smart, we invest in interventions we know work and we'll end the epidemic, we'll end AIDS. And how we're going to do this is we're going to invest in interventions that we know work. We're going to focus on key effective populations and it even costed it all out for us just to make it easy. It said, look, this is what you need to invest. So it said, 2.3 billion US dollars per year will be needed. You invest that, you invest it for long enough, we'll scale up enough and we'll end the epidemic for people who use drugs. So we said, okay, well, how much is being invested? And we looked into it and this is a very conservative figure, it's probably less. But in 2010, and this is the only time anyone attempted to do this and it's still the only number we have we found 160 million US dollars has been invested by donors. That's 7% of what is needed. So we're really, really far behind. So the Strategic Investment Framework was launched, it was very exciting, we're three years on, nothing has changed. This is still the situation that it was before. And it could get worse. It hasn't as yet, but it has every potential to do so. Tanya's going to speak to this tube for you as well. The middle income country issue, 75% of people who inject drugs live in middle income countries and over 40% of new HIV infections related to unsafe injecting are in many middle income countries. So we have a serious problem. This is where the burden of need is, but donor priorities are shifting. Now at the moment, in terms of harm reduction funding, 90% of the funding comes from international donors. It comes from the global fund. It comes from the UK DFID project. It comes from Australia. Government's investing aid money, which ends up funding harm reduction. Only 10% of what is currently invested comes from national governments. And most of those governments are not middle income countries. They're high income countries like the UK, France, Western Europe, etc. So really these middle income countries are totally overly reliant on these international donors. But those priorities are now changing. International donors are saying we should focus on the poorest countries. We need to focus on countries where the burden of need for aid really lies. And that kind of makes some sense to an extent, except when you think about harm reduction. Because when you put a harm reduction lens on this problem, you see these programs will now close. Let me give you an example. So for example, Thailand. Thailand is a country that has been hailed as a country that is now fully funding pretty much HIV responses itself. It's nationally scaling up. 90% of Thailand's national HIV program is spent from domestic funds. As international donors leave, Thailand has come in. However, 21.9% of people who inject drugs are living with HIV in Thailand. That's a big proportion of the population. That's like a fifth of the population. How much of this 90% goes to harm reduction in Thailand? Nothing. Nothing goes to harm reduction in Thailand. So we can't necessarily rely on national governments to invest in harm reduction. It's simply not going to work that way. And in terms of the most important donor for us, the most important donor is the Global Fund. The Global Fund funds a lot of harm reduction. It's our leading donor. They're the most important funder for us. And we need a fully funded Global Fund to do this. We need governments to keep investing. But we also need the Global Fund to be allowed to work in middle income countries. And due to the new funding model, we do have some concerns. 58 countries that previously received harm reduction funding from the Global Fund. Of those 58, 41% are now ineligible. So we're looking at a large number because of their middle income country status. They cannot apply for Global Fund funding. So we have a problem. Who's going to step in and fill that gap? It's not national donors. We know that much for sure. So the ways forward, let's hope it's not all doom and gloom. These challenges are considerable. It is a crisis situation. But we have come up with some recommendations. There are more in the report. Please do have a look. The first is to try and keep the Global Fund global. Thanks, Chloe. Keeping the Global Fund global and allowing it to invest in middle income countries where the epidemic is will allow us to continue this work. We should invest strategically in harm reduction. We know it works. We know it's cheap. We know it ensures the rights of people who use drugs are furthered. And really, if you're smart, if you really want to invest your aid money smartly, invest it in key populations. You invest it in harm reduction. Obviously, an increase in national levels of expenditure is absolutely key. And this needs strong civil society in country. So we must invest in those groups in order to lobby their governments to fund their own responses. And I talked about this a little bit in the last session, but a rebalance of funding is needed. We spend a lot of money on law enforcement. We spend a lot of money on responses that don't work. And just 10% of what we spend globally would fund harm reduction. It would fund everything we need. 10% of what is spent in one year on ineffective practices would fund everything we need for four years at a time. So we have to start critically analyzing this. Why are we spending so much money on these practices? And why are governments allowed to brag about it? More importantly, they brag about the amount of money they spend on these practices. They think it's a good thing. It's not a good thing. They should be investing in harm reduction instead. And everybody agrees with us, including the World Bank, who in 2013 made this statement, the scientific evidence, the public health rationale, and the human rights imperatives are all in accord. We can and we must do better for people who inject drugs. The available tools are evidence-based rights affirming and cost-effective. What is required now is political will and a global consensus of this critical component of global HIV can no longer be ignored and should no longer be under results. Thank you very much for listening to me and please do read the report.