Intervention Summary
Title: Extension to the Accountable Grant for the International Harm Reduction
Association
What support will the UK provide?
To provide an additional and final tranche of £522,899 to support the work of the International
Harm Reduction Association by extending the existing accountable grant funding period until
31 March 2012.
Why is UK support required?
DFID have shown real leadership in promoting the rights and needs of key populations as part
of the HIV response and part of our contribution has included funding for the International
Harm Reduction Association.
There is now collective agreement amongst donors and international organisations that
funding to build capacity for and implementation of advocacy programmes in countries where
key populations are criminalised and discriminated against is critical in order to encourage
country ownership and a focused national response to the epidemic.
A funding mechanism, administered through UNAIDS is currently being designed and should
be launched before the end of 2011 that will fund similar organisations. Harm Reduction
International, as well as the International Drug Policy Consortium (IDPC) and the International
Network of People who Use Drugs (INPUD) have made significant progress in creating an
international network of drug policy groups. They provide collectively policy advice, skills
training and networking opportunities. They will be a strong contender to qualify for a grant
from this new fund.
This contribution represents a final tranche of funding that will keep Harm Reduction
International (now in collaboration with IDPC and INPUD in order to achieve efficiency
savings) activities on track until the UNAIDS fund is up and running
What are the expected results?
Reduced HIV incidence in injecting drug users in countries where unsafe injecting practice
is driving the epidemic through:
 Stronger evidence base on scale and nature of injecting drug use worldwide.
 Civil Society networks who are better organised and better able to advocate for HIV
prevention services in their own countries.
 Regional “Dialogue” Meetings to demonstrate to target country government officials and
other stakeholders the added value of harm reduction interventions.
 Better organised, stronger capacity of drug user groups to meaningfully engage at a
national and international level on HIV prevention.
Business Case for: Extension to the Accountable Grant for the International
Harm Reduction Association.
Strategic Case
A. Context and need for DFID intervention
A severe lack of funds for civil society advocacy and implementation remains a significant
contributory factor to the paucity of HIV – related harm reduction services around the world.
IHRA in the course of the current DFID grant have developed an international reputation as
leaders in advocacy and research in harm reduction and drug policy. They have made
significant efforts to broaden their donor base. The DFID contribution constitutes only 50% of
their overall budget now as opposed to 90% when the grant started. Their work “The Global
State of Harm Reduction” as well as a number of other publications are regularly quoted by
international organisations such as WHO, UNAIDS and UNODC. IHRA have now developed
working relationships with the International Drug Policy Consortium (IDPC) and the
International Network of People who Use Drugs (INPUD) and have agreed that their skill
sets are complementary and mutually reinforcing and have therefore produced a
“consolidated bid” that would be administered through IHRA. The bid achieves efficiency
savings and a more strategic approach to harm reduction advocacy internationally and is a
strong contender for the new UNAIDS funding mechanism.
This extension would allow the new alliance to establish itself as a single entity and position
them to be able to submit a consolidated application to the new fund which is expected to be
successful.
B. Impact and Outcome
The expected outcomes are:
 Stronger evidence base on scale and nature of injecting drug use worldwide.
 Civil Society networks who are better organised and better able to advocate for HIV
prevention services in their own countries.
 Regional “Dialogue” Meetings to demonstrate to target country government officials
and other stakeholders the added value of harm reduction interventions.
 Better organised, stronger capacity of drug user groups to meaningfully engage at a
national and international level on HIV prevention.
 Reduced HIV incidence in injecting drug users in countries where unsafe injecting
practice is driving the epidemic.
As a result the acceptance, implementation, coverage and quality of harm reduction
interventions should improve on a global scale bringing about a reduction in HIV
transmission amongst injecting drug users and an improvement in human rights standards
for some of the most vulnerable communities in the target countries.
Appraisal Case
A. Determining Critical Success Criteria (CSC)
Each CSC is weighted 1 to 5, where 1 is least important and 5 is most important based on the
relative importance of each criterion to the success of the intervention.
CSC
1
Description
Weighting (1-5)
To provide and make accessible high quality and 5
innovative research and analysis necessary to inform
national and international responses to HIV prevention in
injecting drug users.
Strengthened and increased capacity of civil society 5
organisations and drug user groups to engage effectively
in national and international advocacy.
2
B. Feasible options
In the table below:


the quality of evidence for each option is rated as either Strong, Medium or Limited,
the likely impact on climate change and environment is categorised as A, high potential risk /
opportunity; B, medium / manageable potential risk / opportunity; C, low / no risk /
opportunity; or D, core contribution to a multilateral organisation.
Option
Evidence rating
1
Not to provide any further funding to
IRHA - Limited
To provide one final tranche of C
support to IRHA, extending the
current accountable grant until 31
March 2012 - Strong
2
Climate
change
and
category (A, B, C, D)
C
environment
C. Appraisal of options
Option 1
The capacity of IHRA and it’s partners will be seriously impaired, redundancies will be made
risking the investment that DFID have already made in this organisation as well as that of
other donors such as the EU and NL.
Option 2
This is the preferred and recommended option. Key populations, including injecting drug
users feature increasingly in the AIDS response. Needle and syringe exchange, and drug
substitution therapy have long been recognised as cost-effective interventions1. A recent
1
Farrell M et al.1994 , Sorensen JL 2000
Lancet series states that these interventions should be supported on public health and
human rights grounds2. However, only around 10% of people who use drugs worldwide are
being reached, and far too many are imprisoned for minor offences or detained without trial.
High rates of HIV transmission related to injecting drug use have also been found in prison
settings. Political commitment and advocacy are needed to change this situation. Failure to
do so will exacerbate the spread of HIV infection and undermine treatment programmes.
IHRA, IDPC and INPUD provide the only credible HIV prevention with regards to
international drug policy service and have developed a strong international reputation. Many
of the countries that have concentrated epidemics are those that DFID following the BAR
and the MAR will not be focussing bilateral funding towards as they are frequently Middle
Income Countries. The work of IHRA and others will offer DFID the opportunity to continue
to support these populations through our support to civil society, enabling them to develop
their capacity to advocate for legislative and policy change.
The funding mechanism for advocacy for key populations that UNAIDS is developing will
hopefully be launched by the end of 2011. A number of governments including US, NL.
Germany, Sweden, France and UK will be invited to contribute to one fund that will then
distribute to those projects that meet the criteria of providing advocacy and capacity building
to groups supporting at risk populations. The intention is that in future years IHRA and others
will access their core funding from this. The extension to the DFID grant will allow them to
continue with uninterrupted service until the mechanism is operational.
D. Comparison of options
Not applicable for an extension of an existing intervention.
E. Measures to be used or developed to assess value for money
In favour of Option 2.
Value for money will be assessed in terms of the number of countries changing policies and
ultimately the number of infections averted as a result of the policy change that is
leveraged through this project.
Harm reduction interventions are proven to be a cost-effective in preventing infections, with
health benefits for individuals and wider communities. The impact of harm reduction is
maximised when low-cost/high impact interventions are favoured over high cost/low impact
interventions. This programme will develop greater evidence on what works in different
country contexts and support advocacy and capacity building that will result in a more
efficient allocation of resources and greater value for money across harm reduction efforts.
The objective is to ensure policy change in countries where Injecting Drug Use is driving the
HIV epidemic, thereby making it possible for those countries to politically and financially
support their own programmes. Since most of the countries affected are middle income, this
will ultimately relieve the burden on bi-lateral and multi-lateral donors.
The independent evaluation of IRHA concluded 'DFID has received good value for money
from IHRA during the programme and should now consider ways of capitalising on its
2
Beyrer, C et al.: Time to Act: A call for comprehensive HIV responses for people who use drugs.
The Lancet, August 2010
investment by (a) promoting and enabling donor coordination for future IHRA funding, (b)
supporting sustainability of future IHRA funding and/or (c) providing extra funding for
activities not covered completely in the existing programme of work.' This extension takes on
board these recommendations.
Value for money will be one of the key criteria in the project completion report due in March
2012.
Commercial Case
Direct procurement
A. Clearly state the procurement/commercial requirements for intervention
Since this intervention involves contributing to the work of a UK based International NGO,
the proposed funding model is to amend and extend the existing Accountable Grant. The
funding will be provided directly to the International Harm Reduction Association, registered
under this name at Companies House and The Charity Commission but now trading as
Harm Reduction International.
B. How does the intervention design use competition to drive commercial advantage
for DFID?
There is only one organisation which is suitable for covering this area of work, and it must be
funded through an Accountable Grant, so this section is not relevant.
C. How do we expect the market place will respond to this opportunity?
Not applicable see above.
D. What are the key underlying cost drivers? How is value added and how will we
measure and improve this?
Not applicable see above.
E. What is the intended Procurement Process to support contract award?
As for the above.
As for the ongoing intervention each sub-contract to the regional networks will be awarded
based on a written agreement between IHRA and the recipient. This will clearly specify the
terms of the agreement including agreed activities and outputs, schedule of work, reporting
requirements, payment schedule, legal basis of the contract, confidentiality, rights of both
parties, dispute management, and financial accounting to DFID standards.
F. How will contract & supplier performance be managed through the life of the
intervention?
Through standard project management procedures, ongoing monitoring and annual
reporting. Quarterly financial statements as specified in the current Accountable Grant
Agreement Letter and annual audited accounts of income will continue to be provided by
IRHA.
Indirect procurement
A. Why is the proposed funding mechanism/form of arrangement the right one for this
intervention, with this development partner?
Not applicable see above.
B. Value for money through procurement
Not applicable see above.
Financial Case
A. How much it will cost
The existing accountable grant will be increased by £522,899.00 to £2,753,151.00
terminating on 31 March 2012.
01/10/2011 to 31/03/2012
£s
IRHA
Personnel
Operating and Support
Projects
Contribution to
Partners
INPUD
IDPC
Grand Total
Research
CSS
CSA
INPUD TOTALS
(Dev)
32657
23640
67724
48301
17813
14576
49010
29803
7500
6500
0
0
6875
48000
178896
11250 11250 76000
38000 34000 0
129940 131563 82500
136468
71256
89800
105375
120000
522899
Budget £
2006/7
2007/8
2008/9
2009/10
2010/11
2011/12
111722
209213
454237
459668
451617
464614
190903
+ extension
522899
Total 11/12
713802
Total Grant
2,753,151
B. How it will be funded: capital/programme/admin
Under programme funds allocated for the AIDS and Reproductive Health Team.
C. How funds will be paid out
An amendment letter will be issued and signed by both parties and funds will continue to be
processed via the current accountable grant agreement.
D. How expenditure will be monitored, reported, and accounted for
Payment will be made against quarterly financial statements from the IRHA as specified in
the current Accountable Grant Agreement Letter.
IRHA will continue to provide annual audited accounts of income.
Management Case
A. Oversight
The tasks of the Senior Policy Adviser, Research Analyst, Human Rights Advisor, and
Communications and Project Development Officer at IHRA are set out in the original
Logframe. The Administrator at IHRA will be responsible for project financial administration,
administration of sub-contracts to partners including IDPC and INPUD, arranging travel and
meetings, producing project documents, keeping project records, assisting with financial and
administrative reporting to DFID, and recruitment and human resource issues.
B. Management
The project officer for DFID will continue to be Sally Chakawhata with Will Niblett as Quality
Assurer and advisory input from the Harm Reduction and Corruption Adviser based at
UNODC in Vienna and the Health and HIV Adviser for the AIDS and Reproductive Health
Team.
C. Conditionality
None required.
D. Monitoring and Evaluation
Continued reporting as in the Logframe with quarterly meetings and annual reviews
according to DFID corporate requirements.
E. Risk Assessment
None required. IHRA in the course of the current DFID grant have developed an international
reputation as leaders in advocacy and research in harm reduction and drug policy as well as
providing accurate and timely quarterly financial and annual audited statements.
F. Results and Benefits Management
The existing logframe for this project sets out results and benefits management criteria in the
following areas.

Multilateral organisations make explicit reference to, and commitments for, harm
reduction interventions (and the human rights of drug users) in their policy
documentation.

Harm reduction funding from multilaterals (and other donors) increases and is
proportionate to evidenced need, leading to increases in harm reduction resource
allocation and service delivery.

HIV Prevention initiatives for Injecting Drug Users are fully funded by either the
government of the country in question or through multilateral organisations.
Project Management arrangements are being revised to reflect the new collaborations with
IDPC and INPUD as set out in this Business Case.