Resourcing Harm Reduction Blog Series : The Comer Family Foundation

Recently, FCAA released a data spotlight illustrating the intersection of HIV and people who inject drugs (PWID). Given that PWID are 22 times more likely to acquire HIV than the rest of the global population, we felt that it was important to understand where private philanthropy was supporting harm reduction programs. As we worked with partners to analyze the data, it was clear that the numbers tell only one part of the story. We wanted to dig deeper, to understand what challenges grant makers and recipients are facing in funding and implementing these programs.

As part of this important conversation, we are proud to feature the following blog from The Comer Family Foundation

Learn more about this blog series and other entries. 


How did your organization begin/enter into funding harm reduction work?
Our President, Stephanie Comer, lived in New York and San Francisco during the height of the HIV outbreak in the late 80s. After researching the challenges surrounding the virus, she learned that people using IV drugs were the second highest risk group for HIV, and that vital prevention models, like syringe exchange programs, were woefully underfunded. She contacted Dave Purchase, activist and founder of NASEN (North American Syringe Exchange Network) who connected her with the handful of existing syringe exchange programs in the U.S. Subsequently, the Comer Family Foundation made its first grant to Prevention Point in San Francisco in 1992, and, in 1993, provided seed funding for the Harm Reduction Coalition. Since then, we’ve funded over 160 harm reduction programs and invested over $14 million dollars.

What is one major challenge you have faced/had to overcome in funding harm reduction work – either internally (board support, etc.) or externally (political climate, etc.). How have you navigated that challenge?
As the HIV epidemic started to level off and newer risks emerged for people who use drugs (PWUD), we realized our funding focus needed to respond to the syndemics of HIV, the Hepatitis C virus (HCV), and overdose. As syringe service programs, also known as Comprehensive Harm Reduction Programs (CHRPS), innovated and began offering safer smoking kits, fentanyl test strips, and naloxone, we refreshed our funding priorities to support CHRPS and help the community survive.

The largest challenge we have found is finding and funding programs located in small rural areas in the South and Midwest, where CHRPS are not yet mainstream concepts for disease and overdose prevention. We prioritize smaller organizations that include meaningful engagement of people who use drugs and apply evidence-based best practices. It has been a challenge for these programs to find funders willing to invest in grassroots organizations. Our grants assist in establishing the validity of harm reduction practices, while building advocacy and coalitions to drive policy change, particularly where syringe distribution isn’t legal.

What is the most effective strategy, tool, piece of data or resource you have used to successfully overcome a barrier to funding harm reduction work?
The most effective strategy for funding harm reduction is to stay closely connected to the organizations we fund. Understanding emergent trends, funding gaps, and the needs of PWUD not addressed by federal or state government allows us to rapidly respond to the community and provide support such as stimulant harm reduction kits, affordable naloxone, and general operating funds for staff stipends/salaries. We constantly monitor HIV and viral hepatitis trends and areas at greatest risk for overdose. AmfAR’s Opioid and Health Indicators Database offers a single resource for critical metrics, coupled with FCAA’s reporting on where philanthropic dollars are being spent (and not spent) enable us to invest effectively in the right communities.

Are there other ways your organization has been able to take part in the response without directly funding harm reduction (convenings, advocacy, etc)?
We partner with Human Rights Watch to highlight policy gaps and broader access to affordable naloxone, and to create reports that drive recommendations for health and racial equity for PWUD. We have provided capacity grants for next-generation succession planning, grants for small organizations to attend capacity building conferences to start a CHRP, and kickstarted statewide harm reduction coalitions such as West Virginia Health Local Inc. We have supported think tanks for overdose prevention sites and the development of culturally-sensitive language and training for health care practitioners who may treat PWUD. We stay connected to local, regional, and federal partners to advise on evidence-based best practices and advocate for key gaps in funding and services in our health care system for PWUD.

What is your biggest success story as a funder of harm reduction work?
We’ve been thrilled to witness the incredible innovation that comes from the programs we support. Because the CHRPS have meaningful involvement of PWUD, they follow the needs of the community, while assuring cultural humility and racial equity in their services to support their clients. CHRP professionals continue to be on the cutting edge of disease prevention and coordination of care in the public health field, creating a strong support network with law enforcement, primary care, treatment, and housing providers. They have become the champions of peer distribution of naloxone. They have recently advised the Centers for Disease Control and NASTAD on national standards for CHRPS/syringe access. We’ve been honored to support programs that provide the tools and resources for individuals to make healthier decisions and create a compassionate community, reducing the isolation of those experiencing stigma.