Historically, funding for harm reduction in low- and middle-income countries has been part of the HIV response, with a comprehensive package of interventions endorsed at the highest political level as part of the global commitment to end AIDS by 2030. However, in the 15 years that Harm Reduction International (HRI) has monitored harm reduction funding, our findings have been consistently bleak. Inadequate financial support for services and for the advocacy efforts needed to drive political commitment within countries continues to prevent harm reduction initiatives being implemented at scale.