Over the years, harm reductionists have used a variety of strategies to fund their services. Because of the stigma related to people who use drugs and the mythologies that have arisen around drug use, harm reduction was seen as “enabling” problematic behavior at a time when much of the world was still trying to fix problematic drug use by criminalizing it.

As a result, in the beginning, harm reduction was so controversial that only a small handful of foundations or other funders would consider funding harm reduction services – and almost no one would give direct funds for purchasing syringes or other injection supplies. Instead, harm reduction programs received funding for adjunct services, research, HIV and HCV testing, or other services and then funneled as many unrestricted dollars as possible into supply budgets. Another strategy was to enter into mutual aid relationships with clinics, hospitals, or other health care providers who shared syringes and supplies, sometimes clandestinely.

This history has meant that harm reduction programs usually focus their fundraising efforts on just two major sources: foundation grants and government contracts. This is not the norm in the nonprofit sector. On average, nonprofits generally receive about 53% of their income in revenue from goods and services they provide to private entities, and slightly over 70% of all donations to nonprofits are from individuals. By contrast, harm reduction organizations normally report only a fraction of their income from these two sources.