The Global Fund is complex and there are multiple layers of power at every level. This case study will share the evolution of the participation of people who use drugs in the Global Fund and its national processes. It highlights the progress that has been made with support from the Community, Rights and Gender (CRG) Strategic Initiative (SI). It also showcases the progress, impact and outcomes of people who use drugs participating in the Global Fund, showing the value and effectiveness of both national drug user-led organizations and the key role of the global network in facilitating successful engagement in Global Fund processes. The unique combination of adequate funding and technical support by a peer-led global organisation, allows for support in the true sense of the word – professional and personal development of community leaders, organisational development and specific upskilling, education and hands on assistance based on the needs of individual countries and regions. (Page 14 has a link to a Russian language report on the impacts of donor decline for harm reduction in Kyrgyzstan).