By Michel Kazatchkine/BMJ Opinion

For many years, evidence has shown the effectiveness of opioid maintenance therapy in the treatment of opioid dependence and the effectiveness of opioid maintenance therapy and needle syringe programmes in preventing HIV infection among people who inject drugs.

Recent evidence shows that both opioid maintenance therapy and needle syringe programmes can also prevent people who inject drugs from getting hepatitis C. 

The spread of HIV/AIDS among people who inject drugs and their partners has been contained in Western Europe, Australia, Canada, China and other countries of Asia, because interventions such as clean needle exchange and opioid maintenance therapy programmes became mainstream government health policy sanctioned by the World Health Organisation. 

Harm reduction is receiving increasing attention from policy makers across Sub-Saharan Africa. Unsafe drug injection is recognized as an underestimated component in preventing HIV and hepatitis C infection in vulnerable groups in high prevalence settings across sub-Saharan Africa and Asia. 

However, in Eastern Europe and central Asia, harm reduction policies are conspicuous by their absence, even though there are high rates of HIV and hepatitis C infection.