WHRIN is a global platform to expand harm reduction approaches for women.

WHRIN es una plataforma global orientada a reducir los daños asociados al consumo de drogas por parte de mujeres, así como a desarrollar un entorno que favorezca la implementación y expansión de recursos orientados a mujeres para la reducción de daños.

WHRIN est une tribune internationale travaillant pour la réduction des risques associés à la prise de drogues par les femmes et cherchant à développer un environnement adapté à la mise en œuvre des politiques de réduction des risques pour les femmes.

Women and Harm Reduction International Network (WHRIN)

Recent retrograde shifts in foreign aid and diminishing civil society space threaten gains made through decades of evidence-based harm reduction programming that has saved countless lives globally. Civil society organisations providing crucial peer support systems are being defunded and their voices repressed. Concurrently, feminism and LGBTQI+ rights and sexual and reproductive health services, including contraception, gender-based violence services and safe abortion are being assaulted. Now, more than ever, harm reduction and underserved populations are at risk as essential life-saving services are being closed down.

With the expansion of the measurably harmful Global Gag Rule, sexual and gender diversity are being actively attacked, with trans rights violated to the point of erasure of identity, sexual and reproductive health rights invalidated and gender equality goals undermined. Funding strangleholds are constraining lifesaving healthcare for trans people, women living with HIV, people who use drugs and other key populations. This spurious attempt to institutionalise patriarchal heteronormative hierarchy serves to sanction and popularise racism, sexism, userphobia, transphobia and homophobia. Patterns are emerging where under the guise of ‘family values’, ideology trumps science, propelling a climate ripe for societal destabilisation, hate crime and public health dismemberment.

On this International Women’s Day, we [...] stand in solidarity with our gender expansive and cis-sisters who use drugs to denounce the current undermining of public health, science and bodily autonomy which represent a wider offensive against equality norms, rights protections and common sense.

We recognise that the hard-won progress on gender responsive harm reduction is under threat. As part of the feminist movement, we are cognisant of the necessary collective peril we pose to patriarchy and that this new attempt at reinstalling sexist oppression and derailing public health must be rapidly reversed.

This is a call to action for governments, courts and donors for:

immediate reopening of OAT clinics, recognising their lifesaving impact, (including for pregnant women who are opioid dependent)

laws and policies that safeguard the rights of women and gender expansive people who use drugs and key populations in access to harm reduction and other healthcare, including gender affirming care, without discrimination and criminalisation

direct, flexible, sustained and safeguarded funding for women and gender expansive people-led harm reduction organisations and networks of people who use drugs

gender equity indicators and gender mainstreaming in health investments, including funding conditionalities where gender responsive harm reduction, women’s rights and inadequately served populations are prioritised

accessible accountability mechanisms to track health investments and ensure that these are cost-effective, low threshold and congruent with the needs of people who use drugs

We stand in solidarity with the harm reduction and feminist movements and communities worldwide as the aid freeze forces lifesaving programs to shut down. Harm reduction is essential and a basic human right. These decisions are negligent, unjust, will cost lives and must be immediately revoked. We stand ready to continue our work to address systemic barriers to health and rights for women and gender expansive people who use drugs.

Full list of signatories and translations available on WHRIN's website.

Resist and reverse rollbacks: A feminist call to protect harm reduction and sexual and reproductive health

The global spread of harm reduction services continues to stall — a continuation of a trend first observed in 2012. Women are estimated to account for at least one-third of people who use drugs globally yet are consistently reported to have less access to harm reduction services and are at higher risk of HIV and hepatitis C transmission. 

Tools do exist to enable harm reduction services to increase their relevance and reach for women and gender-diverse people who use drugs. These include resources on the use of a gender lens and gender mainstreaming in planning and service delivery. Services that have introduced such approaches are thin on the ground and where these do exist, it is often difficult or not possible to document and promote the approaches applied as well as impact outcomes. As a result, robust data on this subject is scarce. In addition, research on drug use and related health issues rarely produces information about women, gender-diverse people and harm reduction. 

In this context, to leverage greater accountability from governments that have endorsed UN guidelines and resolutions around the provision of services for marginalised communities, it is important to document and promote such services where they do exist. By documenting successful harm reduction services for women and/or gender-diverse people, models can be incorporated, replicated, resourced and established. Likewise, service gaps can be exposed. 

With this in mind, WHRIN undertakes surveys, community consultations and desk research to map gender-responsive harm reduction services around the world. This report provides a summary of regional findings as well as common global trends. Also included is a ‘living’ listing by region of relevant services with a brief description and links for more detail where available. WHRIN invites readers to add to this list - where existing services are not listed, details of services are incomplete or as links are updated.

Global mapping of harm reduction services for women and gender diverse people who use drugs

Through a gender lens, we see women and gender diverse people who use drugs are inadequately served. Acknowledging the needs of this population and committing to their health and wellbeing must be redoubled across the world.

Global mapping of gender responsive harm reduction services 2024

November 25 is the international day for elimination of violence against women which marks the beginning of 16 days of action through to December 10, International Human Rights Day. 

WHRIN encourage interested organisations and groups worldwide to collaborate and organise actions to highlight the need to end violence against women and gender-diverse people who use drugs and actions to end violence against women and gender-diverse people who use drugs and orient drug policy towards human rights, gender awareness and harm reduction. 

To join our global campaign, please adapt/translate and print out the poster and take photos while wearing something orange (to pick up on the international theme colour for eliminating violence against women) while ensuring your action brings particular attention to the situation of women and gender diverse people who use drugs.

You are encouraged to invite media to hear and receive statements from your organisation/s. An optional press release can be translated and adapted to context in your city, adding your own contact or logo etc. To register your EVAWUD planning and/or apply for a small grant, click here. Recommended hashtags include: #EVAWUD24 #orangetheworld #WHRINetwork 

In contexts where publication of identifying images could have negative repercussions, it is proposed that the poster is held in front of faces to protect identity, or that blur face options be offered. Those participating will agree to having the images used for campaign purposes targeting UN agencies, drug policy forums and via partner harm reduction, drug policy and feminist agencies. Campaign organisers will be responsible for coordinating informed consent (see and example template here). 

By December 10-14, please email your photos and a brief description of activity (max 200 words) back to policyandcommunityengagementlead@whrin.site. The reports will be pooled collated and repropelled through relevant networks aiming to achieve a global-level profile for the campaign.

Campaign for the elimination of violence against women who use drugs - EVAWUD 2024

This paper explores ketamine use with a gender lens to show how ketamine social and biological variance across genders begs a tailored harm reduction approach. Ketamine provides dissociative anaesthesia and analgesia, now also used in the treatment of depression. The dissociation is particularly specific to ketamine and explains its medical and recreational utility. While there are some robust generic sources of information on ketamine and harm reduction, WHRIN and TalkingDrugs have identified a critical gap: the experiences of women and gender-diverse people are notably absent in much of the existing harm reduction guidance. While broad harm reduction advice and strategies exist around ketamine, the majority are provided with no consideration of gender-based differences. This oversight is concerning given identified differences in how ketamine affects individuals across gender spectrums and associated, distinct implications for harm reduction messaging.

Much of the existing research (of varied rigour and reliability) is pinned to predominantly male human subjects and/or rodent studies. While our quest is to identify gendered difference in recreational ketamine experience, much of the data comes from clinical administration rather than recreational use contexts. It is also important to note at the outset that within the scientific research on ketamine, where it acknowledges gendered differences at all, these are almost exclusively expressed through a binary understanding of sex. Testing is done on female and male rats, for example, with little consideration as to how this binary may or may not apply to human beings and the diversity of genders and sex 1characteristics contained within. Exploring ketamine use with a feminist and trans-inclusive lens means acknowledging the limitations of this perspective – because of the existence of intersex people; because of the variations in hormone levels within each assigned sex; and because drug use for all genders is shaped by patriarchy together with the gendered impact of drug policy and cannot be understood solely through biological mechanisms. While we rely on this research, we understand that it is hinged on understandings of sex and gender that are incomplete at best and that this will impact both the findings themselves and the types of questions that currently remain unasked.

Gendering ketamine use: Emerging research and harm reduction recommendations

Interactive Dialogue with the UN Special Rapporteur on extreme poverty and human rights

Statement delivered by the International Drug Policy Consortium

On behalf of IDPC, alongside five organisations, we welcome the new report by the UN Special Rapporteurs on poverty and housing on ending the criminalisation of homelessness and poverty. We echo the report’s call on States to repeal all laws and policies that penalise individuals for structural inequality, and to move away from punitive and carceral approaches.

There is overwhelming evidence showing that the criminalisation of drug use and of sex work is deeply discriminatory, disproportionately affecting people on the basis of gender, race, ethnicity and class. It also increases exposure to physical and sexual violence. It is used as adriver of other harmful policies, for instance by restricting access to safe housing and shelter, as well as to safe places of work and labour rights for sex workers.

Positively, a growing number of UN entities and experts have called for the decriminalisation of both drug use and sex work, while an increasing number of jurisdictions are moving towards this policy option.

But more remains to be done. We call on the Special Rapporteur to specifically call for the decriminalisation of all activities related to both drug use and sex work, as a human rights imperative. This should be accompanied with measures to address stigma, racism and discrimination.

Finally, we call on the Special Rapporteur to encourage Member States to consider the responsible legal regulation of drugs - as recommended by the OHCHR and the UN Special Rapporteur on the right to health, among many others.

Women and Harm Reduction International Network

International Women’s Rights Action Watch Asia Pacific (IWRAW AP)

Decriminalising drug use and sex work to end the criminalisation of poverty and homelessness - IDPC and colleagues' submission to the UNSRs on the right to adequate housing and on extreme poverty and human rights

Breaking the cycle: Ending the criminalization of homelessness and poverty

 - Report of the Special Rapporteur on extreme poverty and human rights

Repeal punitive laws against poverty and inequality - Interactive Dialogue with the UNSR extreme poverty and human rights at HRC56


While research has demonstrated associations between experiencing violence from intimate and non-intimate partners and non-fatal drug overdose among women who inject drugs, existing studies focus predominantly on the Global North and are analytically limited. Guided by syndemics theory, this study examined whether different forms of gender-based violence exert independent and interactive effects on non-fatal drug overdose among women who inject drugs in Indonesia.


We recruited 731 cisgender adult women who injected drugs in the preceding year via respondent-driven sampling. We used multivariate logistic regressions to examine associations between self-reported intimate partner violence (IPV), police sexual violence, and police extortion, and non-fatal drug overdose, with covariance adjustment for factors drawn from the risk environment. We tested for interaction effects among violence measures by calculating metrics for attributable proportion (AP), relative excess risk due to interaction (RERI), and synergy index (S).


Experiencing IPV (AOR 2.5; 95 % CI 1.2, 5.1; p = 0.012), police extortion (AOR 2.2; 95 % CI 1.5, 3.2; p ≤ 0.001), and police sexual violence (AOR 3.7; 95 % CI 1.5, 9.4; p = 0.005) each independently predicted non-fatal overdose, after adjusting for potential confounders. A significant positive interaction was detected between IPV and police sexual violence on drug overdose (AP=0.6, p = 0.001; S = 3.8, p = 0.015) such that the joint effect of these two forms of violence was associated with a nearly fourfold increase in non-fatal overdose risk compared to the main effects of each violence exposure.


This is the first study to show that concurrent IPV and police sexual violence exert an amplifying effect on non-fatal overdose beyond the additive effects of each exposure. Supporting the value of gender-responsive harm reduction services that integrate violence and overdose responses, results suggest that eliminating one form of violence when multiple forms of GBV are present could magnify the expected reduction in overdose.

Synergistic effects of exposure to multiple types of violence on non-fatal drug overdose among women who inject drugs in Indonesia

The signing organisations (the International Drug Policy Consortium, Amnesty International, the Global Alliance against Traffic in Women, the Global Network of Sex Work Projects, the International Planned Parenthood Federation, and the Women and Harm Reduction International Network) welcome the initiative to prepare a report on the decriminalisation of poverty and homelessness, to be presented at the 56th session of the Human Rights Council in June-July 2024. We also welcome the background paper shared by consultation.

In order to ensure that the report creates effective and consistent standards for the decriminalisation of poverty and homelessness, we strongly encourage the Special Rapporteurs to include in the conclusions section explicit recommendations for the decriminalisation of drug use and possession of personal use, and of sex work, as the criminalisation of both activities is a major driver of contact between law enforcement and people living in poverty in public spaces, is discriminatory, and has harmful effects on the enjoyment of a broad range of human rights. This informal paper provides a number of key arguments supporting that inclusion.

Decriminalising drug use and sex work to end the criminalisation of poverty and homelessness - Submission to the UNSRs on the right to adequate housing and on extreme poverty and human rights

The EVAWUD23 campaign brings together women who use drugs in all our diversity together with our allies around the world to address the gendered and violent impacts of punitive drug policy. Coinciding with the United Nations Elimination of Violence Against Women and Girls 16 days of action (25 November to 10 December), EVAWUD participants are united by a shared determination to end violence against women and gender diverse people who use drugs.

Women and gender diverse people who use drugs are subject to extreme rates and a wide range of violence due to patriarchal norms combined with punitive prohibition of some drugs. State-driven stigma, criminalisation, harmful gender norms, and corruption drive substantive health and safety harms and pose access barriers between women and gender diverse people who use drugs and critical harm reduction and gender-based violence services.

In 2023 there was an unprecedented record number of grant applications for the EVAWUD23 campaign as well as several organisations participating without small grant support. Summaries were documented, as below, on actions in Brazil, Cambodia, Costa Rica, Australia, Serbia, Greece, Italy, India, Kenya, Catalunya, Mexico, Myanmar, Nigeria, Peru, Portugal, Sierra Leone, Ukraine, and Indonesia. Acknowledgements also to partnering organisations: YouthRISE, EuroNPUD and IDPC.

Women and Harm Reduction International Network (WHRIN)

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