Harm reduction aims to reduce the health, social and economic harms associated with drug use. Where scaled up sufficiently harm reduction interventions, such as needle and syringe programmes and opioid substitution therapy, have had a significant impact on reducing new HIV infections, mortality, and rates of crime.

The success of harm reduction is rooted in the fact that it goes beyond a set of highly effective interventions. It is an approach that is underpinned by the principles of pragmatism, dignity, human rights and public health, and one within which people who use drugs are firmly at the centre. This approach, often implemented in the face of resistance, has saved countless lives and helped people to stay healthy.

Despite such success harm reduction programmes remain underfunded and coverage falls short of what is required to impact HIV epidemics among people who inject drugs. Of the 158 countries or territories which report injecting drug use around 90 countries or territories have at least one needle and syringe programme, and 80 provide opioid substitution therapy. In prison settings the situation is far worse with just 7 countries providing needle and syringe programmes, and only 44 providing opioid substitution therapy, in at least one prison.

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