Out of sight: Women who inject drugs and access to harm reduction in Nepal

In Nepal, people who inject drugs, especially women, are particularly vulnerable and disproportionately affected by HIV and other health and social harms due to structural factors such as stigma, gender-based discrimination and violence, human rights violations, and criminalisation. All contribute to an increased probability of certain risk behaviours and a lack of access to health services.

Harm reduction services available to the population using drugs in Nepal count on Global Fund (GF) support. Services funded include drop-in centres (DIC) and Opiate Agonist Therapy (OAT)1 , the first run by civil society organisations (CSOs) and the last by the national government and CSOs. In addition to mixed services, female only DICs/NSPs are available in five districts. These were supported by UNODC in 2008, stopped after some years due to lack of funding, and supported again by the GF since 2020.

The present report addresses the need to strengthen harm reduction programming to reach better women who inject drugs. To this end, it reviews current harm reduction programs focusing on the perspective of women who inject drugs and the staff assisting them, formulating recommendations for service delivery improvements.