More countries implementing harm reduction services

The number of countries implementing key harm reduction services has increased for the first time in almost a decade, according to the latest Global state of harm reduction report from Harm Reduction International (HRI). 

HRI Global state of harm reduction report 2022The increase has been driven by the launch of new NSP services in five African countries, as well as officially sanctioned consumption rooms in four new countries. Opioid agonist therapy has been introduced for the first time in three countries, while the number of countries with take-home or peer-distributed naloxone programmes has also increased, says HRI. 

More than 90 countries worldwide now have needle and syringe programmes, the document states, with 87 offering opioid agonist therapy. Consumption rooms are now operating in 16 countries, and more than 100 countries officially support harm reduction in their national drug policies. 

The document warns against any complacency, however, stating that the ‘coverage and scale of harm reduction is still limited’. Huge inequalities remain both within and between regions and countries in terms of access to services, with people in rural areas particularly poorly served. While the vast majority of counties in Western Europe, North America and Eurasia implement both NSP and OST, these are still ‘more absent than present’ across Africa, the Middle East, Latin America and the Caribbean. Harm reduction in prisons also remains limited and has seen little expansion in over a decade, says HRI. 

COVID-19 has ‘tested the resilience’ of harm reduction services, the report states, with many services forced to close or scale down during the worst of the pandemic. The invasion of Ukraine and the Taliban retaking control of Afghanistan have also had significant impacts on harm reduction provision, while funding remains an ongoing global challenge. The findings of HRI’s monitoring of investment have been ‘consistently dire’, says the organisation, and this remains the case in the latest report. Only a few international donors fund harm reduction, and their investment appears to be shrinking. ‘In low- and middle-income countries, funding for harm reduction is only 5 per cent of the level needed to meet the estimated service needs for people who inject drugs by 2025,’ says the report. ‘Sadly, the gap between the funding that is required and the funding that is available has only grown wider in recent years.’

UNAIDS executive director Winnie Byanyima
UNAIDS executive director Winnie Byanyima

‘The Global state of harm reduction 2022 shows the positive changes that communities and civil society are making among people who use drugs through evidence- and rights-based harm reduction services,’ states UNAIDS executive director Winnie Byanyima in the document’s foreword. ‘The good news is that change is possible and within reach, as long as governments and donors invest in community-led solutions that work. It is not only the right thing to do, it is their duty. Access to healthcare is a human right for all of us.’

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