2. What is harm reduction?

The review and revision of laws and policies can facilitate access to services and decrease HIV and HCV vulnerability. This includes efforts to decriminalize drug consumption and possession for personal use, as recommended by UNAIDS17 and WHO.2 This kind of drug policy reform can help create an enabling environment for large-scale and effective HIV and HCV programming, improve health and reduce transmission of infectious diseases such as HIV, and reduce prison populations and the misuse of law-enforcement resources. For further information, see the IDUIT.

As defined by Harm Reduction International,18 the term “harm reduction” refers to:

“policies, programs and practices that aim to minimize negative health, social and legal impacts associated with drug use, drug policies and drug laws. Harm reduction is grounded in justice and human rights – it focuses on positive change and on working with people without judgment, coercion, discrimination, or requiring that they stop using drugs as a precondition of support.”

The UNAIDS report Health, Rights and Drugs: Harm Reduction, Decriminalization and Zero Discrimination for People Who Use Drugs (2019) notes:

“Study after study has demonstrated that comprehensive harm reduction services—including needle-syringe programmes, drug dependence treatment, overdose prevention with naloxone, and testing and treatment for HIV, tuberculosis, and hepatitis B and C—reduce the incidence of bloodborne infections, problem drug use, overdose deaths and other harms.”21

The comprehensive package of HIV and harm reduction interventions

The WHO Key Populations Consolidated Guidelines describe a comprehensive package of interventions, implementation of which is essential to ensure reduction of HIV and other bloodborne infectious disease among people who inject drugs.2 The comprehensive package includes the following harm reduction interventions:

Harm reduction for people who use drugs

• All people from key populations who inject drugs should have access to sterile injecting equipment through needle and syringe programs (NSPs)

• All people from key populations who are dependent on opioids should be offered and have access to opioid substitution therapy

• All people from key populations with harmful alcohol or other substance use should have access to evidence-based interventions, including brief psychosocial interventions involving assessment, specific feedback and advice

• People likely to witness an opioid overdose should have access to naloxone and be instructed in its use for emergency management of suspected opioid overdose.

17 UNAIDS (2019). Health, Rights and Drugs: Harm Reduction, Decriminalization and Zero Discrimination for People Who Use Drugs. 18 Harm Reduction International (2019). What is Harm Reduction? [Website].