Tuesday, 29 October 2024 (London, UK)– Indigenous people and youth lack access to critical life-saving harm reduction services which prevent drug-related overdose deaths and the spread of infectious diseases like HIV and hepatitis.

According to a new report released today, the number of countries supporting harm reduction in their policies is higher than ever; 108 countries now include references to it in their national policies. The Global State of Harm Reduction 2024 report tracks the availability of services including drug consumption rooms (also known as overdose prevention centres), needle and syringe programmes, and opioid agonist therapy such as methadone and buprenorphine.

However, harsh policing and other punitive practices continue to undermine this health-based approach to drugs. In Mozambique, where harm reduction is included in the national HIV plan, there have been reports of police arresting people for carrying injecting equipment. In Iran, which also mentions harm reduction in its national HIV policy, the government executed 459 people in 2023 for drug-related offences. In South Africa, 600 human rights violations were reported against people who use drugs in just three months in 2023, including assaults by police and unlawful arrests.

“Policymakers know that a health approach to drugs works. That’s why so many countries now include harm reduction in their policies,” says Colleen Daniels, Deputy Director of Harm Reduction International. “Now it’s time they walk the talk and stop pouring money into failed approaches.”

The report finds that 93 countries now offer at least one needle and syringe programme, and 94 countries offer opioid agonist therapy such as methadone and buprenorphine. Drug consumption rooms or overdose prevention centres—spaces where people can use drugs in a safer, supervised environment—now exist in 18 countries. Colombia and Sierra Leone are the newest additions to this list.

Indigenous people

The report looks at the availability and accessibility of harm reduction services for youth, Indigenous people and in prisons around the world for the first time. It finds that Indigenous people in Australia, Aotearoa New Zealand, Canada and the USA experienced greater drug-related harms than non-Indigenous people but cannot access harm reduction services which aim to minimise the negative impacts related to drugs. Indigenous communities face structural racism in numerous forms when trying to access health and harm reduction services. These include a systematic lack of funding for Indigenous health care, over policing and overprescription of opioids.

“Indigenous people are being left behind,” says Sam Rivera, Executive Director of OnPoint NYC which runs the only two sanctioned overdose prevention centres in the USA. “While we are seeing some positive trends in harm reduction and overdose response, these are not being felt equally.”

Youth

The report finds that because harm reduction services have been designed for adults, they neglect the needs of young people who use drugs. Young people are among the largest demographic groups of people that use drugs, but they lack access to services to reduce the harms related to their drug use. It finds that young people often do not access harm reduction services because they fear academic repercussions or criminal records, which could impact their future opportunities.

“Youth is a time for learning about yourself and the world around you. Young people are among those who need harm reduction services the most but have the least access to them,” says Charity Monareng, youth advocate and Executive Director of Students for Sensible Drug Policy International. She adds, “We need inclusive, judgement-free services that meet the unique needs of young people who use drugs and which respect their autonomy and privacy.”

Sierra Leone 

Despite incremental progress, the report also highlights a worrying trend: funding for harm reduction is in decline. Sierra Leone has recently leaped in their harm reduction policies; it is one of the few countries with a new opioid agonist therapy programme and a drug consumption room. This progress is now at risk due to withdrawal in funding.

The Open Society Foundations (OSF), previously the third largest international funder of harm reduction, has almost halved its support in the last five years. This reduction in funding threatens the sustainability of harm reduction programs globally. 

###ENDS###

Further information:

Suchitra Rajagopalan –

Tel: (+44) 7518 457 693

Email: suchitra.rajagopalan@hri.global

Harm Reduction International will present the findings of the Global State of Harm Reduction 2024, during the report’s online launch on Tuesday, 29 October at 1PM GMT. Register at https://us06web.zoom.us/webinar/register/WN_aGqrrBt-RM6rThPLG-3eQg

Sam Rivera, OnPointNYC (USA)

Colleen Daniels, Harm Reduction International (UK)

Charity Monareng, International Students for Sensible Drug Policy (South Africa)

Aidana Fedosik, UnMode (Russia)

Tracey Potiki, Whare Tukutuku National Māori Addiction Centre (Aotearoa New Zealand)

Harm Reduction International (HRI) is an international NGO using data and advocacy to promote harm reduction and drug policy reform. HRI shows how rights-based, evidence-informed responses to drugs contribute to healthier, safer societies, and why investing in harm reduction makes sense.

HRI will be holding the Harm Reduction International Conference (HR25) in Bogotá, Colombia on 27-30 April 2025. The conference is the main global forum for the exchange of information at the intersection of human rights, public health and drug policy. It attracts over 1000 international delegates, including policy makers, researchers, advocates, harm reduction service providers and networks of people who use drugs, among others.