30 June 2023

HRI 2022 Annual Report

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new strategy, new look

2022 was a big year for Harm Reduction International. We launched our 2022-2025 organisational strategy which emphasises solidarity and justice. Acknowledging broader global crises, this strategy responds to the ongoing use of divisive rhetoric on drugs to justify rights abuses, the urgent need for more community-led services, and a crisis in international donor and government funding for harm reduction.

We continued our work to track major trends in harm reduction and human rights. Our 2022 work highlights that women, Black, Brown and Indigenous people face additional barriers to accessing harm reduction services; that states are failing to protect the health and rights of people who use drugs in prison; and that there has been a rapid increase in the use of the death penalty for drug offences.

global state of harm reduction

We published the latest edition of our flagship publication, the Global State of Harm Reduction 2022 showing that the number of countries implementing life-saving harm reduction services increased for the first time since 2014.

We are continuously evolving the way we collect data and report on regional development. For the latest edition, we expanded our mapping to include harm reduction for non-injected drugs and stimulants, for the first time collecting quantitative data on the availability of safer smoking kits and stimulant pharmacotherapy. We partnered with experts in nine regions to lead the research on their respective regions, and strengthened community review and verification of findings.

Death penalty for drug offences

The use of the death penalty for drugs soared in 2022. We reported at least 285 executions for drug offences in six countries (Iran, Saudi Arabia, Singapore, plus in China, North Korea and Vietnam) last year. This is an 118% increase from 2021, and an 850% increase from 2020. Our monitoring and reporting informed advocacy with governments at the UN Commission on Narcotic Drugs 2021, at the UN Human Rights Council and was submitted to the United Nations Secretary-General.

Our research reveals that people from vulnerable and marginalised groups, including foreign nationals, individuals from ethnic minority backgrounds, and women, are overrepresented among people facing the death penalty for drug offences.

funding for harm reduction

We continue to advocate for funding for harm reduction at the international and national levels to address the dire lack of resources for life saving services globally.

A key part of this work in 2022 involved advocacy for a strong seventh replenishment of the Global Fund to Fight AIDS, TB and Malaria (the Global Fund), the largest donor for harm reduction in low- and middle-income countries.

We presented key data on disease burden and cost-effectiveness arguments to governments and donors, strategised with the Global Fund Advocates Network (GFAN), and co-sponsored a high-level side at the replenishment meeting in New York with Global Fund Board Delegations (the Developing Country NGO Delegation, the Developed Country NGO Delegation and the Community Delegation). Our efforts ensured harm reduction was a part of high-level discussions on funding to end HIV.

In our mapping of funding for harm reduction, we identified both international and national funding sources. We reported funding for harm reduction in 64 out of 135 low- and middle-income countries; and in 38 of these countries, data indicated governments were funding harm reduction from domestic budgets. In follow up, we collaborated with partners in Indonesia, Kenya and South Africa to advocate for increased domestic funding for harm reduction. Central to work in each country, are efforts to establish and strengthen coalitions able to advocate for increased political and financial support for harm reduction, creating the foundations for stronger domestic investment in harm reduction.

hepatitis and harm reduction

People who use drugs are at greater risk of acquiring hepatitis B and C. Harm reduction interventions are thus essential tools in global efforts to eliminate viral hepatitis.

In 2022, we worked with the World Health Organization (WHO) to develop and launch a viral hepatitis data repository. The repository provides data on viral hepatitis and people who inject drugs. The data is sourced from a range of publicly available international datasets and provides global and national estimates, as well as estimates for different regions.

We worked with the World Health Organization (WHO) to develop and launch a viral hepatitis data repository. The repository provides data on viral hepatitis and people who inject drugs.


We have the expertise and track record of convening the harm reduction and drug policy movements for knowledge exchange and strategic advocacy. Through the Harm Reduction International conference and more broadly, we convene diverse actors across regions. We have hosted the Harm Reduction International Conference since 1991. We also host the Lawyering on the Margins Network, support dialogues for the roll out of the International Guidelines on Human Rights and Drug Policy, and host a learning exchange platform on stimulants.

In 2022, we hosted the second Constellations: An Online Festival on Drugs and Harm Reduction. The festival allowed our community to gather and connect, explore innovative solutions, and have urgent conversations to redefine what harm reduction is and what it can be.

Constellations is now established as a way for us to convene the harm reduction movement virtually between Harm Reduction International Conferences and bring harm reduction to new audiences.

racial justice

Decolonising drug policy is a core area of our work dissecting race, ethnicity and drugs through intersectional movements. In 2022 we advanced this work through research, commentary and dialogue. Our webinar, Decolonising Drug Policy: British policing, the war on drugs and the everyday impacts of colonialism, brought together harm reductionists, subject matter experts and advocates. The webinar examined the impact of the criminalisation of drugs as a vehicle for colonial expansion and racial suppression and how the war on drugs has provided the architecture within which racist laws, policies and practices can operate.

We elevated our work at the intersection of drug policy and racial justice via our research, convenings, advocacy, articles and the via UN system. We called for drug policy to be aligned with international human rights standards and challenged the use of drug control as a vehicle for maintaining racist and colonial systems at the United Nations Human Rights Council and with activists from adjacent movements in other international spaces.

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