The Global State of Harm Reduction is the only report that provides an independent analysis of harm reduction around the world. The report’s 9th edition released in 2024 was our most comprehensive analysis of harm reduction services and policies to date, featuring groundbreaking innovations that expand both the scope and accessibility of harm reduction data worldwide.

For the first time in the report’s history, we conducted our global survey in five languages (Arabic, English, French, Spanish, and Russian), dramatically expanding participation and ensuring more representative data. This resulted in contributions from 284 people across 101 countries – the highest participation in the report’s history and a testament to the growing global engagement with harm reduction evidence.

This edition introduced three new thematic chapters focusing on populations that continue to face systemic barriers: Indigenous people, people in prison, and young people. These chapters, developed through dedicated surveys with experts, service providers, and people with lived experience, provide unprecedented insight into the intersectional challenges facing the most marginalised
communities. The focus on these populations directly addresses the reality that many people who use drugs face multiple forms of discrimination and exclusion that restrict their access to essential services.

The Global State of Harm Reduction 2024 provides unique insights into underserved populations and regional challenges. This enables donors to prioritise funding for neglected populations and allocate resources where they can achieve the greatest impact. The expanded scope reflects our commitment to addressing the reality that stigmatisation and criminalisation remain major obstacles for people who use drugs, particularly those with intersecting marginalised identities. By providing concrete data on these underserved populations, we enable advocates to make evidence-based cases for inclusive programming that address the full
spectrum of barriers to harm reduction access.

The release of The Cost of Complacency: A Harm Reduction Funding Crisis in June 2024 marked an important moment in our advocacy for sustainable harm reduction financing. As the only independent monitoring report of its kind, this flagship publication provided irrefutable evidence of the catastrophic underfunding facing harm reduction services worldwide.

The report revealed that identified harm reduction funding amounted to just USD 151 million in 2022 – representing only 6% of the USD 2.7 billion needed annually by 2025. This creates a devastating 94% funding gap, far exceeding the 29% funding gap for the overall HIV response. Beyond documenting the crisis, the report serves as a powerful accountability tool, providing advocates with concrete evidence to challenge donors and governments while highlighting the urgent need for increased transparency in financial data. The impact was immediate and far-reaching. We launched the report at a high-profile UNAIDS Programme Coordinating Board (PCB) side event, co-sponsored by leading organisations including the World Health Organization (WHO) United Nations Office on Drugs and Crime (UNODC), International Network of People who Use Drugs (INPUD), and UNAIDS. Our strategic presentation during the PCB’s thematic segment on sustaining HIV gains ensured that decisionmakers could not ignore the evidence of chronic underfunding.

2024 marked a significant year for our human rights work, as we achieved international engagement and launched tools to strengthen advocacy worldwide. Our side event on the death penalty for drug offences at the UN Commission on Narcotics Drugs (CND), organised with Amnesty International, received a record-breaking 19 co-sponsorships by civil society, UN agencies, and member states, including from the Global South.

The launch of our Human Rights Standards Database in 2024 represents our commitment to making international human rights tools accessible to advocates worldwide. By compiling standards from UN human rights bodies in an accessible format, we’ve created a living resource that enables civil society to hold states accountable using the full weight of international human rights law. The database addresses a critical gap in advocacy resources. While human rights standards related to drug policy exist across multiple UN platforms, they are often inaccessible to advocates not familiar with the UN system. Our compilation provides a userfriendly tool that enables more effective advocacy while strengthening the evidence base for human rights-based approaches to drug policy.

For the Harm Reduction International conference 2025 (HR25) we received 1200 abstracts from 75 countries, including 200+ abstracts from Latin America  with 100+ abstracts submitted in Spanish.

200 members of the HR25 Online Review Commitee evaluated these abstracts using a simple online scoring method and the Programme Commitee met in mid-November to do a deep dive into the abstracts and build the conference programme. Our Programme Committee meeting is mostly online to allow for greater geographic diversity in its makeup. A smaller group of team leaders meets in Liverpool, UK to oversee the process.

2024 marked a breakthrough year for our Divest/Invest campaign calling for donors and government to divest from the drug war and redirect this funding by investing in programmes that prioritise community, health and justice. This multi-year campaign brings together all the different strands of our advocacy.

We expanded our evidence base and continued building a coalition calling for a fundamental divestment of resources from punitive drug control.