Harm reduction saves lives

People who inject drugs need urgent access to harm reduction interventions, including needle–syringe programmes and opioid substitution therapy. There is irrefutable evidence that new HIV infections drop sharply when people who inject drugs have access to harm reduction and other public health programmes.

People who inject drugs, including people in prisons and other closed settings, need access to harm reduction services to prevent HIV infection, including needle–syringe programmes, opioid substitution therapy, antiretroviral therapy and nalaxone.

Evidence shows that harm reduction approaches such as needle-syringe programmes reduce the health, social and economic harms of drug use to individuals, communities and societies. They do not cause increases in drug use.

UNAIDS is calling for the global adoption of a people centred, public health and human rights-based approach to drug use and for alternatives to the criminalization and incarceration of people who use drugs.

Ensure accountability for the delivery of health services for people who use drugs by including public health and human rights pillars in the framework of the UNGASS Outcome Document that incorporate clear objectives for reducing new HIV infections and protect and promote the rights of people who use drugs.

Commit to fully implement harm reduction and HIV services as outlined in the World Health Organization’s consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. Commit to treating people who use drugs with support and care, rather than punishment.

UNAIDS believes that this objective can be achieved only by implementing alternatives to criminalization, such as decriminalization and stopping incarceration of people for the consumption and possession of drugs for personal use.

Ensure that all people who inject drugs and are living with HIV have access to life-saving antiretroviral therapy and other health services to manage tuberculosis, viral hepatitis and sexually transmitted infections. In addition, ensure adequate availability and access to opioids for medical use to reduce pain and suffering.

Ensure that all people who use drugs have access to non-coercive and evidence-informed drug dependence treatment consistent with international human rights standards and the Principles of Drug Dependence Treatment articulated by the United Nations Office on Drugs and Crime and the World Health Organization. All forms of compulsory drug and HIV testing and drug treatment should be replaced with voluntary schemes. The use of compulsory detention centres for people who use drugs should cease, and existing centres should be closed.

Adapt and reform laws to ensure people who use drugs do not face punitive sanctions for the use of drugs or possession of drugs for personal use. Countries should consider taking a range of measures, including alternatives to criminalization, incarceration, penalization and other penalties based solely on drug use or possession of drugs for personal use. These measures include decriminalization, steps to reduce incarceration, removal of administrative penalties and depenalization.

Ensure that the human rights of people who use drugs are not violated, by providing access to justice (including through legal services), prevention, treatment and other social services. Adopt smart policing measures to encourage people to access public health services.

Recognize that incarcerating people in prisons increases their risk of drug use, HIV infection and other health conditions and take steps to ensure that harm reduction and other health services are available in prisons in parallel with efforts to reduce the number of people being incarcerated for non-violent drug offences.

Ensure widespread availability of naloxone among health workers, first responders, prison staff, enforcement officials and family members as a life-saving public health measure to enable timely and effective prevention of deaths from opioid overdose among people who use drugs.

Support and empower community and civil society organizations, including organizations and networks of people who use drugs, in the design and delivery of HIV, health and social protection services.

Undertake a rebalancing of investments in drug control to ensure that the resources needed for public health services are fully funded, including harm reduction for HIV infection, antiretroviral therapy, drug dependence treatment and treatment for hepatitis, tuberculosis and other health conditions.