"The number of countries with at least one needle and syringe programme (NSP) has risen slightly since 2022: 93 countries now provide at least one NSP, compared to 92 in 2022.
"However, there have been some changes in the countries where NSP is available. Brazil has joined the list after introducing NSPs.4,5 In an encouraging development in Bulgaria, NSPs are available again in two cities (Sofia and Plovdiv); they had previously closed in 2020 due to a lack of domestic funding.6,7 In Accra, Ghana, a pilot NSP is operational as of this year.8 However, in the Dominican Republic and Guinea, we can no longer confirm that NSPs are available. The need for NSPs still far outstrips availability, and the latest review finds 190 countries and territories where injecting drug use has been documented, meaning people who inject drugs in 97 countries are unable to access an NSP anywhere.9,10
"Having at least one NSP is a low target for countries to meet, and around the world these services need to be scaled up. According to a recent systematic review, only Oceania has high coverage of NSPs,a and this only relates to two countries in the region (Australia and Aotearoa New Zealand). Central Asia and Western Europe both have moderate coverage, but NSP coverage is low in all other regions.11 Current levels of coverage are not sufficient to effectively prevent the spread of HIV or hepatitis C virus (HCV), as they are not reaching the World Health Organization (WHO) recommended coverage level.12,13"
Harm Reduction International (2024). Global State of Harm Reduction 2024. London: Harm Reduction International.
