Stigma And Discrimination Hinder Access To Harm Reduction Services

"One hundred and eight countries include harm reduction in national policies. However, criminalisation and punitive responses to drugs remain dominant in most places. These approaches undermine harm reduction efforts and continue to fuel stigma and discrimination and deter people who use drugs from seeking vital, life-saving services.^47,48,49,50 This key contradiction must be addressed for meaningful progress to be made. 

"This includes 11 countries in: Eastern and Southern Africa (Ethiopia, Malawi, Mozambique and Zimbabwe), Latin America and the Caribbean (Brazil, Chile and Costa Rica), West and Central Africa (Cameroon, Sao Tome and Principe and Togo) and Asia (Cambodia). However, we could not confirm the continued inclusion of harm reduction in national policies in eight countries that were on the list in 2022 (Dominican Republic, Ghana, Libya, Oman, Philippines, Samoa, Syria and Vanuatu). 

"But supportive references to harm reduction in national policies can mean very different things in different places. For instance, in Ethiopia and Mozambique only OAT is included in national HIV plans.⁵¹ In contrast, Zimbabwe’s HIV plan includes three harm reduction services (OAT, NSP and naloxone distribution). Malawi has explicit references to harm reduction in several national policy documents, including the health sector’s strategic plan as well as the country’s specific plans on drugs, HIV, hepatitis and sexually transmitted infections (STIs).⁵² In Brazil, supportive references to harm reduction appear in several national plans (on drugs, HIV, hepatitis, and STIs), including references to different services (OAT, NSP, infectious disease care and services for non-injecting drug use).^53,54 This is in line with international recommendations for more comprehensive responses.⁵⁵"