"Our systematic review identified 55 NSP unit cost estimates from 14 middle and high-income countries. Higher unit costs were associated with countries with higher HSRI and fewer syringes distributed, and with newer programs, which confirmed our hypothesis. The number of intervention components included was not seen to affect the unit cost, possibly because the majority of programs did not include any additional WHO-recommended intervention components. Using our best performing model, the cost per syringe distributed of a comprehensive NSP was extrapolated to 137 countries. We find that current spend on NSP among 68 countries examined needs to increase by 2.1-times the current spend to achieve the WHO/UNODC/UNAIDS 2020 target goals of 200 syringes distributed per PWID. Reaching the high-coverage targets for NSPs can reduce the burden of HIV and HCV infection among PWID [22] and has been found cost-effective in several settings [15,23,24]."


Killion, Jordan A.a,b,∗; Magana, Christophera,∗; Cepeda, Javier A.c; Vo, Anhc; Hernandez, Maricrisa; Cyr, Cassandra L.a; Heskett, Karen M.a; Wilson, David P.d; Graff Zivin, Joshuaa; Zúñiga, María L.b; Pines, Heather A.b; Garfein, Richard S.a; Vickerman, Petere; Terris-Prestholt, Fernf; Wynn, Adrianea,†; Martin, Natasha K.a,e,†. Unit costs of needle and syringe program provision: a global systematic review and cost extrapolation. AIDS 37(15):p 2389-2397, December 01, 2023. | DOI: 10.1097/QAD.0000000000003718