Harm reduction


Harm reduc­tion refers to the laws, poli­cies, and prac­tices that seek to reduce harm asso­ci­ated with a par­tic­u­lar - rel­a­tively risky - behav­iour. Harm reduc­tion entails sub­sti­tu­tion of a high-risk behav­iour with a rel­a­tively less risky behav­iour. This requires a com­pre­hen­sive set of poli­cies to tackle a pub­lic health chal­lenge which might be banned or crim­i­nalised. For instance, some coun­tries have imple­mented syringe exchange pro­grammes to incen­tivize peo­ple who inject drugs to use a new nee­dle every time. These pro­grammes reduce chances of acquir­ing infec­tions like HIV, Hepati­tis B, and Hepati­tis C from the use of old nee­dles and thereby typ­i­cally improve health out­comes. Other such poli­cies include opi­oid sub­sti­tu­tion ther­apy, safe injec­tion sites and free dis­tri­bu­tion of nalox­one.

Crim­i­nal­iza­tion of HIV and cer­tain behav­iours such as drug use is one of the major imped­i­ments to the imple­men­ta­tion of harm reduc­tion. Crim­i­nal pun­ish­ment, or even the fear of fac­ing crim­i­nal pun­ish­ment, makes these poli­cies less acces­si­ble and thereby less effec­tive.

Effec­tive harm-reduc­tion laws, poli­cies, and prac­tices are rooted in human rights as it pro­tects indi­vid­ual auton­omy, cur­tails dis­crim­i­na­tion and pro­vides equal access to health­care. Despite the wide­spread evi­dence of pos­i­tive impact of harm reduc­tion poli­cies, many coun­tries con­tinue to fail to invest in harm reduc­tion, retrain­ing and sen­si­ti­sa­tion of health­care providers, and lack of com­mu­nity involve­ment while pro­mul­gat­ing and imple­ment­ing harm reduc­tion poli­cies.

States have recently adopted sev­eral inter­na­tional com­mit­ments relat­ing to harm reduc­tion, as reflected in the Lan­guage Com­pendium. These include com­mit­ments to increase national lead­er­ship and resource allo­ca­tion towards harm reduc­tion pol­icy inter­ven­tions.


2021 Political declaration on HIV and AIDS

2019 Political declaration of the HLM on UHC

2018 CND On mother-to-child transmission among women who use drugs

2017 Resolution on international cooperation to address and counter the world drug problem

2016 Outcome Document of the Session on the World Drug Problem

2011 Political Declaration on HIV and AIDS

2010 ILO Recommendation concerning HIV and AIDS and the world of work

2006 Political Declaration on HIV/AIDS

2000 WHA on HIV/AIDS: confronting the epidemic

Expert precedents

2022 OHCHR Annual Report on Human Rights and HIV/AIDS


2022 WHO Guidance on Differentiated and Simplified PrEP for HIV Prevention

2022 WHO Consolidated Guidelines on HIV, Viral Hepatitis and STI Prevention, Diagnosis, Treatment and Care for Key Populations

2021 WHO Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring

2016 Prevention Gap Report