Drug use prevention, treatment, and care: harm reduction works

Harm reduction refers to a range of pragmatic and evidence-based public health policies and practices aimed at reducing the negative consequences associated with drug use and other related risk factors.

Drug use is a public health issue with an impact on development and security. One of the top 20 risk factors to health globally, it is closely associated with HIV, hepatitis, tuberculosis, suicide, overdose death, and cardiovascular diseases. The continuing criminalization of drug use results in fostering the stigma associated with drug use, and generating multiple forms of discrimination and social exclusion, including access to healthcare. People who use drugs are hence further pushed underground and away from services they rightfully need.

What is harm reduction?

Harm reduction refers to a range of pragmatic and evidence-based public health policies and practices aimed at reducing the negative consequences associated with drug use and other related risk factors such as HIV and AIDS. These interventions exemplify human rights in action by seeking to alleviate hazards faced by the injecting drug users, where needed, without distinction and without judgement. The IFRC advocates harm reduction for one very simple reason: It works.

The United Nations estimates that approximately 15.9 million people living in 148 countries regularly inject drugs. Known as injecting drug users, these individuals are particularly vulnerable to HIV, Hepatitis C and B infections owing to risky behaviours such as sharing syringes and needles, unsafe sex practices and a general lack of health-seeking
behaviour. Worldwide, an estimated three million injecting drug users are now living with HIV.

Injecting drug use thus constitutes a serious public health concern that can only be addressed through the rational application of nonmoralistic public health interventions that emphasize harm reduction programming over punishment and censure.

In this context, the IFRC recommends that scientific evidence and a humanitarian spirit should guide the HIV response. Injecting drug users, who routinely face harassment, stigmatization, violence and social exclusion, require not only care but compassion as well. Stigma only further marginalizes already vulnerable individuals and directly impedes efforts to halt the spread of HIV. Reducing marginalization also reduces the transmission of HIV and other infectious diseases.

Out of harm's way report

In this last edition for 2010, the IFRC Health Advocacy Report depicts the stark reality of what it means to be an injecting drug user and living with HIV. It examines the prevention, treatment, care and support needs of this most at-risk population and the International Federation of Red Cross and Red Crescent Societies (IFRC) response to their plight. Read more

Why adopting a harm reduction approach?

• Drug use is a serious public health issue
• Drug users are especially vulnerable to HIV and Hepatitis
• Drugs users have as much right as anyone to access health services
• Dangers of inaction include further propagation and transmission of HIV and other diseases to new populations, more complex HIV epidemics in addition to high rate of mortality and socio-economic destabilization
• The promotion of a non-repressive, evidence-based, human rights approach, i.e. harm reduction, is more coherent with the principles of public health than exclusion and punishment
• Harm reduction programmes decreases the social marginalization of drug users and their subsequent vulnerability

National Societies' activities around harm reduction programmes

• Red Cross and Red Crescent National Societies are implementing harm reduction programmes in more than 20 countries
• Thirty three National Societies  have been involved in harm reduction trainings
• On average, 18,361,133 people were targeted in 2009 with preventive messages and psychosocial support worldwide
• Around 119,370 volunteers were mobilized to work with most vulnerable communities on drug users related HIV prevention
• Around 17.5 million volunteer hours were allocated for this work
• National Societies work with over 40,000 drug users on a daily basis

Watch the Italian Red Cross's Villa Maraini foundation video 

This video illustrates the activities run by the Italian Red Cross's Villa Maraini foundation in Rome which is one of its kind. It delivers all sort of psychosocial support and health services namely for drug users among others. Villa Maraini is also highly regarded for its training Centre.


Read the new borchure on harm reduction.

A call to action

The International Federation of Red Cross Red Crescent Societies (IFRC) advocates on behalf of the individuals suffering most from exclusion within an already marginalized group—injecting drug users living with, or at risk of, HIV and AIDS. The IFRC challenges policymakers, governments and donors to move beyond their own prejudices to work withstakeholders, multi-lateral organizations, civil society and those living with HIV to provideprevention, treatment, care and support to injecting drug users and their families.

Case studies

China case study: harm reduction

By Zhang Ran, Red Cross Society of China: Harm Reduction Project The province of Yunnan lies...

Belarus case study: harm reduction

By Joe Lowry Nikolay and Irina spend all their money on ‘semechki’, a homemade poppy-seed paste,...

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