Global State of Harm Reduction: 2019 updates

The 2019 update to Harm Reduction International’s flagship publication, the Global State of Harm Reduction, includes updates to some of the key data in the report, including the opening of new drug consumption rooms, availability of needle and syringe programs, and references to harm reduction in national policy documents, among many other things. 

The Global State of Harm Reduction is a biennial report from Harm Reduction International. First published in 2008, it involves a coordinated effort across practitioners, academics, advocates and activists to map global data and responses to drug-related harms. 

It is the only report to provide an independent analysis of the state of harm reduction in the world and has become the go-to source on global harm reduction developments for researchers and advocates in our sector and beyond.

In November 2019, the Public Health and Social Policy team at Harm Reduction International worked to provide an update one year on from the publication of the Global State of Harm Reduction 2018. 

We found that the spread of harm reduction services is still stalling globally in a continuation of a trend we have observed since 2012. 

We also found that:

• Since 2018, the total number of countries implementing needle and syringe programmes (NSP) has increased by just one, from 86 to 87.
• The re-introduction of NSPs in Bulgaria and the first NSP opening in Sierra Leone have been countered by the closure of services in Uganda.
• No new countries have begun implementing opioid substitution therapy (OST) programmes since 2018. 

Notably, two new countries have implemented drug consumption rooms since the Global State of Harm Reduction 2018: Portugal and Ukraine. 

In Portugal, a mobile drug consumption room is now operational in Lisbon, while in Ukraine a fixed-site facility opened in late 2018 in Sumy. While these are undoubtedly positive developments, in other countries well-developed political and social movements in favour of drug consumption rooms have been unsuccessful so far. This includes Ireland, Scotland and the United States of America.

The data presented here has been gathered over the course of 2019 from publicly available sources and in cooperation with our partners around the world. To report any inaccuracies, please contact us at office@hri.global.

Global Availability of Needle and Syringe Programs (NSP) in the Community and in Prisons

*Colour indicates that at least one NSP operates in the country.

• At least one NSP in prison and in the community
• At least one NSP in the community only
• No NSP available

Opioid Substitution Therapy (OST) in the Community and in Prisons

*Colour indicates that at least one OST programme operates in the country.

• At least one OST programme in prison and in the community
• At least one OST programme in the community only
• No OST available

The Global Harm Reduction Response

Countries or territories employing a harm reduction approach in policy or practice