The Global State of Harm Reduction 2020

The Global State of Harm Reduction is the only report that provides an independent analysis of harm reduction in the world. Now in its the seventh edition, the Global State of Harm Reduction 2020 is the most comprehensive global mapping of harm reduction responses to drug use, HIV and viral hepatitis.

The report can be downloaded and read in full or by chapter below.

The Global State of Harm Reduction 2020 includes:

A chapter which looks at the impact of the COVID-19 pandemic and related lockdowns on the provision of harm reduction services worldwide

Additional thematic chapters on hepatitis C and tuberculosis

Examples of progress in harm reduction from across the world

Examples of legal and policy changes which impact harm reduction service provision

Foreword by Dr Tlaleng Mofokeng, United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health

Data on the number of people who inject drugs and the number of people in prison for drug use globally

View or download a PDF of the full report here.

Click here to download the maps and infographics from the report.

The chapter on Eurasia is available in Russian here.

The chapter on Latin America and the Caribbean is available in Spanish here.

The chapter on the Middle East and North Africa is available in Arabic here.

The chapter on sub-Saharan Africa is available in French here.

Map 1: Global availability of needle and syringe programmes (NSPs) in the community and in prisons

NSP available in the community
NSP available in the community and prison
NSP not available

Map 2: Global availability of opioid agonist therapy (OAT) in the community and in prisons

OAT available in the community
OAT available in the community and prison
OAT not available

Country or territory	At least one needle and syringe programme operational	NSP in at least one prison	At least one opioid agonist therapy programme operational	OAT in at least one prison
Asia
Afghanistan	✓	✘	✓	✓
Bangladesh	✓	✘	✓	✘
Bhutan	✘	✘	✘	✘
Brunei Darussalam	✘	✘	✘	✘
Cambodia	✓	✘	✓	✘
China	✓	✘	✓	✘
Hong Kong	✘	✘	✓	✘
India	✓	✘	✓	✓
Indonesia	✓	✘	✓	✓
Japan	✘	✘	✘	✘
Laos	✘	✘	✘	✘
Macau	✓	✘	✓	✘
Malaysia	✓	✘	✓	✓
Maldives	✘	✘	✓	✘
Mongolia	✘	✘	✘	✘
Myanmar	✓	✘	✓	✘
Nepal	✓	✘	✓	✘
Pakistan	✓	✘	✘	✘
Philippines	✘	✘	✘	✘
Singapore	✘	✘	✘	✘
South Korea	✘	✘	✘	✘
Sri Lanka	✘	✘	✘	✘
Taiwan	✓	✘	✓	✘
Thailand	✓	✘	✓	✘
Vietnam	✓	✘	✓	✓

Country or territory	At least one needle and syringe programme operational	NSP in at least one prison	At least one opioid agonist therapy programme operational	OAT in at least one prison
Eurasia
Albania	✓	✘	✓	✓
Armenia	✓	✓	✓	✓
Azerbaijan	✓	✘	✓	✘
Belarus	✓	✘	✓	✘
Bosnia and Herzegovina	✓	✘	✓	✓
Bulgaria	✘	✘	✓	✓
Croatia	✓	✘	✓	✓
Czechia	✓	✘	✓	✓
Estonia	✓	✘	✓	✓
Georgia	✓	✘	✓	✓
Hungary	✓	✘	✓	✓
Kazakhstan	✓	✘	✓	✘
Kosovo	✓	✘	✓	✘
Krygyzstan	✓	✓	✓	✓
Latvia	✓	✘	✓	✓
Lithuania	✓	✘	✓	✓
North Macedonia	✓	✓	✓	✓
Moldova	✓	✓	✓	✓
Montenegro	✓	✘	✓	✓
Poland	✓	✘	✓	✓
Romania	✓	✘	✓	✓
Russia	✓	✘	✘	✘
Serbia	✓	✘	✓	✓
Slovakia	✓	✘	✓	✘
Slovenia	✓	✘	✓	✓
Tajikistan	✓	✓	✓	✓
Turkmenistan	✘	✘	✘	✘
Ukraine	✓	✘	✓	✓
Uzbekistan	✓	✘	✘	✘

Country or territory	At least one needle and syringe programme operational	NSP in at least one prison	At least one opioid agonist therapy programme operational	OAT in at least one prison
Latin America and the Caribbean
Argentina	✘	✘	✓	✘
The Bahamas	✘	✘	✘	✘
Bolivia	✘	✘	✘	✘
Brazil	✘	✘	✘	✘
Chile	✘	✘	✘	✘
Colombia	✓	✘	✓	✘
Costa Rica	✘	✘	✘	✘
Dominican Republic	✓	✘	✘	✘
Ecuador	✘	✘	✘	✘
El Salvador	✘	✘	✘	✘
Guatemala	✘	✘	✘	✘
Guyana	✘	✘	✘	✘
Haiti	✘	✘	✘	✘
Honduras	✘	✘	✘	✘
Jamaica	✘	✘	✘	✘
Mexico	✓	✘	✓	✘
Nicaragua	✘	✘	✘	✘
Panama	✘	✘	✘	✘
Paraguay	✘	✘	✘	✘
Peru	✘	✘	✘	✘
Puerto Rico	✓	✘	✓	✘
Suriname	✘	✘	✘	✘
Uruguay	✘	✘	✘	✘
Venezuela	✘	✘	✘	✘

Country or territory	At least one needle and syringe programme operational	NSP in at least one prison	At least one opioid agonist therapy programme operational	OAT in at least one prison
Middle East and North Africa
Algeria	✓	✘	✘	✘
Bahrain	✘	✘	✘	✘
Egypt	✓	✘	✘	✘
Iran	✓	✘	✓	✓
Iraq	✘	✘	✘	✘
Israel	✓	✘	✓	✓
Jordan	✘	✘	✘	✓
Kuwait	✘	✘	✘	✘
Lebanon	✓	✘	✓	✓
Libya	✘	✘	✘	✘
Morocco	✓	✘	✓	✓
Oman	✘	✘	✘	✘
Palestine	✘	✘	✓	✓
Qatar	✘	✘	✘	✘
Saudi Arabia	✘	✘	✘	✘
Syria	✘	✘	✘	✘
Tunisia	✓	✘	✘	✘
UAE	✘	✘	✘	✘
Yemen	✘	✘	✘	✘

Country or territory	At least one needle and syringe programme operational	NSP in at least one prison	At least one opioid agonist therapy programme operational	OAT in at least one prison
North America
Canada	✓	✓	✓	✓
United States	✓	✘	✓	✓

Country or territory	At least one needle and syringe programme operational	NSP in at least one prison	At least one opioid agonist therapy programme operational	OAT in at least one prison
Oceania
Australia	✓	✘	✓	✓
Fiji	✘	✘	✘	✘
Kiribati	✘	✘	✘	✘
Marshall Islands	✘	✘	✘	✘
Micronesia	✘	✘	✘	✘
New Zealand	✓	✘	✓	✓
Palau	✘	✘	✘	✘
Papua New Guinea	✘	✘	✘	✘
Samoa	✘	✘	✘	✘
Solomon Islands	✘	✘	✘	✘
Tonga	✘	✘	✘	✘
Vanuatu	✘	✘	✘	✘

Country or territory	At least one needle and syringe programme operational	NSP in at least one prison	At least one opioid agonist therapy programme operational	OAT in at least one prison
Sub-Saharan Africa
Angola	✘	✘	✘	✘
Benin	✓	✘	✘	✘
Burkina Faso	✘	✘	✓	✘
Burundi	✘	✘	✘	✘
Cameroon	✘	✘	✘	✘
Cape Verde	✘	✘	✘	✘
Central African Republic	✘	✘	✘	✘
Chad	✘	✘	✘	✘
Côte d’Ivoire	✘	✘	✓	✘
Democratic Republic of the Congo (DRC)	✘	✘	✘	✘
Djibouti	✘	✘	✘	✘
Ethiopia	✘	✘	✘	✘
Gabon	✘	✘	✘	✘
Gambia	✘	✘	✘	✘
Ghana	✘	✘	✘	✘
Guinea	✘	✘	✘	✘
Kenya	✓	✘	✓	✓
Lesotho	✘	✘	✘	✘
Liberia	✘	✘	✘	✘
Madagascar	✘	✘	✘	✘
Malawi	✘	✘	✘	✘
Mali	✓	✘	✘	✘
Mauritius	✓	✘	✓	✓
Mozambique	✓	✘	✘	✘
Niger	✘	✘	✘	✘
Nigeria	✓	✘	✘	✘
Rwanda	✘	✘	✘	✘
Senegal	✓	✘	✓	✘
Seychelles	✘	✘	✓	✓
Sierra Leone	✓	✘	✘	✘
Somalia	✘	✘	✘	✘
South Africa	✓	✘	✓	✘
Tanzania	✓	✘	✓	✘
Tanzania (Zanzibar)	✘	✘	✓	✘
Togo	✘	✘	✘	✘
Uganda	✘	✘	✘	✘
Zambia	✘	✘	✘	✘
Zimbabwe	✘	✘	✘	✘

Country or territory	At least one needle and syringe programme operational	NSP in at least one prison	At least one opioid agonist therapy programme operational	OAT in at least one prison
Western Europe
Andorra	nk	nk	nk	nk
Austria	✓	✘	✓	✓
Belgium	✓	✘	✓	✓
Cyprus	✓	✘	✓	✓
Denmark	✓	✘	✓	✓
Finland	✓	✘	✓	✓
France	✓	✘	✓	✓
Germany	✓	✓	✓	✓
Greece	✓	✘	✓	✓
Iceland	✓	✘	✓	✓
Ireland	✓	✘	✓	✓
Italy	✓	✘	✓	✓
Luxembourg	✓	✓	✓	✓
Malta	✓	✘	✓	✓
Monaco	nk	nk	nk	nk
Netherlands	✓	✘	✓	✓
Norway	✓	✘	✓	✓
Portugal	✓	✘	✓	✓
San Marino	nk	nk	nk	nk
Spain	✓	✓	✓	✓
Sweden	✓	✘	✓	✓
Switzerland	✓	✓	✓	✓
Turkey	✘	✘	✓	✘
United Kingdom	✓	✘	✓	✓