Harm reduction emerged at the height of the HIV epidemic as an innovative approach to curb the spread of HIV among people who inject drugs. At its core, harm reduction is a practical, evidence-based approach that places individual and public health above all other considerations. It is a clear example of how individual and public health can and should always be prioritised, even when it comes into tension with policy frameworks.  

In the context of a public health response to drugs, ‘harm reduction’ refers to “policies, programmes and practices that are aimed at minimising the negative health, social and legal impacts associated with drug use, drug policies and drug laws.” For the World Health Organization (WHO) harm reduction encompasses “a comprehensive package of evidence-based interventions, based on public health and human rights, including NSPs (Needle and Syringe Programs), OAMT (Opioid Agonist Maintenance Therapy) and naloxone for overdose management. Harm reduction also refers to policies and strategies that aim to prevent major public and individual health harms, including HIV, viral hepatitis and overdose, without necessarily stopping drug use.”

Harm reduction interventions aim at “meeting people where they are at” without judgment, accepting that not everyone may be ready or willing to stop using drugs. They acknowledge that abstinence from drugs, while it may be a valid goal of some individuals, should never be a precondition for accessing health and social services. Harm reduction services should be available and accessible to all people who may require them (including specific populations such as women and people in prison) without discrimination and should be adequately funded.