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In 2008, Harm Reduction International (HRI) released the first Global State of Harm Reduction, a report that mapped responses to drug-related HIV, viral hepatitis and tuberculosis (TB) around the world for the first time. The data gathered for the report provided a critical baseline against which progress could be measured in terms of the international, regional and national recognition of harm reduction in policy and practice.

Since 2008, the biennial report has become a key publication for researchers, policymakers, civil society organisations, UN agencies and advocates, mapping harm reduction policy adoption and programme implementation globally. Over the last decade, reports of injecting drug use and the harm reduction response have increased; harm reduction programmes are currently operating at some level in almost half of the 179 countries in the world where injecting drug use has been documented.

With patterns of drug use globally continuing to evolve, Harm Reduction International reached out in 2017 to civil society networks across the world to ask what they wanted to see in this report. The 2018 report has a broader scope, containing information on:

  • The number of people who inject drugs and the number of people imprisoned for drug use (where data is available).
  • Needle and syringe programmes (NSP), opioid substitution therapy (OST), HIV and hepatitis C and TB testing and treatment for people who use drugs, in both the community and in prisons.
  • The harm reduction response for people who use amphetamine-type stimulants, cocaine and its derivatives, and new psychoactive substances.
  • Drug-checking in nightlife settings.
  • Harm reduction for women who use drugs.
  • Drug consumption rooms.
  • Drug-related mortality and morbidity and the overdose response, as well as naloxone peer distribution in the community and naloxone provision in prisons.
  • Developments and regressions in funding for harm reduction.
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