People who inject drugs are a key population in the global response to HIV, viral hepatitis, sexually transmitted infections and tuberculosis. Injecting drug use occurs in most countries and is closely linked to preventable infections, overdose and premature death. Sharing or reusing injecting equipment can rapidly transmit blood-borne infections, while barriers such as stigma, discrimination and criminalization often prevent access to health services. As a result, people who inject drugs experience a disproportionate burden of HIV, hepatitis B and C, tuberculosis and other health conditions. Expanding access to services for this population is therefore essential to achieving global goals to end AIDS and TB, eliminate viral hepatitis and strengthen prevention and treatment services for substance use.

WHO recommends a comprehensive public health and human-rights–based approach that combines harm reduction, prevention, testing, treatment and supportive policies. Harm reduction interventions such as needle and syringe programmes, opioid agonist maintenance treatment and community distribution of naloxone help prevent infections, reduce overdose deaths and provide an entry point to health care and social services. These services also enable access to HIV testing and treatment, hepatitis B vaccination and treatment for hepatitis B and C, tuberculosis screening and care, and sexual and reproductive health services. Integrating these services into national health systems strengthens universal health coverage and improves outcomes for individuals and communities.

Legal and social environments strongly influence health outcomes. Punitive laws, stigma, discrimination and violence limit access to care and undermine effective public health responses. Removing these barriers, empowering communities and ensuring sustainable domestic financing are critical to expanding coverage and achieving impact. Scaling up evidence-based services for people who inject drugs is one of the most effective and cost-efficient investments countries can make to improve public health, reduce health inequalities and accelerate progress towards global targets.

A comprehensive package of services is recommended to address health conditions in people who inject drugs. These packages of interventions are part of the 2022 Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations. See chapters 4 and 5 for more information.