New Report: Scaling Up Needle and Syringe Programs
Co-authored by CanHepC Investigators Drs. Guillaume Fontaine, Adelina Artenie and Jason Grebely, this report provides an evidence-based roadmap to strengthen harm reduction globally using implementation science.
“Addressing Health System and Policy Barriers to Needle and Syringe Program Scale-Up” was developed through the INHSU 2024 Policy Day. The report demonstrates that Needle and Syringe Programs (NSPs) are one of the most effective and cost-efficient interventions to prevent the transmission of sexually transmitted and blood-borne infections (STBBIs), including HIV and hepatitis C. By providing sterile injecting equipment and linking people who use drugs to health and social services, NSPs reduce risk behaviors and improve individual and community health outcomes. Developed with WHO, UNAIDS, and other multilateral partners, it identifies key barriers and practical strategies across global policy, national systems, procurement, and community engagement.
“It’s not just about having the evidence,” said co-author and CanHepC investigator Dr. Guillaume Fontaine, who leads McGill’s RISE3 Implementation Science Lab. “It’s about applying it in the real world—understanding the context, identifying barriers, and choosing the right strategies to scale up services that reach the people who need them most.”
Five key takeaways from the report
- Community engagement is essential: People who inject drugs should help choose NSP equipment and estimate what’s needed. Their input makes services stronger and more effective
- Implementation science strengthens strategy: Using structured, evidence-informed frameworks can help identify priority barriers and map out practical solutions — what works, in which settings, at what cost. This process can easily be replicated or adapted to suit different contexts
- Political will and sustained investment are non-negotiable: Scaling up NSPs requires long-term funding commitments and policy support at both national and global levels
- NSP products must be high-quality and preferred by people who will use them: Requests for commodities must reflect preferences of local communities and NSP suppliers should agree on quality standards and fair pricing for preferred products
- Coordinated messaging and shared goals will accelerate progress: A multi-stakeholder push can support governments in adopting and scaling NSPs. There are education and technical assistance needs but together they can be met.
