(c) Nell Freeman for the Alliance (c) Alliance

Providing the evidence: the benefits of harm reduction


Aids Alliance
Kenya’s east coast is part of a major route for the drug trade, particularly for opiates such as heroin. So while heroin has been readily available, access to safer injecting equipment has not.

The most significant story of 2012 for the four-year, five country Community Action on Harm Reduction programme (CAHR) was the establishment of a needle exchange programme in four towns on the east cost of Kenya – to demonstrate the benefits of this approach.

In December 2012 these programmes reached 140 people who inject drugs. These may seem modest figures, but they show harm reduction starting to make its mark in Kenya after years of resistance.


Over 100 days of technical support were provided to KANCO, the Alliance’s CAHR partner in Kenya, which covered the basics of harm reduction and running outreach programmes, and involved exchange visits to learn from projects in Malaysia, Mauritius, Tanzania, and Ukraine.

For example, in Pahang, Malaysia, many fishermen cope with the harsh reality of a life spent at sea by injecting heroin. KANCO was able to learn from outreach teams there, who have also experienced resistance to harm reduction programmes.
“People equate drug users as being HIV-positive. There’s stigma around this ... so it makes it hard for people who use drugs to be accepted,” says Zulkefi Abdulleadin, manager of the local outreach programme DiC Pahang, which is supported by the Malaysian AIDS Council.

“When we started a needle exchange in 2007 we experienced a police raid while doing outreach. . . Now we find them friendly, they’re ok and let us get on with our job.”

 “The reception of the local community is also changing through the CAHR programme,” says Abdulleadin. “This has come about through the work we are doing with village chiefs. We go from one village to another to explain what the programme does.”


The figures speak for themselves. Back in 2002, 18 people a day tested positive for HIV – mostly people who inject drugs. Now the number of new infections has halved, thanks in large part to grassroots schemes such as DiC Pahang.

KANCO is hoping to replicate similar success, inspired by seeing how deeply-held beliefs within tight-knit communities can change. Other organisations in Africa are also following KANCO’s journey with keen interest.

The Alliance is one of the largest civil society organisations delivering harm reduction services. To date, our CAHR programme has reached 136,000 people who inject drugs and their partners and families, across five countries. 

This case study is an example of how we support community-based organisations, which is response 2 of our 2010-12 strategy, HIV and Healthy Communities. Find out more about our impact in our 2012 Annual Review: Ambition and Acceleration.

More info: View our photo gallery of our global harm reduction work with people who use drugs here, and a second gallery of the work in Malaysia here.






Government of the Netherlands Ministry of Foreign Affairs (BUZA)