3. The international guidance on harm reduction interventions in prisons

Like all persons, people in prison are entitled to the highest attainable standard of health. This right to health is enshrined in international laws and standards. For example, the United Nations Standard Minimum Rules for the Treatment of Prisoners, also known as the Nelson Mandela Rules, emphasize that people in prison should enjoy the same standards of health care as those in the community.

The aim is to present the international standards and normative guidance on harm reduction interventions in prison, the current situation and related challenges.

UNODC and partners drafted a report on HIV in prisons that has submitted to the UNAIDS Programme Coordinating Board in December 2021. The report details the challenges and main achievements of countries and regions in prisons and other closed settings in addressing HIV prevention, treatment and care, including harm reduction interventions.

The reality is that HIV harm reduction interventions in prison are lacking across the globe and remain limited compared to what is available in the broader community. Introducing or expanding harm reduction programmes in prisons is challenged by political, legal and regulatory barriers. In 2021, OST programmes were available in prisons only in 59 countries and NSEP were available in prisons in only 10 countries.

The provision of HIV harm reduction interventions that are evidence-based, genderresponsive, high-quality and universally accessible is not a policy option, but a legally binding human rights obligation. It must be prioritised and resourced by international societies, national leaders and prison authorities.