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Size estimation and service mapping: introducing harm reduction in Zambia

Harm reduction is new in Zambia. Mainline was asked to estimate how many people inject drugs in the country and to map the already existing harm reduction and HIV services for people who use drugs. Based on this information, we drafted practical service guidelines. In doing so, Mainline hopes to have contributed to the introduction of harm reduction in Zambia.

size estimate

Mainline’s work complements the size estimate that is currently being implemented by ICAP Global Health (Columbia University). To avoid a duplication of effort, we focused on three cities: Kabwe, Kitwe and Solwezi. The two studies combined will provide an accurate picture of the number of people who inject drugs in Zambia.

The size estimate was implemented in very close collaboration with local researchers and Zambia’s National AIDS Council. 


A second part to the assignment was to create an overview of the available services for people who inject drugs. Services could range from HIV centres to drop-in centres and from local general practitioners to peer to peer service provision and local sober houses.

recommendations for programming

An important outcome of this assignment is a hands-on service guideline. This guide aims to lay the foundation for harm reduction services in Zambia. The guideline was released during a dissemation meeting on 7 and 8 October 2021. It is available upon request. The step-by-step service guide is the property of the Zambian National HIV-AIDS-STI-TB Council (NAC). The development of this guide was initiated under Zambia’s Ministry of Health.

You can request more information about this project via Machteld Busz.

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Support and finance

The assignment to develop this guide was commissioned and funded by UNODC under UNAIDS Unified Budget, Results and Accountability Framework (UBRAF).