Matt Curtis has worked in harm reduction advocacy and services for more than 20 years in the USA, Eastern Europe, and Asia. Currently a managing director at the California-based Sierra Health Foundation, he previously worked for the California Department of Public Health, VOCAL-NY, the Open Society Foundations, and elsewhere.

Between 2017 and 2024 in the U.S. state of California, the combined efforts of harm reduction organizations, people who use drugs, local and state government, and other advocates succeeded in nearly tripling the number of syringe services programs (SSPs) and developing more than $150 million of new funding for harm reduction organizations. These efforts also increasingly integrated harm reduction into the public health and healthcare systems, including through low-barrier opioid treatment services at harm reduction organizations and hundreds of hospital. And they produced important changes to law and public policy, often in the face of intense local opposition in more conservative parts of the state and in ways that will be protective for SSPs over the long-term. This presentation will draw on direct experience in this work and state, programmatic, and other data to describe a practical framework for action that may inform efforts to create sustained, widespread access to harm reduction services in other locations. In particular, the presentation will focus on how harm reduction advocates intentionally collaborated across multiple sectors - including mutual aid groups, community-based organizations, government, and medicine - in ways that centered drug user heath and safety ahead of narrower interests of their organizations or fields.