Mat Southwell is Managing and Technical Director of Coact a community-led technical support agency.

NSP is recognised as a critical HIV prevention strategy with PWID supported by community mobilisation’s role as a critical enabler. The new Global AIDS Strategy sets bold targets for the contribution of community-led partners to the HIV response.  The question is whether this is bold strategic thinking or aspirational tokenism.

The history of P2PNSP will be described as a lens through which to view the development, functions and funding of NSP. After telling the origin stories of P2PNSP from the Netherlands,  the contribution of drug users to the development of the UK’s largely professional model of NSP will be reviewed. While the development of P2PNSP in the UK has been exceptionaland on the margins, P2PNSP in New Zealand and Australia is integrated into the national strategy, secured with State funding, and respected as key stakeholders in the response.

The activist roots of NSP in the USA were also clear from the start but most drug user activists choose to organise through the National Needle Exchange Forum. More open organising as drug user groups has become possible due to changing drug policy.

Drug user advocates formed critical alliances with academics that secured the evidence that informs global guidelines which in turn impacts on decisions about international development funding. In 2019 the Federal Ministry of Health of Nigeria entrusted their NSP pilot to 3 community-led organisations reflecting the importance of strong community-led organisations and leaders and community-led technical support.

The role of P2PNSP in responding to high risk settings, championing innovation, and reaching the diversity of people who inject drugs will be discussed with examples from around the world. Finally, issues of participatory planning and procurement of harm reduction commodities will be discussed. The speech will end with a call to match targets with investment if communities are to ever truly lead.