"Stigma and discrimination against people who inject drugs continue to exist and hinder service access in all contexts,[12–15]  affecting organisations implementing NSPs. In South Africa, for example, one NSP was closed in 2018 due to concerns of insufficient stakeholder consultation and the systems available for waste management. Though the service was reinstated in late June 2020, programme staff have yet to reach the previous cohort of clients that had accessed the service before its closure.
"In addition to geographical gaps and stigmatisation of people who inject drugs, there are groups of people who inject drugs that experience barriers to access. The lack of appropriate, gender-specific programmes for women who use drugs is a recurring issue throughout most regions. Furthermore, the needs of Indigenous people are not appropriately met in Oceania,[10,11] and there are reports of migrants who inject drugs facing barriers to accessing harm reduction services in Western Europe.[6,9,19] NSP provision for people who use stimulants is suboptimal in many regions despite the risks involved. In Western Europe, for example, stimulant injecting has been associated with local HIV outbreaks in five countries in the past five years.[20–22]"
Harm Reduction International (2020). Global State of Harm Reduction 2020. London: Harm Reduction International.