The Needle and Syringe Programme Project has substantially strengthened access to comprehensive, low-threshold, and rights-based health and social services for people who use and inject drugs (PWUD/PWID) in Temeke and Kigamboni districts, contributing to improved health outcomes, reduced stigma, and enhanced social inclusion of one of Tanzania’s most marginalized populations. Funded by the Global Fund through the Government of Tanzania and implemented in collaboration with the Drug Control and Enforcement Authority (DCEA), the project has operated from 2018 to 2023, with a potential extension to 2026, ensuring continuity and sustainability of harm reduction services at community level.
Through peer-led outreach and fixed community safe spaces, the project has delivered an integrated package of harm reduction services, including the distribution of sterile injecting equipment through the Needle and Syringe Program (NSP), safe collection and disposal of used syringes, SBCC-driven health education, wound care, HIV testing and linkage to care, TB screening and treatment support, mental health and psychosocial services, and preparation and linkage to medication-assisted treatment (methadone). These interventions have directly reduced HIV, TB, and injection-related infections, minimized unsafe injecting practices, and promoted safer behaviors, dignity, and self-efficacy among PWUD/PWID.
The project has also strengthened access to broader health and social protection services through referrals for sexual and reproductive health (SRH) services, paralegal support delivered by trained crisis response teams, and empowerment sessions for women who use drugs and their children.
Implementation under a formal memorandum of understanding with DCEA and in close collaboration with local government authorities and health facilities has improved community-based harm reduction services
and the public health system. Sensitization and engagement of stakeholders have contributed to increased community acceptance of harm reduction approaches, reduced stigma and discrimination, and improved service uptake. The use of peer educators and outreach workers drawn from the same communities has built trust, ensured cultural relevance, and positioned harm reduction services as a critical entry point to sustained HIV, TB, MAT, and mental health care.
Beyond direct service delivery, the project has generated lasting system-level impact by strengthening national capacity for harm reduction programming. As one of Tanzania’s pioneering local organizations in this field, MUKIKUTE has supported scale-up and sustainability through mentorship and capacity building of eight civil society organizations implementing NSP and related interventions. Collectively, these efforts have improved quality of life for PWUD/PWID, enhanced public health and community safety, and laid a strong foundation for sustainable, community-owned harm reduction services in Tanzania.
