Abstract:
In the Global South, young people who use drugs (YPWUD) are exposed to multiple interconnected social and health
harms, with many low- and middle-income countries enforcing racist, prohibitionist-based drug policies that generate physical and structural violence. While harm reduction coverage for YPWUD is suboptimal globally, in low and middle-income countries youth-focused harm reduction programs are particularly lacking. Those that do exist
are often powerfully shaped by global health funding regimes that restrict progressive approaches and reach. In this
commentary we highlight the eforts of young people, activists, allies, and organisations across some Global South
settings to enact programs such as those focused on peer-to-peer information sharing and advocacy, overdose
monitoring and response, and drug checking. We draw on our experiential knowledge and expertise to identify
and discuss key challenges, opportunities, and recommendations for youth harm reduction movements, programs
and practices in low- to middle-income countries and beyond, focusing on the need for youth-driven interventions.
We conclude this commentary with several calls to action to advance harm reduction for YPWUD within and across
Global South settings.