amfAR, The Foundation for AIDS Research

Investing in Syringe Exchange Results in Future Cost Savings



Used with permission from Nguyen TQ, et al.

Harm reduction approaches for those who inject drugs, including the distribution of clean needles and syringes, are proven interventions to prevent transmission of HIV and other blood-borne viruses, and are recommended by the World Health Organization (WHO) and other leading public health agencies.

Recent studies in the U.S. and China have demonstrated that investments in syringe exchange programs (SEPs) are cost-saving HIV prevention interventions.

During the 19th International AIDS Conference in July 2012, researchers reported that increasing SEP coverage in the U.S. from the existing 2.9 percent to 5 percent would avert 169 HIV infections.¹  Although this would require US$19 million of additional investment, it would save US$66 million in future treatment costs. Greater program coverage was associated with even greater savings over time (see chart).

A study in China² estimated that between 2002 and 2008, the SEP in Yunnan province averted approximately 16–20 percent (5,200–7,500) of new HIV infections. With total spending of US$1.04 million on the program during that time period, researchers estimated that it saved between US$1.38 and US$1.97 million in care and treatment costs averted.

The findings of major returns on SEP investments are lessons for all Asian countries, where 4.5 million of the estimated 15.9 million people who inject drugs live.³ Although injecting drug use is a key driver of the regional HIV epidemic, SEP coverage has been inconsistent. Delays in SEP scale-up are resulting in lost opportunities to prevent new infections and capitalize on cost savings for national HIV programs struggling with shrinking budgets.

1. Nguyen TQ, Weir BW, Pinkerton SD, Des Jarlais DC, Holtgrave D, Increasing investment in syringe exchange is cost saving HIV prevention: modeling hypothetical syringe coverage levels in the United States, 19th International AIDS Conference, Washington DC, Abstract MOAE0204

 2. Zhang L, Yap L, Xun Z, Wu Z, Wilson DP, Needle and syringe programs in Yunnan, China yield health and financial return, BMC Public Health 2011 11:250.  

 3. Harm Reduction International. The Global State of Harm Reduction 2012: Towards an integrated response,, Accessed 19 August 2012.