Harm reduction measures aimed at preventing HIV and hepatitis C virus (HCV) transmission in prisons are neither new nor groundbreaking in Canada. Prison systems have implemented, to varying degrees, forms of harm reduction such as condoms, bleach and methadone maintenance treatment. However, as of September 2008, no Canadian jurisdiction had established a prison-based needle and syringe program (PNSP), despite significant evidence that PNSPs reduce risk behaviours associated with HIV and HCV transmission, result in other health benefits for prisoners, do not pose health and safety risks to prisoners or prison staff, and do not increase drug use.
This paper outlines the available evidence and the legal rationale, under federal Canadian and international human rights law, for Canada to implement PNSPs without delay. The analysis focuses on the federal prison system and its governing legislation, but the evidence and the basic principles are equally applicable to provincial prison systems in Canada.