On 24 June, Kenya’s cabinet passed its new National Policy Prevention of Alcohol, Drugs, and Substance Use (2025), developed by the National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA). It is lauded as a comprehensive prevention framework to protect youth and vulnerable groups, particularly alcohol consumers.
Government officials highlighted how the policy is a major advancement for Kenyan public health, restricting alcohol advertising and sales and promoting youth-focused prevention. Though NACADA acknowledges the potential of harm reduction, and pushes for alternatives to incarceration, the policy leaves out any plans for tangible harm reduction policies to put in place.
Prevention first
“The single most important change introduced by this policy is the systematic and aggressive prioritisation of prevention,” a NACADA spokesperson said.
Kenya’s new policy bans alcohol sales within 300 metres of schools, prohibits supermarket and online sales, raises the legal drinking age to 21, and imposes near-total advertising bans. The spokesperson said, “By making alcohol less visible, less glamourised, and harder for minors to obtain, this policy directly attacks the pipeline that feeds addiction.” These measures align with the World Health Organisation’s (WHO) “best buys” for alcohol harm reduction and its SAFER protocols.
But, though the policy focuses intensively on alcohol and tobacco, these are not the only substances that Kenyans use. The “National Policy Prevention of Alcohol, Drugs and Substance Use” actually makes little mention of substance care.
According to Harm Reduction International, there are an estimated 27,056 people who inject drugs (PWID) living in Kenya, and an estimated HIV prevalence of 11.3% among PWID. The prevalence of hepatitis C in the general population is 6.31%, and among PWID it is 20%. According to one study, 40% of people who use drugs in Kenya have reported an overdose.
It is estimated that Kenya would need to allocate more than US $500m to cover harm reduction funding shortfalls after recent USAID and PEFAR cuts. Coming in their shadow, the policy could’ve been an opportunity to enshrine harm reduction in law. Instead, PWID are almost entirely missing from feeding into the new paradigm created by the substance.
Reducing harm
Although the policy allows for the adoption of harm reduction “as applicable,” it makes no concrete commitment to establish programmes.
“The policy does not explicitly endorse needle and syringe programmes or opioid substitution therapy as stand-alone interventions,” according to the NACADA spokesperson. “Instead, it incorporates the principles of harm reduction in a broader, more conservative context.”
Since 2013, NSPs have provided sterile injecting equipment through more than 35 drop-in centres, reaching tens of thousands of people who inject drugs (PWID). On average, clients receive about 189 clean needles per year — just short of the UN target of 200. Methadone-based OST began in 2014, and to date, roughly 9,500 people have used these services. Yet coverage remains limited, reaching only 13% of PWID.
Analysts report that around 28 clinics closed or scaled back services after US cuts, including some providing methadone in Medically Assisted Treatment (MAT) clinics. In Nairobi, some clinics have stayed open thanks to local backing, while others were forced to close. At the time of writing, only one drop-in centre remains operational in Kenya.
“Pilot programmes for OST, in particular, could be developed under the guise of medication-assisted treatment within licensed facilities,” said the spokesperson.
Naloxone distribution is similarly fragile. Though available in limited clinical and peer-outreach settings, there is no national programme to ensure overdose prevention. A recent study warned that most PWID remain without access to naloxone during overdose crises, underscoring the need for community-level interventions.
The policy is not explicitly against harm reduction for people using drugs, the spokesperson said, but views it conservatively. “Integration would likely be slow and pilot-based, focused within clinical settings rather than as community-wide programmes,” they said.
Community criticism
On the bill’s launch, the Women Who Use Drugs & Recovering Addicts Development Association (WRADA) for a national harm reduction bill. At Kenya’s UN Human Rights Review in February 2025, WRADA’s Rita Gatonye urged lawmakers to adopt “a human rights, health, and evidence-based approach.”
Nairobi MP Esther Passaris has pushed for harm reduction to be implemented across Kenya, tabling a national harm reduction bill (download link here) which calls for a harm reduction strategy that protects the health of people with substance use disorders, including assuring their right to HIV-related services, NSP, medically assisted therapy and more.
Speaking to TalkingDrugs, she said; “While the national policy makes commendable efforts in prevention and awareness especially among youth, it continues to fall short where it matters most: harm reduction.”
“Prevention is essential, but it must be matched with funding and legal backing for needle exchange, opioid substitution therapy, psychosocial support, and community-led outreach especially for women and youth who face layered vulnerabilities. Through Kenya’s Harm Reduction Bill, we’re working to anchor harm reduction in national law,” she added.
International partners echo these concerns. UNAIDS’ 2024–2025 reporting flags service continuity issues at methadone sites and the need for integrated MAT aftercare planning. Kenyan community networks and allies argue that, without explicit national commitments to NSP, OST and naloxone, the policy’s prevention gains will bypass those at highest risk—a gap they want closed through legislation, funding and community-led services.
Shifting approaches
“The Government shall adopt proportionate sentencing with alternatives to incarceration for petty drug and alcohol offences and offenders with substance use disorders,” according to the policy document.
The policy introduces alternatives to incarceration — advocating proportional sentencing and diversion into treatment instead of prison for low-level, non-violent offenders with SUDs. The NACADA spokesperson said “this approach acknowledges that addiction is a health condition, not a moral failing.”
Despite these positives, the lack of harm reduction is still a glaring omission. Modelling indicates that full scale-up of NSP and OST could reduce HIV incidence by over 50% and HCV by almost 85% by 2030 — gains not possible under current policy gaps.
Internationally, Kenya is a paradox: these new alcohol restrictions would be some of the most stringent globally, yet its lack of harm reduction places it behind global trends. The spokesperson acknowledged the tension but said, “Prevention remains the priority.”
Yet prevention and harm reduction are complementary—not contradictory—approaches. Research from Kenya shows that access to NSPs and OAT correlates with sharp reductions in needle-sharing, surges in viral suppression, and steep drops in HIV incidence among PWID.
Kenya’s silence on harm reduction is thrown into relief when compared with regional peers. South Africa’s National Drug Master Plan (2019–2024) explicitly embeds NSPs and OST within its national HIV prevention strategy. In Pretoria, the COSUP initiative distributes thousands of methadone doses and clean syringes to people who use drugs, backed by local and national support.
Missing pieces
Kenya’s 2025 drugs policy is being pitched as a landmark in prevention and youth protection. However, sidestepping harm reduction is a lost opportunity to ensure services for vulnerable communities. Whilst not explicitly against harm reduction, the legislation feels like a missed opportunity to enshrine harm reduction in Kenya’s laws.
The policy does aim for “tailored, limited adoption rather than a full embrace” of harm reduction, the spokesperson said, potentially leaving the door open for more inclusive policies in the future. For now, PWID are missing from Kenya’s supposed drug policy, and Kenyans will be waiting for that void to be filled.
