Simply put, prison health is community health.

Prison needle and syringe programs (PNSPs) don’t just protect prisoners from infection. They would also protect the health and lives of all people in Canada.

In 2012, a former prisoner, community partners and the Canadian HIV/AIDS Legal Network launched a lawsuit against the Government of Canada over its failure to protect prisoners’ right to health and prevent the spread of HIV and HCV in federal prisons. This lasted eight years, during which time our court proceedings actually spurred the Correctional Service of Canada (CSC) to introduce a ‘Prison Needle Exchange Program’ (PNEP) in federal prisons. That program, which began in 2018, is currently rolling out to prisons, albeit much too slowly and with critical flaws; so most prisoners still don’t have access to sterile injection equipment.

In April 2020, the Superior Court of Justice in Ontario released a disappointing decision. In our lawsuit we asked the court to recognize that access to sterile injection equipment is essential health care and that prisoners have a constitutional right to this care. The judge said that there were "compelling constitutional arguments" on this front, implying that there is a Charter right to a program. But at that point, he said it was too early to decide whether CSC’s current program breaches prisoners’ constitutional rights.

We’re proud of what we have accomplished to date. When we launched the case, PNEPs didn’t exist in Canada, or even in North America. We’ve successfully moved the needle on this critical issue — even securing a commitment by Canada’s Public Safety Minister to implement the program in all federal prisons.

Meanwhile, we will continue to voice our support for prison harm reduction because prisoners’ rights are human rights and prison health is public health.

Follow the links to learn more about prisoners’ right to health, PNSPs, and the eight-year lawsuit.


Report: “They’re Just Watching You All the Time”: The Surveillance Web of Prison Needle Exchange

July 2023 — They’re Just Watching You All the Time examines surveillant functions of the PNEP through the first-hand experiences of thirty people who experienced incarceration at a prison with such a program.

Read the report

Report: Points of Perspective: Research Report on the Federal Prison Needle Exchange Program in Canada

November 2022 — Four years after the implementation of Canada’s Prison Needle Exchange Program (PNEP), the Points of Perspective report explores barriers to accessing the PNEP.

Read the report

Statement: A Setback for Prisoners’ Rights and Public Health

May 1, 2020 — In a disappointing decision, the Ontario Superior Court of Justice today declined to find that the prison needle exchange program (PNEP) currently being implemented by the Correctional Service of Canada (CSC) breaches prisoners’ constitutional rights by failing to meet professionally accepted standards for such health services. The court said such a conclusion would be premature because the roll-out of the current program is only partially complete and the program continues to evolve.

Read the statement on the HIV Legal Network website.

Statement: A Public Health Failure: Former Prisoner and HIV Groups in Court Suing the Government of Canada for Failing to Provide Access to Effective Prison Needle and Syringe Program

December 9, 2019 — A court hearing is being held in Toronto today about Canada’s “Prison Needle Exchange Program (PNEP).” The Canadian HIV/AIDS Legal Network, along with a former prisoner and three other HIV organizations, is suing the federal government over its failure to provide prisoners with easy, confidential, and effective access to needle and syringe programs.

Read the statement

Media Advisory: Former Prisoner and HIV Groups in Court Suing the Government of Canada for Failing to Provide Access to Effective Prison Needle and Syringe Program

December 9, 2019 — The Canadian HIV/AIDS Legal Network, a former prisoner, and three other HIV organizations are suing the Government of Canada over its failure to provide prisoners with easy, confidential, and effective access to needle and syringe programs.

Read the media advisory

Statement: Prisoners’ Justice Day Highlights Fundamental Flaws with Government Of Canada’s Current Prison Needle Exchange Program

August 9, 2019 — Seventy health and human rights organizations, which represent more than 286 member groups with tens of thousands of constituents Canada-wide, are speaking with one voice. What we’re saying is clear, evidence-based, and firmly rooted in health and human rights:  Prisoners need to have easy and confidential access to sterile injection equipment to protect their health and save their lives.

Read the statement on the HIV Legal Network website.

Statement on the Supervised Consumption Site at Drumheller Institution

June 12, 2019 — Drumheller Institution in Alberta recently opened a supervised drug injection site. The Canadian HIV/AIDS Legal Network issued a statement in response, citing serious concerns about whether and how this model will work behind bars. For a prison-based supervised injection site to succeed, prisoners must trust staff and believe that they can access the service confidentially, without exposing their drug use — a highly stigmatized and criminalized activity — to other prisoners and staff. This trust and confidentiality simply does not exist within the current prison. In fact, no prison anywhere in the world offers prisoners access to supervised injection rooms for these very reasons.

Read the statement on the HIV Legal Network website.

The government’s evaluation of its “Prison Needle Exchange Program”

A group of scientists wrote an open letter to the Government of Canada urging it to base the design of Correctional Service of Canada’s PNEP on a robust evaluation that thoroughly assesses prisoners’ access to this health service.

Read the letter on the HIV Legal Network’s website.

court case adjourned for one year

September 21, 2018 — On September 13, the co-applicants were in court regarding our ongoing lawsuit against the Government of Canada, seeking the implementation of PNSPs. At that time, the case was adjourned for one year, until September 2019, while the Government of Canada implements a program it quietly announced in May 2018. We believe that this program is sorely inadequate, but the pressure of our court case that compelled the government to finally commit to implementing this vital health service. Over the next year, we will continue to monitor the government's program to share its shortcomings in court and advocate for prisoners' meaninful access to sterile injection equipment.

Read the decision on the HIV Legal Network's website.


May 15, 2018 — Public Safety Minister Ralph Goodale and Correctional Services Canada (CSC) Interim Commissioner Anne Kelly quietly announced a prison needle exchange program (PNSP) to be implemented in two federal prisons. Many prisoners, public health experts and advocates, including the Canadian HIV/AIDS Legal Network, have fought for more than 20 years for prisoners to have access to these types of vital health programs in Canada’s prisons.

Read the statement responding to the announcement on the HIV Legal Network website.

Why no needle and syringe program in our federal prisons, Mr. Trudeau?

November 1, 2017 — Five years ago, the Canadian HIV/AIDS Legal Network joined co-applicants in a constitutional court case seeking the implementation of needle and syringe programs in federal prisons. These programs could prevent numerous new HIV and Hepatitis C virus infections each year, saving tens of millions of dollars.

Despite the Trudeau government's commitment to harm reduction and evidence-based policy, the federal government continues to drag its feet.

The Legal Network's director of research and advocacy, Sandra Ka Hon Chu, and executive director Richard Elliott were recently published in the Ottawa Citizen, making the case for these necessary programs and calling on the federal government to implement them immediately.

Read the piece on the Ottawa Citizen's website.

Open letter and brief to Prime Minister Trudeau and cabinet ministers

October 27, 2017 — The Legal Network recently wrote to Prime Minister Justin Trudeau and other ministers in the federal cabinet on behalf of the co-applicants. Visit the About the Lawsuit page to see the open letter and documents in the brief.

Un rights experts criticize canada's failure to end racist drug policies affecting black and indigenous people

October 12, 2017 — In its Concluding Observations on its review of Canada, the UN Committee on the Elimination of Racial Discrimination expressed serious concern about the disproportinately high rate of incarceration of Indigenous and Black people for drug crimes in Canada — a violation of the government’s obligations under the International Convention on the Elimination of All Forms of Racial Discrimination. The expert body called on Canada to re-examine its drug policies and provide evidence-based alternatives to incarceration for non-violent drug users.

Read the news release with more information about CERD's recommendations to Canada. You can also read more about the findings from Nicholas Caivano, policy analyst with the Canadian HIV/AIDS Legal Network, on Ricochet.

insights on prison needle and syringe programs: research with former prisoners in canada

October 12, 2017 — Despite the frequent occurrence of injection drug use in Canada's federal prisons, the correctional service does not allow prisoners access to sterile injection equipment as a harm reduction measure. Emily van der Meulen, Tara Marie Watson and Ann de Shalit present qualitative data from a community-driven study with 30 former prisoners in Ontario, Canada, in which participants shared insights that are valuable for understanding the prison context in relation to the need for prison-based needle and syringe programs in Canada and other jurisdictions.

Read the abstract Insights on Prison Needle and Syringe Programs: Research With Former Prisoners in Canada. If you would like more information about the study, please email Emily van der Meulen at


May 3, 2017 — During the last federal election, in response to a questionnaire that the Legal Network sent to the five major parties asking their position on key questions related to HIV and human rights, the Liberal Party of Canada indicated that there is "compelling evidence" for prison-based needle and syringe programs (PNSPs). They promised to “carefully review statements” by the Legal Network and others contending that prisoners’ constitutional rights are being violated by the failure to provide such programs inside prisons.

This promise, coupled with the Liberal government’s explicit commitment to “evidence-based policies” and harm reduction, made mediation — and thus the possibility of reaching a successful outcome (i.e., the implementation of PNSPs in federal prisons) more quickly and effectively — an attractive option to resolve our outstanding lawsuit. The applicants raised the possibility of mediation, which is an attempt to settle a dispute with the assistance of a neutral third party, outside a courtroom.

The government agreed, a mediator was secured, and mediation was to begin on January 23, 2017. After four years of litigation and 20 years of advocacy, the prospect of actually implementing life-saving PNSPs seemed within reach.

But in an inexplicable move, the government abruptly withdrew from mediation at the last minute — a nonsensical decision in the face of increasing overdoses happening behind bars, ballooning treatment costs for hepatitis C and HIV, and consensus from health and human rights groups that PNSPs work.

At this time, we engaged with media and a number of pieces were written about this frustrating development, including a terrific editorial in the Globe and Mail “Needle exchanges in federal prisons can save money and lives” which concluded that prisoners “shouldn’t be denied the health protections that are available to everyone else. The government should have faith in its evidence-based approach, and bring harm reduction inside prison walls.” The issue was also covered by Postmedia (“Evidence supports fight for harm reduction plans”) and the Canadian Press (“Providing clean needles for inmates too risky, Canadian prison officials say”) among others, and an op-ed the Legal Network wrote was published in the Ottawa Citizen (“Why has the federal government rejected harm reduction in our prisons?”).

In the meantime, we continue to carry on with the lawsuit. Cross-examinations will begin in the coming months, and a hearing is scheduled to take place before the end of the year. We will also continue to advocate for PNSPs with federal policy makers. Earlier this month, at Canada's Drug Futures Forum in Ottawa, we asked the Minister of Health Dr. Jane Philpott about scaling up harm reduction in prisons, including access to sterile injection equipment. Minister Philpott responded by pointing to pilot projects as a step to move PNSPs forward. You can see the exchange on the Drug Future Forum’s Facebook page, with the clip beginning around the 41:15 mark. While the federal government’s decision to withdraw from mediation was a profound disappointment, it did not dissuade us from working with our co-applicants to uphold the human rights of people in prison. We will continue the fight for PNSPs, no matter how long it takes.

“It Goes on Everywhere”: STUDY ON Injection Drug Use in Canadian Federal Prisons

February 22, 2017 — International and Canadian research on in-prison injection drug use has documented the frequency of its occurrence as well as some of the resulting consequences such as increased prevalence of HIV and hepatitis C virus. Access to prison-based harm reduction programming is thus important. The aim of this study conducted by Emily van der Meulen, PhD, Associate Professor at Ryerson University's Department of Criminology, was to learn from former prisoner experiences and insights on in-prison injection drug use in order to advance and improve access to harm reduction options, in particular prison-based needle and syringe programs (PNSPs).

Read the abstract of “It Goes on Everywhere”: Injection Drug Use in Canadian Federal Prisons. If you would like a full copy of the study, please e-mail Emily van der Meulen at


November 2016 — Last year, the Legal Network made submissions to the Committee on the Elimination of Discrimination against Women (CEDAW Committee), a body of independent experts appointed by UN Member States that monitors implementation of the Convention on the Elimination of All Forms of Discrimination against Women, on its compliance with the Convention, urging it to recommend, among other things, the implementation of prison-based needle and syringe programs in Canada’s prisons. We also attended the Committee’s review of Canada in Geneva in order to advocate for the Committee’s inclusion of our recommendations. In November 2016, the Committee released its concluding observations on the combined eighth and ninth periodic reports of Canada.

In its concluding observations, the CEDAW Committee expressed concern about “the excessive use of incarceration as a drug-control measure against women and the ensuing female over-population in prison” and acknowledged “high rates of HIV/AIDS among female inmates.” The CEDAW Committee also recommended that Canada “Expand care, treatment and support services to women in detention living with or vulnerable to HIV/AIDS, including by implementing prison-based needle and syringe programmes, opioid substitution therapy, condoms and other safer sex supplies.” This is an historic recommendation, and the first time an international human rights review body has urged Canada to introduce needle and syringe programs in prisons. The Committee’s ground-breaking affirmation of these programs will be most helpful as we continue to push for these programs with the federal government. For more of our commentary on the CEDAW Committee’s recommendations, see here.  

Nearly 250 Organizations across Canada Call for Prison-Based Needle and Syringe Programs

June 1, 2016 — Close to 250 Canadian organizations have signed a statement urging federal and provincial governments to immediately implement prison-based needle and syringe programs (PNSPs) in institutions across the country. Representing the views of a broad cross-section of Canadian civil society, the statement highlights the overwhelming scientific, empirical and human rights rationale for Canada’s governments to act without delay.

Read the statement with list of signatories and read the associated news release.

On Point: Recommendations for Prison-Based Needle and Syringe Programs in Canada

February 3, 2016

This report is the culmination of a multi-phase, multi-year undertaking that involved broad consultation and primary research to create recommendations for implementing prison-based needle and syringe programs (PNSPs), which provide sterile injection equipment to prisoners who inject drugs and help prevent the spread of HIV and hepatitis C virus (HCV), in Canadian federal prisons.

The report highlights three phases of the research project — a stakeholder meeting (phase 1), prison site visits in Switzerland (phase 2), and a community-based research project (phase 3) — and concludes with six recommendations on how PNSPs can and should be implemented in Canadian prisons without delay.

Click here to read the February 3, 2016 press release of this report.

Election 2015: Prisoners’ right to health — Canada’s major federal parties respond

October 9, 2015

This is the fifth in a series of blog posts being published by the Canadian HIV/AIDS Legal Network ahead of Election Day on October 19, 2015. Recently, the Legal Network sent a questionnaire to the five major federal parties, asking their position on key questions related to HIV and human rights. Four out of five parties responded. Their responses are shared here, along with the Legan Network's comments.

Across Canada, publicly funded needle and syringe programs help prevent the spread of infectious diseases, including HIV and hepatitis C (HCV). But these programs do not exist inside Canadian prisons — even though the federal government’s own research shows that drugs get into prisons despite efforts to block them, and that many people in prison struggle with addiction and inject drugs, including by sharing makeshift injection equipment.

In Canada, the prevalence of HIV and HCV infection among people in prison is at least 10 and 30 times higher, respectively, than in the overall population. If implemented, prison needle and syringe programs (PNSPs) would give people in prison access to the same health services available outside prisons, and also make workplaces safer for prison staff by reducing the likelihood of accidental injuries via non-sterile injection equipment shared by many people.

Despite the overwhelming evidence of the benefits of PNSPs around the world, no Canadian prison currently permits the distribution of sterile injection equipment to prisoners. This continuing failure of Canada’s lawmakers and prison authorities undermines the health of prisoners, violates human rights and leads to significant, avoidable costs of treating HIV and HCV infections that could have been prevented. Because most people in prison eventually return to the community, the health of prisoners is also a broader public health concern.

We asked the major political parties whether they would support the implementation of PNSPs in Canada’s federal prisons.

All four parties that responded were in favour of harm reduction programs, with varying degrees of clear commitment.

The New Democratic Party explicitly stated its support: “New Democrats believe that harm reduction does not stop at the prison gate. And protecting the health and lives of prisoners, prison staff and, in the longer term, the public-at-large by eliminating the transfer of infectious diseases is a question of harm reduction and should be dealt with as such. In this respect, all the proven, scientifically-based benefits of needle and syringe programs apply inside prisons as much as in the community. An NDP government will support the implementation of such programs. Denying these programs constitutes a needless risk to human health and is bad public policy.”

The Bloc Québécois also explicitly supported PNSPs, stating simply: “The Bloc Québécois supports the idea of needle exchanges in Canada’s federal prisons.”

The Green Party was also direct and unequivocal in its support: “Yes. Harm reduction practices work — and they are desperately needed in our increasingly overcrowded prisons. Prisoners’ rights are human rights. Prisoners do not forfeit their right to health care just because they have committed a crime. In fact, their unique needs and risk factors for addiction and other health challenges warrant specialized health services, including prison needle and syringe programs in Canada’s federal prisons.” (The Green Party also shared its criticism of mandatory minimum prison sentences, poor prison conditions such as over-crowding and solitary confinement, and other ideas for improving correctional policy.)

The Liberal Party stated that “[w]e recognize that there is compelling evidence to support needle and syringe programs (NSP) in prisons,” and adding that “any changes must rely on evidence to demonstrate that [harm reduction programs] are necessary to ensure Canadians’ safety.” The Liberal Party promised to “carefully review statements by groups like the Canadian HIV/AIDS Legal Network that the Conservative government is violating the rights of inmates under the Canadian Charter of Rights and Freedoms by failing to provide prison needle and syringe programs inside prisons.”

The Conservative Party of Canada did not respond to the questionnaire.

Needle and syringe programs in prison: Why?

June 9, 2015

When we call on the Government of Canada to protect prisoners’ right to health by introducing prison-based needle and syringe programs, it is essential that the voices of people living in Canadian prisons be heard. Jarrod, a current federal prisoner, writes about how the Canadian government is failing to protect its prison population and must act now to address this life-and-death issue.

Needle and syringe programs in prison: Why?
By Jarrod G. Shook

Why would you give someone in prison a needle? Didn't we put people in prison because they broke the law? And aren't drugs illegal? So why would we give prisoners the equipment they need for intravenous drug use? Wait ... why are there drugs in prison at all?

I will admit that, at first glance, the idea of a [prison needle and syringe] program does seem bizarre, even absurd, to me, and I am a prisoner. I can just imagine how someone with no familiarity with life behind the wall would react to such a suggestion. Read more.


On April 30, 2015,the Canadian HIV/AIDS Legal Network co-hosted an ancillary event on this topic at the Annual Canadian Conference on HIV/AIDS Research (CAHR), along with the Canadian Aboriginal AIDS Network (CAAN), Native Youth Sexual Health Network, Prisoners with HIV/AIDS Support Action Network (PASAN), and Ryerson University’s Department of Criminology. Read more about the event here.

A closer look at harm reduction in prison: why PNSPs are best practices

February 10, 2015

Emily van der Meulen and the Legal Network’s Sandra Ka Hon Chu have published an important article calling much-needed attention to prison-based needle and syringe programs in the Canadian prison system as harm reduction best practice.

We encourage you to read Harm reduction behind bars: Prison-based needle and syringe programs.

New commentaries on harm reduction in Canadian prisons

February 10, 2015

Tara Marie Watson’s posts in a three-part series highlight the critical need to consider policy and program reform relating to harm reduction in Canadian federal prisons. Watson has longstanding interests in drug policy and correctional populations, and research experience related to public health programming for people who use drugs.

Subject: Op/ed: Lack of needle exchange in federal prison a costly policy for inmate health, taxpayers

November 12, 2014
Stephanie Claivaz-Loranger and Anne Marie DiCenso
The Kingston Whig-Standard, Opinion Column

Recently, correctional investigator Howard Sapers tabled his annual report on the state of Canadian prisons. Importantly, the report focused on the "varied, complex and extensive" needs of prisoners, both current and former, and how the Correctional Service of Canada (CSC) meets or fails to meet these needs. Given the intersecting burdens of an ideologically misguided "war on drugs" (often aptly described as a war on people who use drugs) and a recent political penchant for incarceration, Sapers points to some critical realities facing our prison population, their health and human rights. The picture isn't pretty.

Read more here.

Subject: The politics of harm reduction in federal prisons

November 11, 2014

In correctional facilities across Canada, there is an identified need for prison needle and syringe programs (PNSPs). The Correctional Service of Canada has barriers in place so that PNSPs currently cannot operate within the federal prison system. In “The politics of harm reduction in federal prisons,” Tara Marie Watson examines these political barriers

This is an abstract of the paper; to access the full version, you can purchase it here.

The politics of harm reduction in federal prisons

By Tara Marie Watson
Centre for Criminology and Sociolegal Studies, University of Toronto


Background: We need to understand better the political barriers to prison-based harm reduction programs. In this paper, I examine the situation in the Correctional Service of Canada (CSC), a federal prison agency with a zero-tolerance drug policy and general opposition to prison needle and syringe programs (PNSPs) and safer tattooing initiatives.

Methods: This study draws on 16 interviews with former CSC senior officials, former frontline staff, and external stakeholders; CSC policy and practice documents; and testimony from a House of Commons Standing Committee public study. Thematic coding and comparison of texts were used to examine emergent themes of interest.

Results: Four interrelated issues were central for understanding the political barriers: a narrower definition of harm reduction used in corrections, both in principle and practice; the Conservative government’s tough-on-crime agenda; strong union opposition; and stakeholder perceptions that political constraints will likely persist, including the view that litigation may offer the only way to introduce PNSPs.

Conclusion: The system is at an impasse and key questions remain about the importability of harm reduction services into federal prisons. Despite a highly challenging policy environment, moving forward will demand asking new, critical questions and devising more strategic ways of entering the political-operational dialogue that opposes evidence-based programs.

On Point: Making Prison Needle and Syringe Programs Work in Canada

On Point: Making Prison Needle and Syringe Programs Work in Canada, co-hosted by prison health advocates and Ryerson University on January 23, 2014, was a lively panel discussion on the reasons prison needle and syringe programs are essential, and why prisoners’ right to health – in Canada and around the world – matters. Using strong examples from other countries’ prison needle and syringe programs, experts  showed how Canada could learn from these success stories.

Please watch each of the On Point speakers (Daniela De Santis - Hindelbank Prison, Switzerland; Ruth Elwood Martin - University of British Columbia, Vancouver; Sandra Ka Hon Chu - Canadian HIV/AIDS Legal Network, Toronto; and Julie Thomas - Healing Our Nations, Nova Scotia) below.  Some of their PowerPoint presentations are also included. Many thanks to the OHTN for video-recording the event, and to CATIE for editing the videos. 

On Point with Julie Thomas, Healing Our Nations, Nova Scotia


On Point with Sandra Ka Hon Chu, Canadian HIV/AIDS Legal Network, Toronto

On Point: making prison needle and syringe programs work in Canada (PPT: 1.17 MB)

On Point with Daniela De Santis, Hindelbank Prison, Switzerland

In prison drugs do not enter! That's what the authorities mostly say… (PPTX: 11.97 MB)

On Point with Ruth Elwood Martin, University of British Columbia, Vancouver

Women’s experiences of incarceration in Canada: HCV/HIV and IDU (PPTX: 4.51 MB)

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It's easy to become addicted to drugs in prison because of the negative atmosphere. People feel depressed and it's an escape from reality.”