The Middle East and North Africa (MENA) region has witnessed a slow but steady increase in the harm reduction response since 2016. It is likely that such gains are threatened by the impact of COVID-19. Very little is known about the health response and situation of people who use drugs (PWUD) during the pandemic in the region. A mixed method study was conducted by the MENA Harm Reduction Association (MENAHRA) to assess the situation of PWUD and impacts on harm reduction services during COVID-19. Twelve countries and two regional viewpoints responded to the survey. A virtual focus group was held with the MENA Network of People who Use Drugs (MENANPUD) focal points (n = 11). The study highlights how COVID-19 aggravated existing marginalization and stigmatization of PWUD and other key populations in the MENA region, with government level resourcing severely impacted by COVID-19. It further illustrates the commitment by harm reduction non-governmental organizations (NGOs) in diversifying their response, particularly through mobile outreach to drug hot spots, and the reliance of technology to support awareness raising, telemedicine, and medicine supplies. Positive shifts are observed in harm reduction policy by governments in some MENA countries and the continued commitment to support PWUD communities by existing harm reduction NGOs. Continued advocacy for and implementation of harm reduction responses at the domestic and regional levels should be underpinned by inclusion in state health emergency planning and disease control efforts, awareness raising around innovation and telemedicine to support health and NGO support systems and medicine supply chains, resourcing of NGOs, and provision of economic support for PWUD, disease surveillance, and research.

自 2016 年以来，中东和北非 (MENA) 地区的减害响应缓慢而稳定地增长。这些成果很可能受到 COVID-19 影响的威胁。关于该地区大流行期间吸毒者 (PWUD) 的健康反应和状况知之甚少。MENA 减害协会 (MENAHRA) 进行了一项混合方法研究，以评估 PWUD 的情况以及在 COVID-19 期间对减害服务的影响。十二个国家和两个地区的观点对调查做出了回应。与中东和北非地区吸毒者网络 (MENANPUD) 联络点（n = 11)。该研究强调了 COVID-19 如何加剧了中东和北非地区 PWUD 和其他关键人群现有的边缘化和污名化，政府层面的资源受到 COVID-19 的严重影响。它进一步说明了减少危害的非政府组织 (NGO) 致力于多样化应对措施，特别是通过对毒品热点的移动外展，以及依靠技术来支持提高认识、远程医疗和药品供应。一些中东和北非国家的政府在减少伤害政策方面出现了积极转变，现有减少伤害的非政府组织继续致力于支持 PWUD 社区。