Reportedly, Egypt has a high rate of drug use in comparison to neighboring countries. Cannabis and Opioids are the main drugs of use (UNODC, 2011). There is a variety of treatment approaches and services addressing drug use provided by governmental, non-governmental and private sectors. In-patient and out-patient detoxification, residential rehabilitation and self-help groups are available, mainly in larger cities. It is estimated that there are between 57,000 and 120,000 PWIDs in the country (Egypt MoH, 2010). 

In Egypt, HIV prevalence is low in the general population. It seems that there are concentrated epidemics among MSMs and PWIDs. Sexual transmission is the main drive of the spread of HIV transmission in the country. Up until 2010, PWIDs were contributing to 28.3% of HIV cases (Egypt MoH, 2012). In the years 2006 and 2010, BBSs have been conducted on PWIDs (Egypt MoH, 2012; Soliman, et al., 2010) and provided key information on the characteristics of PWIDs, HIV knowledge, risk behaviors and HIV prevalence. HIV prevalence increased from 0.6% in 2006 to over 6% in 2010. Unsafe injecting, as well as unprotected sex, were common in both studies. In addition, Egypt has one of the highest HCV prevalence rates in the general population in the world. Needle sharing has contributed significantly to this epidemic (Sievert, et al., 2011).

Egypt is developing its fourth National Strategic Plan for HIV/AIDS for the years 2012-2016. It is a comprehensive prevention, treatment and care program and has envisaged increasing coverage of prevention interventions for most at risk populations (MARPs) as a priority (Egypt MoH, 2012). HIV prevention interventions for PWIDs were begun in the country in 2010. The interventions include drop–in-centers (DICs) and outreach with free rapid testing as well as condom and syringe package distribution provided by NGOs. More than 3,000 PWIDs were reached in Cairo and Alexandria, in the years 2010 and 2011 (Egypt MoH, 2012). OST is not available in the country. VCT is provided all over the country through fixed or mobile units. However, less than 10% of PWIDs have ever been tested for HIV (Egypt MoH, 2012). VCT and HIV prevention have been made available in several prisons. ART is also available and offered in six cities (Egypt MoH, 2012).

Egypt needs to scale-up services to cover tens of thousands of PWIDs in various areas of the country. NGOs should be strengthened considerably to be capable of taking responsibility for the expanded task. According to the high number of drug users attending treatment services, provision of OST should be discussed. Various external partners are significantly supporting the National Strategic Plan and this provides an opportunity for capacity building, both at a national level as well as at the service level.