Abstract
Although needle and syringe programmes in Western nations are superficially similar, they are a response to and reflection of the time, place and circumstances of their conception and evolution and therefore distinctively different from each other. A Needle and Syringe Exchange Programme (NSEP) was established in New Zealand in the late 1980s, shortly after the implementation of needle and syringe programmes in some Australian states. New Zealand’s NSEP is unusual in several key respects, notably the fact that drug user groups operate peer-based needle exchanges under contract to the government, and its principle of full cost recovery for needle and syringe provision. This paper seeks to describe the context in which needle and syringe exchange was established in New Zealand and explain how it has affected the programme’s evolution.