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At the end of the 1990s, Iran’s health ministry commissioned a survey of drug use, which showed that drug injection was far more widespread than people had thought, and rising at explosive rates.  There had already been three notorious outbreaks of H.I.V. in prisons.  Iran was facing a genuine health crisis, one exacerbated by the punitive policies it had been using, since the strongest predictor of whether someone had H.I.V. was whether he had been in prison.

This gave an opening to doctors in Iran who knew the evidence about harm reduction.  They were able to cast it as a solution to a health problem and base the program in the health ministry, not the drug control officials ─ a much more congenial place.  The AIDS crisis helped to depoliticize a normally controversial program.