Background: Harm is not only a physical damage. Harm is a set of multifactor problems that encompasses individual, community and society levels. This study aims in identifying drivers and barriers involved during the development of public policies on Harm Minimisation for injected drug users in two distinctive countries and cities (Sydney, Australia and Santos, Brazil). It also draws lessons and policy historical experiences with both successful and failure outcomes. 

Methods: Based on the historical analysis of open-ended review of published data. Results: Findings strongly suggested that political support and the judiciary cannot be detached from health policy and its successful outcomes demands also further community support and ownership. 

Conclusion: the paper was able to shed light on the role of political engagement and the community in the development of sustainable public health policy.