The City of Tshwane and University of Pretoria Community Oriented Substance Use Programme, COSUP, is unique in South Africa. The City has adopted an evidence based harm reduction approach to the use of drugs, and seeks to offer compassionate, scientific and effective solutions to all the people who live in Tshwane. The model, based on the community oriented primary care (COPC) approach to public health, offers community based, low threshold services along a continuum of care. It also offers an affordable and sustainable model for responding to drug use by integrating services into the existing infrastructure, and ensures reach by including peers as part of the multi-disciplinary teams. Here a number of the COSUP staff, and the MMC, Cllr Sakkie Du Plooy, explain the programme, the benefits and early results.