There are many tools for HIV and HCV prevention amongst people who use drugs, though access, availability, and acceptability remains a challenge in many countries. Low dead space syringes and needles (LDSS) is one such tool. Direct sharing of needles and syringes account for most HIV and HCV infections among people who inject drugs in many countries. A recent modelling study estimated that removing the transmission risk due to injecting drug use could prevent 43% of all new HCV infections globally. As a result, the design of needles and syringes distributed in harm reduction programmes should be a consideration in efforts to reduce infections.