Elton has urged compassion for people who inject drugs, saying "stigma and criminalisation" robbed them of their humanity and exposed them to a life of addiction and disease.
Clean needles, opiate substitution therapy and sound advice can help drug users reduce the risk of overdose and HIV and set them on the path towards overcoming addiction, he told AFP.
"In the 1980s and 1990s, we saw HIV cut down hundreds of thousands of people while governments did nothing," the AIDS campaigner said.
"It was clear then, and is still clear, that many governments don't value the lives of their own citizens because of needless stigma and criminalisation of drugs and sex."
Elton, who has in the past admitted to narcotics use, was speaking to AFP in an email exchange ahead of an International Harm Reduction Conference opening in Vilnius, Lithuania, on Sunday.
His AIDS foundation supports the conference, which will gather hundreds of scientists, politicians, researchers, health workers, doctors and activists from about 70 countries.
"Harm reduction" refers to programmes that seek to help intravenous drug users, one of the highest-risk population groups for the AIDS virus.
Injecting drug users may be addicted, poor and marginalised, which makes them more at risk of contracting -- or spreading -- a virus by sharing a syringe or working in the sex industry to pay for drugs.
The four-day conference will focus on an HIV hotspot: central and eastern Europe and central Asia, where there are more than 3.7 million injecting drug users, almost a quarter of the worldwide tally.
Eastern and central Europe has the fastest-growing HIV epidemic of any region in the world, with injecting drug use accounting for around three-quarters of new cases, according to the UN agency UNAIDS.
In Russia, some 1.5 million people are living with HIV compared to some 100,000 a decade ago.
Elton blasted politicians who, he said, appealed to selfishness rather than compassion.
"Laws are passed that shun the poor, show no forgiveness for those who break the law and discriminate against immigrants and minority communities."
But the United States was a good example of how progress was possible, he noted.
"Conservative politicians have banned the use of national government funding for syringe exchange," he said.
"But at state and city level, governments are changing laws to reduce restrictions on pharmacy sales of syringes, allow people to legally carry syringes and through national healthcare reform there will likely be increased access to medical care, mental health care, opiate substitution therapy and overdose prevention."
The artist said his foundation spent about $1 million a year on harm reduction in the U.S., mainly for syringe access.
He appealed for tolerance, saying everyone is susceptible at some point to a bad choice or situation exposing them or others to harm, be it reckless driving, smoking, teenage drinking or depression.
"None of us is perfect," added the musician.