Countries and territories

Country profiles provide not only a short summary of the situation of harm reduction in each of the 29 countries, with which EHRA works, but also gives a concise overview of laws that form the basis of drug policies in every state. For each country, available recent data about the number of people who inject drugs (PWID), the prevalence of HIV, hepatitis B and C among this group, as well as the number of needle and syringe program (NSP) and opioid substitution therapy (OST) sites (including in prisons) is provided. The profiles also offer a glimpse at the availability of life-saving naloxone. You can also find lists of organizational EHRA members from each state. (Note: Only registered members of EHRA can access the lists of individual members).

Although the state of harm reduction differs from country to country, there are some similar trends identified in the whole region of Eurasia. NSPs are being implemented in all but two countries – Bulgaria and Turkmenistan, and OST is not available in three states: Russia, Uzbekistan, and Turkmenistan. Even though NSP and OST are provided almost in all the countries in the region, the existing coverage is not sufficient to reach the targets for HIV prevention as identified by WHO and UNAIDS. According to the research published in the Lancet, in October 2017, only two countries from the region – Croatia and Slovenia – have high OST coverage – (40 OST recipients per 100 PWIDs) and only Estonia, Kyrgyzstan, and Tajikistan have high NSP coverage (more than 200 syringes distributed per person per year).

In the majority of countries in the region, the provision of harm reduction services has remained relatively stable in the past few years. However, some states have experienced the decrease or scaling down of services, mostly because of the lack of funding as a result of the withdrawal of international donors, primarily the Global Fund to Fight AIDS, Tuberculosis and Malaria. Due to the stigmatization of people who use drugs and the still prevailing misconception that drug users should be punished rather than integrated into societies, authorities in most countries are still unwilling to finance the provision of harm reduction services comprehensively. 

Another unifying trend in the region remains the prevalence of repressive drug policies. Except for just a few countries, drug policy firmly resides in the framework of law enforcement, with large numbers of PWIDs still persecuted under criminal law or heavily fined. Highly punitive drug policy frameworks are changing rather slowly and lack supportive, human rights-centered and balanced approach to prevail over stigma and punishment. Alternatives to penalties for drug use or possession for personal consumptions are available in but a few of the countries.

Please contact us at if you’ve noticed any mistakes or have updated information regdarding the situation in your country.

The Association’s geographical focus includes Central and Eastern Europe and Central Asia (CEECA), which consists of 7 sub-regions:

  • Baltics (Estonia, Latvia, Lithuania),
  • Central Europe (Czech Republic, Hungary, Poland, Slovakia, Slovenia),
  • South-Eastern Europe (Albania, Bosnia-Herzegovina, Bulgaria, Croatia, Macedonia, Montenegro, Romania, Serbia, the Kosovo territory),
  • European Countries of the Commonwealth of Independent States (Belarus, Moldova, Ukraine),
  • Caucasus (Armenia, Azerbaijan, Georgia),
  • Russia,
  • Central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan).