The state of harm reduction in Eurasia has remained largely stable and worrying. Harm reduction is still mentioned in national government policies in 26 of the 29 countries in the region. Needle and syringe programmes are available in 27 of the 29 countries in the region at least on one site.  Opioid substitution therapy remains available in 26 of the 29 countries in the region. In Russia, which retains considerable influence in parts of the region, the government’s punitive policies and practices towards drug use continues, with a national ban on OST and extremely limited NSP site provision, despite increasing rates of HIV and hepatitis C  in the country among people who inject drugs.

The funding crisis for harm reduction is having a negative impact on a number of countries in Eurasia. Austerity, international donor retreat, and poor political support for harm reduction are the primary factors underpinning this. In some countries in Eurasia, the withdrawal of the Global Fund has left gaps in service provision that the government struggles to fill with often losing quality and scope of services. Often where harm reduction services do exist, they are not inclusive; for example, women experience greater difficulty in accessing services, and very few, if any, adapted models of harm reduction service provision for women are in operation. The role of NGOs and community-led service providers in harm reduction is still not supported by the majority of governments in the region of Eurasia