According to the latest update on the global state of harm reduction published in 2010, OST is available in 70 countries and territories around the world. The global coverage is estimated at the level of between 6 and 12 OST clients per 100 PWID and reaching as high as 61 OST recipients per 100 PWID in Western Europe and 52 OST recipients per 100 PWID in Iran.

However, in most countries of Eurasia, coverage is limited due to long-term pilots and the lack of systematic scale-up.

The purpose of this paper is to provide an up-to-date overview of the state of OST service provision in Eurasia, with a particular focus on access and quality issues. 

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