Each year the Eurasian Harm Reduction Network (ЕHRN) issues a yearly note with a review of events in the sphere of harm reduction that took place in Eastern and Central Europe and Central Asia. The year 2009 was a challenging one for many harm reduction supporters and services in our region as the economic crisis began to have impact, but it was also a year in which some important progress was made on key issues in harm reduction. In this yearly note EHRN focuses on the following topics: drug policy, opioid substitution treatment, overdose, stigma, special populations and financing of harm reduction.