Eastern Europe and Central Asia

HIV-related philanthropy to Eastern Europe and Central Asia in 2021:

Eastern Europe and Central Asia (EECA) has long had the world’s fastest growing HIV epidemic. Over the past decade, new HIV transmissions in EECA have increased by 48% and AIDS-related deaths have risen by 32% while decreasing globally. Of EECA’s estimated 1,800,000 people living with HIV (PLWH), only 63% know their status, 51% are on ART, and 48% are virally suppressed—far below global averages and targets. According to UNAIDS, over 90% of new HIV transmissions are concentrated in key populations and their sexual partners, transmissions fueled by stigma and discrimination. The situation in EECA has escalated dramatically since Russia’s invasion of Ukraine in February 2022. This has led to a humanitarian crisis, including the mass migration of over 12 million Ukrainians, displacing key populations and PLWH and disrupting HIV services.

The Elton John AIDS Foundation has been funding work in the EECA region for over 25 years and supports local community-based organizations who can access key populations effectively and compassionately. Since 2019, the Foundation has partnered with Gilead Sciences, Inc. in a ground-breaking initiative called RADIAN, which aims to support local organizations to help end the HIV epidemic in EECA.

The Foundation’s partners identify and respond to tractable unmet needs while addressing the objectives of our EECA strategy, which are:

1. Significantly improve HIV-related health outcomes in key populations and PLWH.
2. Have a lasting impact on HIV-related health outcomes by sustainably improving existing health systems.
3. Reduce stigma and discrimination experienced by key populations and PLWH.

The Foundation also provides technical assistance to local partners to implement evidence-based models of prevention and care for key populations and to exchange learnings in a community of practice.

In 2022, the Foundation’s partners across EECA reached 45,954 people from vulnerable communities with services, tested 38,190 of them for HIV, initiated 9,378 PLWH on ART, and trained 3,631 change agents to reduce stigma toward key populations and PLWH. This work also reached thousands of Ukrainian key populations and PLWH with humanitarian and HIV-related support services, including through our support to 44 shelters across 21 cities in 16 regions of Ukraine to acquire the specific vital equipment each of them needed to support people from vulnerable communities with shelter and care.

One of the unmet needs in the region that the Foundation is addressing in partnership with local organizations is access to effective health services for migrant key populations and PLWH. Criminalization of migrating with HIV in major EECA countries prevents migrant key populations from accessing HIV services. Since 2020, the Foundation has been supporting regional projects that provide key populations and migrant PLWH with tailored prevention, testing, and care services. The Foundation’s implementing partners have reached over 4,000 key population migrants with high-impact services and have piloted innovative systems improvements, including remote initiation of migrant PLWH on ART from their home countries.

Expanded international donor support in EECA is urgently needed, and the Foundation’s programming has shown that effective philanthropically funded HIV services for key populations in challenging EECA environments are possible, if programs (1) intentionally earn communities’ trust, (2) optimize service modalities, and (3) bake in sustainability approaches. Donors interested in learning more about funding work in the region should please reach out to the Elton John AIDS Foundation at radian@eltonjohnaidsfoundation.org.