This year’s World AIDS Day theme, ‘let communities lead’, is both an answer and a call to action. Despite global progress, Eastern Europe and Central Asia is experiencing the sharpest rise in new HIV infections in the world and continues to see an increase in AIDS-related deaths.

The sustainability of the HIV response in the region remains a concern amidst conflict and a challenging legal environment: existing and worsening punitive laws and policies targeting marginalized communities continue to act as barriers to life-saving services.

For decades, communities – particularly people living with HIV and key populations such as gay men and other men who have sex with men, transgender people, people who inject drugs and sex workers – have been connecting their peers to critical services and challenging harmful policies, laws and social norms so all people can realize their right to health.

Last month, UNDP announced US$1 million in Law & Access grants through the SCALE Initiative to key population-led organizations across 16 countries. The SCALE Initiative: Removing Barriers to HIV Services is a two-year partnership led by UNDP that scales up their efforts to counter discriminatory laws and HIV-related criminalization. Five of these projects are in Eastern Europe and Central Asia.

Access and protection

In Kazakhstan, two key population-led civil society organizations (CSOs) are focusing on social service access and improvement, as well as constructive legislative reforms through their grants. The Almaty branch of Answer is working to support ongoing legislative efforts that help ensure equitable access to specialized social services for people living with HIV, including in collaboration with the Ministry of Labor and Social Protection.

Revanche, in collaboration with My Home, Nursenim and Fund of Women Living with HIV, is focused on improving protections for female sex workers, women who use drugs and women living with HIV, with the aim of creating a network of shelters for these communities and survivors of gender-based violence in all regions of the country. The work of these organizations follows a multi-sector dialogue hosted by SCALE in Almaty this September, where community participants focused on identifying ways to strengthen collaboration and cross-sectoral programs to more effectively address HIV and to reform existing punitive laws.

In Tajikistan, NGO SPIN Plus strengthens the work of HIV decriminalization by creating safe space for dialogue with communities and expanding the competencies of lawyers in their assistance to key populations. Tais Plus, a Kyrgyzstan-based CSO founded and led by sex workers, is using its grant to develop a strategy to protect the human rights of sex workers in an increasingly punitive context through legal environment monitoring, community mobilization and improving access to legal aid services.

Prevention services

Across the region, access to HIV prevention services remains challenging for key population communities. People who inject drugs are impacted the most – they are nearly seven times more likely to be living with HIV than adults in the general population. In Kyrgyzstan, Attika, an organization led by and for people who use drugs, is working to implement recommendations from an assessment they had previously conducted with Global Fund funding on reforms of by-laws related to drug trafficking to reduce stigma and discrimination against people who use drugs by law enforcement agencies. 

In addition to country-level responses, UNDP also supported a regional task force led by community representatives to tackle discrimination against and criminalization of key population groups. The task force is working to mitigate challenges posed by existing punitive laws and respond to emerging issues in the region. Stay tuned for updates on the progress of these organizations and others: in the coming months, the SCALE Initiative will also be announcing a new round of grants to organizations in Ukraine.

In 2021, UN Member States adopted the 10-10-10 targets as part of the 2021 Political Declaration on HIV and AIDS, which call for less than 10 percent of people living with HIV and key populations to experience stigma and discrimination, less than 10 percent to experience gender-based inequalities and violence, and less than 10 percent of countries to have punitive laws and policies. 

Unfortunately, progress remains fragile at best. Countries in the region must look to and be responsive toward the needs of communities most impacted in order to accelerate action and get back on track. 

By partnering with key population-led organizations, civil society, national governments, the Global Fund, UN and others, UNDP helps strengthen community leadership and scale-up HIV responses to end AIDS as a public health threat by 2030.

People living with HIV and key populations are forging a path forward because they know best how to meet their own health needs. UNDP, partners and governments must listen to them and strengthen their efforts, on this World AIDS Day and every day going forward.