On December 1, the world once again turns its attention to HIV. This year, the global theme is “Overcoming disruption, transforming the AIDS response.” It’s far from an abstract slogan for Eastern Europe and Central Asia, but a precise description of the region’s reality: war, authoritarian shifts, attacks on LGBT communities and shrinking international funding. And yet, communities remain resilient, keeping the system afloat even when the system itself is cracking at the seams.

ECOM welcomes December 1 with updated data on HIV among MSM and trans people in the region and with a very simple but important message: we mustn’t let crises erode the rights of people living with HIV and people from key populations.

The HIV situation among men who have sex with men (MSM) in the region remains alarming. In a number of countries, the share of MSM among new HIV cases is disproportionately high, and in others, it continues to grow. It’s convenient to attribute this to “risky behavior,” but the data and experience of organizations show something different: the key problem isn’t the people, but the conditions in which they live and seek help.

Trans people in the region live at the intersection of several forms of vulnerability: transphobia, HIV-related stigma and, often, economic instability and violence. ECOM’s data on HIV among trans people show higher levels of vulnerability, later diagnostics and more frequent cases of losing contact with the care system after being diagnosed.

There’s another side to the picture: where the approach changes, so do the outcomes. Evidence of this is the development of pre-exposure prophylaxis (PrEP) in the region. It’s no longer an “idea from a pretty presentation” but a real tool: in several countries, models have emerged where PrEP is accessible, understandable and integrated into people’s lives, rather than existing “for reporting purposes.”

Importantly, these models increasingly emerge not as imported “best practices” from the West, but as solutions created within the region itself: clinics where doctors don’t ask unnecessary questions; NGOs that fill gaps in information and support; and teams that build services around people’s lives, not around formal requirements.

2025 has shown the dangers of political decisions made far beyond the region’s borders. Budget cuts for international healthcare programs, ideological attacks on gender and LGBT agenda, pressure on foundations that have financed HIV prevention for decades — all of this is already affecting real services: testing sites are closing, outreach programs are shrinking, and community support is declining.

In this situation, the question of resources becomes fundamental — both politically and humanly. Today, much in the region depends on the enthusiasm of activists, the flexibility of NGOs and the professionalism of individual teams. But enthusiasm cannot replace sustainable funding. This is why ECOM emphasizes that discussing funding cuts and mobilizing new resources is not a “narrow technical topic,” but a prerequisite for preserving people’s lives and health.

“Across the world we’re witnessing growing attacks on the rights of key populations, especially LGBT communities, while donor funding for HIV programs is rapidly declining. And this is happening precisely at the moment when new prevention tools capable of radically changing the course of the epidemic are becoming available. At such a difficult time, governments in our region must take responsibility and ensure sustainable domestic funding for HIV programs. And we, as communities, must unite and consistently defend our right to health, safety and dignity,” said Vitaly Djuma, Executive Director of ECOM.

In anticipation of December 1, ECOM updated and published regional overviews of the HIV situation among MSM and trans people in Eastern Europe and Central Asia. This is not just a set of numbers — it’s a tool that helps:

  • show where the system is failing key populations;
  • make a case for funding at the national and international levels;
  • strengthen the voice of communities in dialogue with government and donors — and therefore design services based on real needs.

The key lesson of 2025 is simple: no one will come to “save” the region. And this represents not only a risk but also an opportunity. Eastern Europe and Central Asia are already creating their own models of prevention, support and treatment based on real community engagement, transparent data and respect for human dignity.

ECOM will continue to:

  • collect and analyze data on HIV among LGBT people;
  • support community organizations and activists across the region;
  • advocate for the rights of LGBT people and people living with HIV at national and international levels;
  • speak openly about shrinking funding and demand resources that meet real needs.

World AIDS Day isn’t about a single day of the year. It’s a reminder that the HIV response is built every day — in doctors’ offices and street outreach, in ministries and chatbots, in small community centers and at international conferences.

And as long as the region has people and organizations that continue this work — testing, counseling, supporting, defending rights — the HIV response in Eastern Europe and Central Asia won’t be reduced to statistics. It’ll remain a story about people who, despite everything, overcome disruption and genuinely transform the AIDS response.