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Changemakers

Courage at the Core: Scaling RADIAN to Address the Evolving HIV Crisis in Eastern Europe and Central Asia

By: Roman Yorick, RADIAN Portfolio Lead

The HIV epidemic in Eastern Europe and Central Asia (EECA) is an emergency hiding in plain sight — growing fast but often overlooked in the global response.

I’ve seen firsthand what’s possible when local changemakers have the resources they need to confront the HIV epidemic in EECA head-on: solutions co-created and delivered by local communities. What comes next for RADIAN is a chance to build on this momentum.

In 2024, RADIAN partners Gilead Sciences and the Elton John AIDS Foundation announced that we’re renewing and strengthening our commitment to the region through RADIAN 2.0. This five-year extension of the programme will see us expand our geographic reach to include European Union countries that are hosting people who’ve fled the ongoing conflict in Ukraine.

We’re proud to start 2025 by announcing our first RADIAN 2.0 grant recipients: innovators addressing structural barriers to HIV care, promoting equity and scaling proven solutions from RADIAN’s first five years.

These new partners include local organisations in Germany, Moldova and Poland, three of the countries most impacted by people fleeing Ukraine. With support through RADIAN 2.0, they will work to expand testing and counseling and help reduce stigma and discrimination against people seeking asylum and people living with HIV in the receiving countries.

Elena

Elena leads Revanche, a community organisation she founded to support people living with or at risk of HIV

Strengthening health systems is a critical need in the region. That is why we are funding ICAP at Columbia University, a leading global health institution, to help us make good on our promise of taking what has worked in the first phase of RADIAN and expanding these tactics to new communities. Uzbekistan has the third-largest HIV epidemic in the EECA region and is home to an estimated 62,000 people living with HIV. For the next three years, RADIAN 2.0 will support ICAP, along with the Uzbekistan Republican AIDS Centre and local community-led organisations, to adapt a proven model of care implemented in Kazakhstan’s largest city to carry it out in Samarqand Oblast, Uzbekistan.

The power of community-led response

Adapting tactics developed in one setting to meet the needs of another requires trust, understanding and the unique perspective that only someone rooted in the community can bring. One of the most rewarding parts of my work with RADIAN’s grant recipients in the region is working with EECA leaders carrying out the day-to-day work.

For example, I recently visited Elena and Boris, who have each played a key role in delivering RADIAN’s successful model of HIV care in Almaty, Kazakhstan. Elena leads Revanche, a community organisation she founded to support people living with or at risk of HIV, such as people who use drugs, women who have been imprisoned and those who have survived gender-based violence. Boris works as a peer counselor for Revanche. It’s exciting to see the lessons learned and documented successes piloted by community partners like Elena and Boris in Kazakhstan now being deployed in Uzbekistan.

In its first five years, through the work of partners like Boris and Elena, RADIAN has:

  • Reached 290,000 people with direct HIV services
  • Administered 148,000 HIV tests
  • Identified 11,000 new people living with HIV
  • Initiated or reinitiated 32,000 people into antiretroviral therapy (ART)
  • Trained 16,000 frontline workers to help reduce HIV stigma and improve quality of, and access to, HIV care
  • Successfully traced more than 26,000 people lost to follow-up and reconnected them to care

Boris

Boris works as a peer consultant at Revanche and finds his personal experience living with HIV valuable when connecting with others through his work.

Scaling to meet new challenges

We’re incredibly proud of this success, but I see every day in my work across the region how much remains to be done. Luckily, EECA has no shortage of local innovators eager to apply their passion to getting prevention, testing, counselling and care to more people.

From outreach at nightclubs to support for people migrating across borders, RADIAN grant recipients are going places no one else can to reach those left behind in the global HIV response. They continue to bravely show up, building trust and working to make sure every person in their community has access to care and support.

To harness this local passion and meet the growing needs across EECA, we are launching three new initiatives under RADIAN 2.0:

  1. The Innovation Challenge Fund to support new and original ideas around challenging stigma and delivering HIV services,
  2. The Equity Challenge Fund to address the root causes driving the HIV epidemic in the region, and
  3. The RADIAN Success Replication Fund to support RADIAN grantees in scaling what works.

And while the challenges ahead are significant, our determination is even greater. Hope is a powerful tool—and when combined with action, trust and partnership, it’s unstoppable.

February 2025

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