As part of the regional information and advocacy campaign EECA Voices at AIDS 2026, implemented by VirusOFF with the support of the UNAIDS EECA and Asia-Pacific Office, we continue to look at the key messages emerging from AIDS 2026 through the lens of Eastern Europe and Central Asia.
The campaign focuses on three questions that are central for the region today: how to make HIV prevention more accessible, how to protect community-led responses in a changing funding landscape, and how to ensure that innovation reaches people — not only pilot projects.
At AIDS 2026 in Rio de Janeiro, much of the conversation is about the future of the HIV response: long-acting PrEP options, digital solutions, telemedicine, artificial intelligence, new testing models, sustainable financing and stronger national ownership.
But across these discussions, one central question keeps emerging: will innovation, science and political commitments actually reach the people who need them most?
For Eastern Europe and Central Asia, this question is especially urgent. In our region, HIV prevention has long gone beyond the walls of a medical office. It depends on trust, navigation, peer support, safe spaces, human rights, decriminalization, sustainable financing and the work of community-led organizations.
That is why the AIDS 2026 theme — Rethink. Rebuild. Rise. — speaks to EECA not as a slogan, but as a practical challenge.
We need to rethink prevention not as a set of separate tools, but as a system of access. We need to rebuild financing so that it supports not only medicines and clinics, but also the pathways that allow people to actually reach care. And we need to strengthen communities, which are often the first point of trust for people facing stigma, criminalization, war, migration or discrimination.
At the opening of AIDS 2026, UNAIDS Executive Director Winnie Byanyima said that the next phase of the HIV response would be a “three-front battle”: rights, science and funding. These three fronts now define the future of HIV prevention in the EECA region.
Progress exists. But it is fragile.
AIDS 2026 is taking place at a moment when the global HIV response shows both major achievements and serious risks. According to UNAIDS, in 2025 there were 41.0 million people living with HIV globally, 1.2 million new HIV infections and 570,000 AIDS-related deaths. Antiretroviral therapy coverage reached 78%, while coverage of services to prevent vertical transmission reached 87%.
This shows that the world knows what works. But that is no longer enough.
At the press conference ahead of AIDS 2026, Winnie Byanyima warned: “Progress is slowing.” She also noted that every day around 3,400 people acquire HIV and around 1,600 people die from AIDS-related illnesses. Her conclusion was clear: the HIV pandemic is not over, and without urgent action, it can regain force.
For EECA, this warning has a very specific meaning. UNAIDS reports that between 2010 and 2025, new HIV infections in Eastern Europe and Central Asia increased by 17%.
That means prevention in the region cannot remain a vulnerable or secondary part of the HIV response. It must be central. And it must be truly accessible.
A tool is not the same as access
PrEP, PEP, HIV testing, harm reduction, condoms, long-acting injectable options, digital navigation and telemedicine can all change the future of HIV prevention.
But AIDS 2026 makes one thing clear: a tool alone does not equal access.
A tool becomes access only when a person knows about it, trusts the person or system offering it, can seek help without fear or judgement, and does not face risk because of their identity, status, behaviour or life circumstances.
UNAIDS highlights that new PrEP options, including long-acting injectable regimens, are creating renewed momentum for HIV prevention. At the same time, community-led organizations are essential in generating demand and delivering services in ways that are equitable, acceptable and accessible to the people who need them most.
For EECA, this is a key lesson. If innovation is not accompanied by financing, clear pathways, trained teams, community-based delivery, navigation, trust and protection of rights, it risks remaining a pilot.
And HIV prevention cannot be a pilot for people who need it today.
When funding is cut, bridges to people disappear
The funding crisis is one of the central issues at AIDS 2026. But for EECA, this is not only about budgets. It is about which parts of the system will be protected.
UNAIDS reports that in 2025, external financing for the global HIV response in low- and middle-income countries declined by 18% compared with 2024. The report also notes that these changes have strongly affected HIV prevention, testing and key components of treatment programmes, including community-led services that reach people most affected by HIV.
What is most often put at risk is precisely what may not look like “classic medicine”: peer counselling, outreach, navigation, mental health support, legal assistance, community-led monitoring, accompaniment and trust-building.
But these are often the elements that determine whether a person reaches HIV testing, PrEP, treatment or support.
Without them, a system may have medicines, protocols and clinics — but no road leading people to them.
Communities are not an add-on. They are access infrastructure.
At AIDS 2026, the role of communities is not being discussed as a symbolic issue. It is being discussed as a condition for the survival of the HIV response.
UNAIDS emphasizes that community-led organizations play a critical role: they organize, advocate, demand and facilitate access to HIV services and scientific advances. They are important providers of prevention, treatment, adherence support and services in spaces free from stigma and discrimination, including in humanitarian crises.
For EECA, this is especially important. In a region where war, migration, criminalization, stigma and distrust in formal systems often intersect, community-led organizations help people remain connected to care.
They explain. Refer. Accompany. Protect. Restore trust. And often reach places where formal systems do not.
That is why community-led response must not be the first thing cut. And it must not be called “additional”.
Human rights are a condition for prevention
Another strong message from Rio is that HIV prevention does not work when people are afraid to be visible.
Criminalization, stigma, discrimination, violence and political pressure directly affect whether a person seeks HIV testing, asks about PrEP, receives PEP, continues treatment or trusts a counsellor or healthcare provider.
UNAIDS notes that criminalization remains a serious barrier to HIV services for people living with HIV, people affected by HIV and people at risk of acquiring HIV. In 2026, only 7 out of 193 countries did not criminalize at least one of the following: same-sex sexual relations in private, transgender people, sex work, possession of small amounts of drugs, or HIV non-disclosure, potential or actual HIV exposure.
For EECA, this means that human rights are not a separate advocacy block. They are part of effective prevention.
If a person is afraid of the system, they will not seek services. If they do not seek services, prevention does not work.
Sustainability must protect access, not only treatment
Sustainability is another key discussion at AIDS 2026. But for EECA, it is important not to reduce sustainability to a technical replacement of donor funding with domestic funding.
UNAIDS reports that in 2025, total financial resources for HIV in low- and middle-income countries amounted to US$17.6 billion, 59% of which came from domestic resources. At the same time, achieving the global targets by 2030 requires US$21.9 billion annually.
But the question is not only how much money is available. The question is what exactly will be funded.
If domestic financing covers medicines but does not support prevention, navigation, community-led services, legal protection, stigma reduction and quality monitoring, sustainability will remain incomplete.
The new global framework gives a clear direction: by 2030, 30% of HIV testing and treatment-support services should be delivered by community-led organizations; 80% of people-centred prevention programmes for key populations should be delivered by community-led organizations; and 60% of programmes supporting societal enablers should also be delivered by community-led organizations.
This is an important political signal: communities must not remain at the margins of the system. They must be at its centre.
What AIDS 2026 says to EECA
For Eastern Europe and Central Asia, AIDS 2026 sounds like a very concrete call.
We cannot talk about innovation without access.
We cannot talk about sustainability without communities.
We cannot talk about prevention without human rights.
We cannot talk about ending AIDS as a public health threat if people are afraid to seek help.
EECA needs an HIV response that sees people on the move, people in crisis, people under pressure from criminalization, people who do not trust the system, and people who need not only a medicine, but a safe pathway to it.
The main conclusion from Rio is simple: the world has the science, the tools and the experience. But that is not enough.
What is needed is a choice — to invest in prevention, support communities, protect human rights, bring innovation to people and build systems that do not lose those who need help the most.
For EECA, this choice is especially important.
Because HIV prevention will not work if it exists only on paper. Innovation will not change the situation if it remains in pilots. And no system will be sustainable if it does not have people’s trust.
Innovation must reach people. Funding must protect access. And communities must be not an add-on to the HIV response, but its leaders.
