Country level activities

On 25 June 2025, a tripartite meeting was held in the Republic of Moldova to reaffirm the importance of opioid agonist therapy (OAT) and related support programmes, and to identify sustainable solutions for improving their implementation. Discussions focused on challenges related to expanding access and strengthening service quality.
Participants included representatives of the Ministry of Health, the Republican Narcology Dispensary, civil society organizations, communities of people who use drugs, and service providers operating within the OAT framework.
Similar meetings are scheduled to take place in Georgia and Kazakhstan in Q3–Q4 2025

To support PrEP implementation and scale-up, an Excel-based QuantPrEP tool for needs estimation and costing was adapted from the existing PAHO tool. The tool enables estimation of total PrEP needs within a specific geographic area or service and forecasting of provision costs for key populations in subsequent years. Initial meetings have been conducted to introduce the tool and establish country-level teams comprising key stakeholders.

Online round tables with national counterparts and regional partners to discuss the current state of PrEP implementation and next steps, including ensuring access to long-acting injectable PrEP and needs for WHO technical assistance were held.

Jointly with WHO HQ, the regional office organized the regional webinar on integration of STIs into HIV PrEP services on 8 April 2025. During the webinar, an overview of the rationale for integrating STI and PrEP services was provided and best practices from the European region were highlighted. Practical WHO guidance to support implementing and improving integration of STI management and PrEP services was presented.

Modelling to identify where new HIV infections occur by looking at the new infections in different populations (multi-country project) is planned in 2026.

The study, including a comprehensive overview of access, coverage, and quality across the HIV prevention and care cascade for KPs in EECA, as well as gaps in national HIV programmes was finished. The publication in a journal is expected.

A draft protocol and data collection tool was developed for analyzing the HIV prevention, testing, and treatment cascade among key populations (KPs) in Eastern Europe and Central Asia (EECA) (as for 1 August 2025).

A technical assistance visit is planned for 2026.

The adaptation of the information campaign is planned for 2026.

EHRA developed a methodology for shadow reporting on the EU accession processes of Moldova, Georgia, and Ukraine through the lens of criminal drug law and policy. Between October and December, this methodology was applied to gather national data and produce two full analytical document sets for Georgia and Moldova. Building on this, policy briefs and publications based on civil society and community consultations will be issued in Q1 2026. To strengthen advocacy, EHRA presented the methodology at the EU Civil Society Forum on Drugs in Brussels, securing direct cooperation with the DG ENEST team responsible for drug policy in the EU accession process for the Western Balkans and Eastern Partnership countries, including their commitment to review civil‑society evidence in the reports. The methodology was also showcased at the international online conference “European integration processes and humanisation of drug policy: mutual experience of Ukraine and Moldova” on 17 December 2025.

EHRA produced the regional publication “Mapping Repression: Legal Trends Impacting Civil Society in Central and Eastern Europe and Central Asia” documenting the expansion of punitive “foreign agent” laws, drug propaganda bans, and anti‑LGBTQI+ legislation across 29 CEECA countries, and showing how these measures undermine human rights, public health, and civic freedoms.
On March 6, 2025, EHRA participated in the Panel Discussion on the Realization of Human Rights in Sustaining and Increasing the Gains Made in the HIV Response and Leaving No One Behind at the 58th session of the Human Rights Council. During CND68 in Vienna, EHRA and the Civil Society Forum on Drugs (CSFD) hosted the side event “Protecting Civil Society Space in Drug Policymaking: The European Experience” bringing together government officials, regional agencies, and civil society to discuss both good practices and emerging risks. At the Civil Society Hearing of the International Narcotics Control Board (INCB), EHRA delivered a statement emphasizing the essential role of civil society in international drug control and warning about legal and political trends threatening this cooperation in the CEECA region.
In December 2025, EHRA developed the Regional analytical report “Shrinking civic space and marginalized communities in Eastern Europe and Central Asia” .

On May 20, 2025, online presentation of the publication: HIV Service Package for Migrants and Refugees in the EECA region was held. The document in English and Russian is available at link.

On June 17, 2025, the meeting of the Regional Working Group (WG) on remote registration and treatment of migrants with HIV was held. Representatives from 6 EECA countries discussed the issues of remote registration of migrants with HIV and ways of delivering ARVs to them.

On December 18 on the International Migrants Day, REG held an online meeting, “Migrant Health Beyond Barriers: Human Stories and Pathways to Sustainable Community Health” focusing on improving access to healthcare services for key populations among migrants in host countries. The meeting brought together experts from NGOs and migrant programs, as well as representatives of international organizations and donor institutions supporting health and migration initiatives.

A panel discussion included presentations of specialists from Poland, Georgia, Moldova, and the UK. Speakers strongly emphasized that, in the current context, NGOs and community-led organizations are often the only link between vulnerable migrant and refugee groups and healthcare systems in host countries, while NGOs are increasingly facing existential threats due to prevailing political climates. The sustainability of these organizations is crucial for engaging clients in prevention, testing, and treatment services, as well as maintaining adherence.

The regional report is currently in preparation. The final regional report is planned for completion by the end of the first quarter of 2026.

On 10 December 2025, ECOM conducted a thematic webinar focusing on the protection of LGBT rights amid the ongoing shrinking of civic space across the region. The event aimed to highlight resilient advocacy approaches, share practical experiences, and strengthen the capacity of local initiatives. Participants received practical guidance on adapting advocacy strategies in restrictive environments, utilizing international mechanisms effectively, and building safer and more sustainable advocacy practices under challenging political conditions.

In 2025, ECOM prepared eight submissions to UN Human Rights Treaty Bodies, Special Procedures, and the OSCE, documenting systemic SOGIESC‑related human rights violations across project countries.
A key achievement was the project’s contribution to Kazakhstan’s review by the UN Human Rights Committee. A coordinated coalition submission helped secure five strong recommendations in the Committee’s September 2025 concluding observations, calling for: comprehensive anti‑discrimination legislation covering SOGI; protection from discrimination and violence; effective investigation and accountability for SOGI‑motivated hate crimes; non‑discriminatory registration and operation of civil society organizations, including LGBT groups; and removal of barriers to legal gender recognition for trans people.
Additional actions included coalition submissions to CESCR for Georgia and Tajikistan and to CEDAW for Kazakhstan, as well as contributing data on hate incidents against LGBT people to the OSCE.
Overall, the project strengthened visibility of SOGIESC‑related violations within international mechanisms and demonstrated the effectiveness of coordinated, community‑led advocacy in achieving concrete normative outcomes.

Progress has been achieved across key advocacy areas in four countries of the region: Georgia, Kazakhstan, Moldova, and Ukraine. Official submissions have been prepared and sent, meetings with communities and experts conducted, and changes to relevant documents initiated. Risks of discriminatory practices have been identified, along with proposed mechanisms to address them. A foundation has been established for further work with donors and pharmaceutical companies. The work of the ENPUD Expert Council on Treatment in 2025 demonstrated the effectiveness of coordinated efforts by consultants, communities, and partners, creating a sustainable basis for continued advocacy and resource mobilization.

Two key policies have been developed and prepared for voting by the ENPUD General Assembly: the Policy on Protection from Sexual Harassment and the Response Mechanisms Policy.
Based on the findings of the 2023–2024 Gender Assessment and within the framework of gender‑transformative education, the following priority topics were identified: misogyny—how to recognize and counter it; misogyny and repressive drug policy; sexual harassment and gender discrimination—creating a safe environment; protection of rights and response mechanisms grounded in zero‑tolerance values.
Experts from the ENPUD Feminist Council share their knowledge and experience.

The first part of the investment proposal for the ENPUD SafeDrive Mob App has been prepared: the purpose and application areas of the program have been defined, including its potential use both within state protocols and outside official certification. Online communication with the Trimbos Institute has been conducted, and preliminary agreement has been obtained regarding support for research on psychoactive substance levels in human blood; the process of coordinating a letter of support for ENPUD is underway. A logo concept and a prototype interface for the ENPUD SafeDrive Mob App, reflecting the values of the Community, have been developed.

During the first year of the project, a series of workshops were conducted covering key topics to inform and motivate organizations about Web3 and related solutions. The workshops addressed specific terminology, main principles such as data security and decentralization, included discussion of practical examples, and provided detailed instructions for organizations to transition to the new model.

In collaboration with partners, a toolkit was developed and adapted to the needs of civil society, which includes simple-language explanations of all essential issues, and sequentially describes the essence, process, and steps that organizations can follow to adapt innovative financing models.

The project team developed three strategic documents exploring the application of Web3 and AI tools to enhance health system sustainability, with a particular focus on HIV services.

• “Bridging Web3 and Web2” – Introduced a conceptual vision for linking decentralized Web3 technologies with existing digital health systems to improve transparency, trust, and data integration.
• “Web3 and AI-Enabled Transition Framework” – Outlined a phased roadmap for deploying smart contracts, predictive AI tools, and decentralized ID systems to strengthen HIV service delivery and crisis response.
• “Web3 Enhanced Sustainability” – Proposed models for decentralized health governance, blockchain-based accountability, and token-driven community engagement.

The onboarding process for the HelpSpace platform is currently underway. A waitlist of organizations is being prepared, identifying those that will be onboarded first based on their readiness and alignment with platform objectives.

Guidelines are being developed for these organizations to ensure their legal compliance and ability to participate in crypto fundraising. The consultations address the regulatory framework and legal requirements that organizations must meet to engage in cryptocurrency-based fundraising activities.

At the conducted workshops, interested parties met organizations and speakers who represent significant nodes. For civil society representatives, their expertise, field, and experience are crucial, both as individual specialists and due to their organizational affiliations. Organizations such as Giveth, Partisia Blockchain, and Crypto Altruists are important players in the Web3 ecosystem, from educational opportunities to fundraising capabilities.

At the initial stage, the project conducted a comprehensive analysis of the status and availability of mental health services within HIV and TB programmes for key populations.

This work resulted in the development of country-specific document entitled “Mental Health Integration for KP Population in HIV-TB Programs: Country-Specific Context Review and Recommendations”, which provided in-depth reviews of national context, identified key mental health challenges among HIV-TB affected populations, and formulated tailored, evidence-based recommendations for each country, alongside cross-cutting guiding principles applicable across all three settings.

Building on this evidence, the project actively advocated for the inclusion of mental health components in national HIV responses, engaging key stakeholders and directly contributing to the development and revision of national HIV programme frameworks.

SEH’s consultant was involved in the technical process supporting the preparation of the Global Fund funding request (signed December 2025), including participation in consultations and drafting discussions. The signed GF request includes mental health components, such as consultations by psychologists, social protection, and legal support, including services for those facing psychological violence, Art Therapy sessions.

The health systems sustainability framework, as well as the strategy for bridging HIV response measures with Web3, has been formulated. This strategy and framework were discussed at global level and have been presented at high-level meetings with WHO and other partners. Regional challenges and experiences, lessons learned from the pandemic, war, and political instability, create an evidence-based vision for future development and ensuring continuity of life-saving services.

Develop a unified AI supported continuity planning as a key instrument for strengthening health system resilience and recovery. - In Moldova, within the National HIV, STI, and Viral Hepatitis Program (2026–2030), crisis response plans were developed to ensure continuity of HIV services, information systems, and related processes during emergencies, with the integration of new technologies.

Policy recommendations on Health Service Continuity Planning are integrated into national health strategies.

SEH’s consultant supported the preparation of the Global Fund funding request through participation in national consultations and drafting discussions. The approved request strengthens health service continuity, resilience, and sustainability of the national HIV and TB response by promoting adaptive service delivery models, digital health solutions, and strengthened health information systems to ensure uninterrupted services during emergencies.

The DHIS2-based National HIV Prevention, Care and Support System was successfully adapted and launched in Georgia. The system was deployed with two implementing organizations and is now operational for routine service monitoring.

A total of 3,702 service entries for 2,785 clients have already been captured, demonstrating early uptake and functionality. Ongoing work focuses on system customization, user support, and gradual scale-up, including alignment with national reporting requirements and Global Fund indicators.

Efforts continued to build and strengthen a regional DHIS2 expert community to support sustainable system development and knowledge exchange across EECA countries.

This includes fostering collaboration between national implementers, providing technical guidance, and supporting peer-to-peer learning on DHIS2 configuration, maintenance, and data use. The initiative aims to gradually transition technical ownership to regional and national actors.

TWIIN digital assistant is being further improved and actively promoted and used in Ukraine (co-funding from Gilead, SIDA). New functionalities are being added that will highly improve the effectiveness of the other EECA country version that are to be developed and launched within the regional grant.

Progress was made on the localisation and adaptation of TWIIN for Moldova, Georgia, Kazakhstan, Tajikistan.

Terms of Reference (TORs) were developed to guide country-specific adaptation and development, and preparatory work had reached various levels across countries. This included technical adaptation, content localisation, and coordination with national stakeholders.

Public communication milestones, including announcements around World AIDS Day, marked the transition from planning to early testing for Tajikistan.

The Regional HIV data dashboard is being maintained and fundraising efforts will be put forth
to further develop and scale it up.

Organisations in Moldova, Georgia and Kazakhstan have been identified to collaborate on the adaptation and implementation of the NGO Management tool that will enhance the organisations’ internal decision-making processes and thus significantly improve performance. ToRs had been developed and the teams are fully prepared to start development.