The Unfinished Fight: HIV Resurgence in Eastern Europe Defies Global Trend

LUBLIN, Poland – December 01, 2025 – As the world marks World AIDS Day, a stark and troubling paradox is coming into sharp focus: while global progress against HIV continues, a devastating resurgence is taking hold in Europe’s eastern corridor. Organizations on the front lines, like the AIDS Healthcare Foundation (AHF) in Poland, are sounding the alarm that the fight is far from over, with 1.3 million new infections still occurring globally each year. The data reveals a story not of universal success, but of a deeply fractured response, where geography, politics, and market economics dictate who lives and who dies.

While global AIDS-related deaths have fallen by more than half since 2010, the trend in Eastern Europe and Central Asia (EECA) is moving in the opposite direction. This region stands alone as the only one globally where the epidemic is still growing, a sobering reality that challenges the narrative of a world on the verge of conquering HIV.

A Tale of Two Continents: Europe's Deepening Divide

The statistical chasm between Western Europe and its eastern neighbors is widening into a public health crisis. Recent data from UNAIDS and the World Health Organization paints a grim picture. Since 2010, AIDS-related fatalities in the EECA region have surged by a staggering 48%, even as global deaths have been cut by 54% from their peak. This alarming divergence underscores a systemic failure that demands urgent attention.

“Europe is at risk of losing ground in the fight against HIV,” warned Daniel Reijer, AHF Europe Bureau Chief, in a statement. “While Western Europe has made steady progress, in Eastern Europe and Central Asia, the epidemic continues to grow. We need renewed political will and stronger health systems that prioritize testing, prevention, and care.”

The failure is not abstract; it is measured in missed targets and human lives. The global 95-95-95 targets—aiming for 95% of people with HIV diagnosed, 95% of them on treatment, and 95% of those on treatment virally suppressed—remain a distant dream for much of the EECA region. In 2024, only about 51% of the 2.1 million people living with HIV in the region were receiving the antiretroviral therapy that could save their lives and prevent transmission. This treatment gap is a primary driver of the region's rising death toll. Compounding the problem is the prevalence of late diagnoses, with over half of all new HIV cases in the broader WHO European Region being identified too late for optimal treatment outcomes.

The Anatomy of a Regional Crisis

The roots of the EECA region's HIV crisis are a complex web of social stigma, punitive laws, and underfunded healthcare infrastructure. Unlike in other parts of the world where public health strategies have evolved, many EECA countries have been slow to adopt evidence-based approaches, particularly for key populations. Criminalization of sex work, drug use, and same-sex relationships creates insurmountable barriers, driving the epidemic underground and away from the reach of healthcare providers.

This legal and social hostility means that people who inject drugs, sex workers, and men who have sex with men—groups disproportionately affected by HIV—are often too afraid to seek testing or treatment. Unsafe drug injecting practices remain a significant factor, accounting for over a quarter of new infections in the region.

“The lack of universal health education, including sexual health, and the exclusion of disadvantaged groups—such as migrants or people experiencing addiction crises—from prevention, testing, and treatment efforts is a direct path to disaster,” adds Anna Szadkowska-Ciężka, Country Program Manager for AHF Poland. “Public health requires thoughtful strategies that tailor actions to the needs of specific social groups.”

Poland itself has seen a dramatic spike in HIV cases, with new diagnoses in 2023 surpassing the previous year's record high. While partially attributed to the influx of migrants from Ukraine, which has a more severe epidemic, the trend highlights existing vulnerabilities and the critical need for inclusive, cross-border public health strategies. The situation is exacerbated by a regional funding gap for HIV services, estimated at 54% of what is needed to meet 2025 targets, leaving community organizations and health systems struggling to cope.

Innovation's Bottleneck: The High Price of Prevention

Even as scientific innovation promises a potential "HIV prevention revolution," economic realities are creating a formidable bottleneck. Groundbreaking tools like long-acting injectables, such as lenacapavir which requires only a twice-yearly dose, have the potential to transform prevention. However, their high price tags place them far out of reach for the countries and populations that need them most.

This issue of access has led to sharp criticism of "pharma greed" from advocacy groups like AHF. They argue that pharmaceutical companies are prioritizing profits over people, effectively locking away life-saving innovations behind a paywall. The argument is simple: innovation is meaningless if it is not accessible. This dynamic is not new; it echoes the decades-long fight for affordable antiretroviral treatments, a battle that organizations like Médecins Sans Frontières have long waged.

The problem extends to existing prevention methods. Pre-exposure prophylaxis, or PrEP, a highly effective daily pill to prevent HIV, remains underutilized across Europe. Despite its proven efficacy, only 38 of 52 countries in Europe and Central Asia have national PrEP guidelines, and implementation is inconsistent. In 2024, the region fell significantly short of its goal for PrEP users, demonstrating that even when a tool is available and affordable, systemic barriers and lack of political commitment can cripple its impact.

The Frontline Response: Community and Advocacy in Action

In the face of these systemic challenges, the role of non-governmental and community-led organizations has become more critical than ever. Groups like AIDS Healthcare Foundation operate on the front lines, working to bridge the gaps left by governments and the market. By providing direct medical care, free testing, and relentless advocacy, these organizations reach marginalized communities that are often invisible to or actively excluded from official health systems.

AHF Poland's focus on tailoring services for the hardest-to-reach populations—including migrants, the homeless, and people with addictions—exemplifies the kind of targeted, grassroots response needed to turn the tide. This community-based model builds trust and dismantles barriers in a way that large, impersonal health systems often cannot. They create safe spaces where individuals can access stigma-free care, education, and support.

The persistence of the HIV epidemic, especially its resurgence in developed parts of the world, serves as a powerful reminder that medical breakthroughs alone are not enough. Ending AIDS requires a multi-pronged assault that combines scientific innovation with social justice, political will with corporate responsibility, and top-down policy with bottom-up community action. As advocates stress on this World AIDS Day, the fight is not over, and complacency is the greatest threat to the progress that has been made. The health of our most vulnerable populations and the integrity of our global public health commitments depend on reigniting the urgency that characterized the early days of the epidemic.