Podcast Summary: Special Episode – What Will It Take to Reverse HIV in Eastern Europe and Central Asia?

Podcast: This Week in Global Development
Date: March 23, 2026
Host: Kate Oren (Devex)
Guest: Dennis Denisenko (Eastern Europe and Central Asia Portfolio Lead at Elton John AIDS Foundation, Radian Partnership)
Sponsor: Gilead Sciences

Main Theme

This special episode explores the growing HIV epidemic in Eastern Europe and Central Asia (EECA)—the only global region where AIDS-related deaths have risen since 2010. Host Kate Oren and guest Dennis Denisenko examine the unique challenges facing the region, such as stigma, legal barriers, underinvestment, and the major impact of the war in Ukraine. The discussion centers on how the Radian partnership (Elton John AIDS Foundation + Gilead Sciences) is driving community-led, innovative solutions, and highlights what it will take for the international community to reverse these worrying trends.

Key Discussion Points & Insights

1. The Crisis in Numbers and Context

• HIV epidemic uniquely worsening in EECA: Over 2.1 million people living with HIV; ~28% unaware of their status; about 50% of HIV-positive individuals not receiving treatment ([00:09]–[02:16]).
• The only global region with rising AIDS-related deaths since 2010.
• The war in Ukraine has created large-scale displacement, putting extra pressure on already-strained health systems.

2. Why Is EECA Different?

• Barriers beyond biology:
  • High stigma and discrimination prevent access to testing and treatment.
  • Restrictive laws limit outreach and innovation.
  • Mass displacement (especially post-Ukraine war) disrupts care delivery and continuity ([02:55]).
• Quote:
  “Many people cannot have access to the testing and treatment because of stigma, because of discrimination… the war and a lot of displacement—Ukrainians first of all.”
  — Dennis Denisenko ([02:55])

3. The Radian Approach: What’s Different?

• Community-Led Focus:

  • Prioritize needs as defined by key affected communities themselves.
  • Build trust between donors, local groups, and vulnerable populations ([03:56]).

• Innovation Mechanism:

  • Support for creative, locally-driven solutions, e.g., digital health tools, new models of care, peer-to-peer education.

• Scaling What Works:

  • Pilot locally, then scale up successful approaches regionally.

• Quote:
  “We try to—hear the voice of the community, try to understand their needs, not just provide some solutions, but also asking them what they need. And it builds the trust between donors and community-led organizations…”
  — Denisenko ([03:56])

4. Impact of the Ukraine War: Service Disruptions and Adaptation

• Refugees face language barriers, healthcare system mismatches, and disorientation in new countries ([05:26]).

• Radian supports navigation projects for refugees across Poland, Moldova, Germany:

  • Local groups help victims navigate country-specific systems and access care.
  • Peer-to-peer outreach (in clubs, camps).
  • Mobile/testing clinics and digital apps in refugees' languages ([05:26]–[07:03]).

• Advocacy within camps for treatment access; software for orientation and translation.

• Quote:
  “Sometimes in some projects they provide some software solution so you could download the apps and quickly orient on your own language in the local healthcare system.”
  — Denisenko ([06:29])

5. Concrete Adaptations During the War

• Initial chaos with destruction of clinics/ARV stocks and massive internal displacement ([08:24]).

• Pre-existing networks (built with Radian) allowed rapid response:

  • Deployment of mobile clinics/testing
  • Emergency shelters and flexible service delivery ([08:24]–[09:44]).

• Quote:
  “Lots of ARV therapy spots [were] shelled and damaged… but [because of] a strong network of organizations… they flexible[ly] change the approach. They provide mobile clinic, mobile testing, they provide a lots of shelters for the people.”
  — Denisenko ([08:24])

6. Lessons for HIV Response—Applicable Beyond EECA?

• Trust is central: Listening to, respecting, and resourcing community-led organizations ensures effective reach ([10:27]).

• Localized, flexible service delivery: Mobile units, digital tools, navigation support, partnerships across borders/organizations.

• The importance of donor collaboration with local networks, as opposed to top-down approaches.

• Quote:
  “We really need to rely on community-led organizations. That’s actually the difference with other donors—that we try to hear the voice of community and build this trust.”
  — Denisenko ([10:27])

7. The Radian Funding Pillars and Innovations

• Three-pronged funding approach:

  1. Innovation Fund: Seed new approaches/technologies (e.g., AI for patient engagement, language-access apps).
     • Example: Kazakhstan project using AI to monitor patients’ emotional state, alerting social workers to prevent treatment interruption.
  2. Success Replication Fund: Scale and adapt proven models (e.g., “index testing” model piloted in Almaty, Kazakhstan and replicated in Romania).
  3. Equity Challenge Fund: Tackle core barriers—structural, legal, stigma—via targeted projects ([12:14]).

• Quote:
  “This application helps doctors and social workers make a strong connection between their patients—by video, by artificial assistance… [the] system could check your emotional status and prevent you from interrupting the treatment.”
  — Denisenko ([13:46])

8. Message for the Global Health Community

• Urgency and Inclusion:

  • EECA must not be left behind—ending HIV globally is impossible without it.
  • International donors must invest for the long-term, focusing on community leadership and locally-driven innovations.
  • Partnerships, patience, and flexibility are essential ([15:37]).

• Quote:
  “We cannot end the global HIV epidemic while leaving Eastern Europe and Central Asia behind. So closing that gap will require long-term commitments, long-term solutions, stronger partnership with the communities, and the investment in solutions that come from within the region.”
  — Denisenko ([15:37])

9. Reason for Hope

• Resilience of Local Communities:

  • Despite war, stigma, and funding challenges, grassroots organizations persevere and innovate.
  • Witnessing this resilience firsthand is a source of optimism ([16:30]).

• Quote:
  “What gives me hope... is their resilience. They so resist all these challenges. And it gives me a hope each time when I visited our partners.”
  — Denisenko ([16:30])

Notable Quotes and Memorable Moments

• “We try to hear the voice of community, try to understand their needs… that’s the main difference.”
  — Denisenko ([03:56])
• “Sometimes in some projects they provide some software solution so you could download the apps and quickly orient on your own language in the local healthcare system.”
  — Denisenko ([06:29])
• “Lots of ARV therapy spots [were] shelled and damaged… but [because of] a strong network of organizations… they flexible[ly] change the approach.”
  — Denisenko ([08:24])
• “We cannot end the global HIV epidemic while leaving Eastern Europe and Central Asia behind.”
  — Denisenko ([15:37])
• “What gives me hope... is their resilience.”
  — Denisenko ([16:30])

Timestamps for Key Segments

• 00:09 — Setting the stage: HIV epidemic in EECA, vital statistics.
• 02:55 — Discussion of unique barriers and drivers of HIV rise in the region.
• 03:56 — What sets Radian’s approach apart.
• 05:26 — Specific challenges of displacement, language, and access for refugees.
• 08:24 — Organizational adaptation amidst the Ukraine war.
• 10:27 — Effective approaches: Trust, local leadership, flexibility.
• 12:14 — Deep dive into Radian’s funding structure and innovation pipeline.
• 15:37 — Urgent message for international donors and policymakers.
• 16:30 — Closing reflection on hope and resilience.

Conclusion

This episode underlines that reversing the HIV epidemic in Eastern Europe and Central Asia demands more than medical solutions: it requires locally-driven, community-led innovation, flexible support amid crisis, and a sustained commitment from the global health community. The war in Ukraine compounds existing vulnerabilities, but with resilient local actors and scalable models, there is hope for change—if the global community pays attention and invests accordingly.