Civil society organizations in Uzbekistan help deliver peer-to-peer outreach, HIV testing, awareness-raising and prevention. As external funding for HIV declines in the land-locked country in Central Asia, it now faces a critical task: ensuring that prevention and community-led services are sustained.

Community organizations provide support that is not always visible in the country. Over the years, their direct engagement with populations affected by HIV or at risk of HIV has shown that barriers to services exist.  Stigma, fear, limited awareness and existing policy constraints continue to prevent people from accessing testing, treatment and health care.

“Our added value lies in our grassroots experience,” said Sobir, a local representative of a community organization providing HIV services. “We know what the challenges are in the healthcare system and understand where the gaps are.”

He gave the example of self-testing kits. Despite being available online people still did not use them. “The government is working to expand access, but our role is to help ensure these services actually reach people and that they trust us.”

With an estimated 60,000 people living with HIV and a growing share of infections linked to sexual transmission, Uzbekistan ranks among the third highest epidemic in Eastern Europe and Central Asia.

Uzbekistan has made significant progress in expanding access to HIV testing and treatment and strengthening national ownership of its response. Most HIV treatment and diagnostic services are now financed through the state budget, and treatment is free and accessible to all people in need. But HIV prevention programmes and community outreach have so far relied heavily on external support, including from the Global Fund to Fight AIDS, Tuberculosis and Malaria. 

“Bridging this gap will be essential to maintaining progress and reducing new HIV infections,” said Eamonn Murphy, UNAIDS Regional Director for Eastern Europe and Central Asia and Asia-Pacific. “Treatment alone will not end the epidemic. Strengthening prevention, supporting community-led services and addressing stigma are critical.” 

In his view with sustained investment in community-led services, strong partnerships, and a long-term commitment to programme sustainability, the country could well become the first in Central Asia to reach the 95–95–95 targets. The Government’s decision to strengthen cooperation with the non-governmental sector and national and local level resources have been encouraging signs. 

“We actively work with the Republican AIDS Center, the Ministry of Health and social protection,” said Sergey Uchayev, Head of Ishonch va Hayot, the ‘'Union of People Living with HIV in Uzbekistan’ network.” They involve us in developing policies, strategies, and plans. There is growing interest at different levels in working with us,” he said. 

At the same time, he echoed concerns raised by many civil society organizations about the absence of a functioning mechanism that allows government institutions like his to contract HIV services from community-based organizations.

“State budget allocations for HIV services require defined standards, budgeting frameworks, financing mechanisms, and strong transparency and accountability systems,” he said. “Without this, available resources from state and local budgets cannot yet be effectively channeled to community-led HIV services.”

The time to act is now. “With many of the key elements already in place, and while donor funding is still available, we should not miss this opportunity,” he added.

Such systems are already in place in Moldova, as well as in Kazakhstan and Kyrgyzstan. He believes UNAIDS and partners can play a critical role in bringing stakeholders together and facilitating this process.

In Tashkent, mid-March 2026, the United Nations in Uzbekistan convened the first Joint UN–Government Steering Committee meeting on the new United Nations Sustainable Development Cooperation Framework (UNSDCF) 2026–2030. The meeting discussed priority areas for joint action, including the sustainability of the HIV response.

As Uzbekistan undergoes rapid social and economic transformation, the public health sector is no exception.

UNAIDS is deeply saddened by the passing of His Excellency Ratu Epeli Nailatikau, a steadfast champion of dignity, inclusion, and the HIV response across the Pacific.

“Ratu Epeli Nailatikau played an important role in shaping the HIV response in the Pacific. His efforts to address stigma and promote community-led approaches have left a lasting impact on the region’s journey toward ending AIDS.” – Winnie Byanyima, Executive Director of UNAIDS

As UNAIDS Goodwill Ambassador for the Pacific, and across his distinguished service as Speaker of Parliament and former President of Fiji, Ratu Epeli demonstrated a rare combination of leadership and humility, using his influence not for recognition, but in service of others, particularly the most vulnerable.

His commitment to HIV was deeply personal and unwavering. He stood publicly and consistently with communities affected by HIV, at a time when stigma and silence often prevailed. He used his voice to normalize open dialogue, challenge discrimination, and advocate for responses grounded in dignity and human rights.

Ratu Epeli’s contributions to the HIV response in Fiji and the Pacific were both visible and transformative. He played a pioneering role in convening regional leadership, including chairing a landmark meeting of Pacific Parliamentarians on HIV in 2004 in Fiji, helping to elevate political ownership of the response at an early stage. He championed legal and policy reforms that strengthened the enabling environment for HIV, including his leadership during the enactment of Fiji’s HIV/AIDS Act in 2011, which embedded a human rights-based approach to the national response. He also supported the removal of HIV-related travel restrictions, positioning Fiji as a leader in reducing discrimination and advancing equitable access to services.

Beyond policy, he was deeply engaged at the community level. He travelled across Fiji, including visiting schools, to speak directly with young people about HIV prevention, awareness, and responsibility, helping to shape a generation with greater understanding and openness. He also engaged directly with people living with HIV and key populations, lending his presence and voice to efforts aimed at breaking down stigma and strengthening community-led responses.

Ratu Epeli worked closely with UNAIDS over many years, not as a symbolic figure, but as an active and trusted partner. From global platforms, including addressing the United Nations High-Level Meeting on AIDS, to national and community engagements, he consistently called for bold action to end stigma and advance equitable access to prevention, treatment, and care.

He was more than an ambassador in title. He was a bridge between leadership and community, between policy and lived experience. His advocacy helped shape a more open, inclusive, and people-centred HIV response in Fiji and across the Pacific. Like the spirit of rugby he often invoked, he reminded us that ending AIDS requires teamwork, discipline, and collective responsibility, no one wins unless we move forward together.

UNAIDS extends its heartfelt condolences to his family, the people of Fiji, and communities across the Pacific whose lives he touched through his leadership and compassion.

His voice will be deeply missed, but his legacy will endure in the continued effort to end HIV and ensure that no one is left behind.

During the 2026 Carnival in Salvador de Bahia—one of the largest street festivals in Brazil, which gathered around 12 million people—UNAIDS, the Municipal Health Secretariat of Salvador, Bahia, and the non-governmental organization Motirô BA provided HIV information, testing and prevention services to its participants through the “Rolê da Prevenção” initiative.  

Rolê da Prevenção (which could be translated to English as Prevention Hangout) was carried out as a pilot in 2025 and following its success, it was incorporated by the city’s authorities as one of the 2026 official health activities of the Carnival. This represented a significant increase in the uptake of HIV testing and outreach. In total, 1.7 million male and female condoms were distributed and nearly 8,000 rapid HIV tests were performed—an increase of 68% compared to the same period previous year.  

According to Salvador’s Municipal Health Secretary, Rodrigo Alves, this initiative strengthens the city’s commitment to equity. “Rolê da Prevenção is an initiative that reaffirms our commitment to care, especially for the populations most vulnerable during Carnival. We are expanding access to testing, prevention supplies and quality information, bringing prevention closer to those who need it most. Our goal is to ensure that the celebration is also a space for care, protection and access to health services.” 

In 2025, UNAIDS conducted peer education trainings on combination HIV prevention, including capacity building on health equity and ways to respond to racism and LGBTphobia. This year, the same peer educators, financed by the local government through Motirô BA, offered rapid tests for HIV, syphilis, and hepatitis B and C along with qualified counselling and referrals for Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP). 

The outreach teams were composed of members of key populations—such as people from the LGBTQIA+ community and black communities—thereby strengthening connection, identification and trust with the public and increasing community engagement. 

All HIV prevention supplies (condoms, lubricants), diagnostic supplies (HIV testing and self-testing), and treatment supplies (care and specialized services) were provided free of charge to everyone by the Unified Health System (SUS), Brazil’s public health system. 

“The continuation of the Rolê da Prevenção initiative in 2026 reinforces the priorities of the Global AIDS Strategy 2026–2031, especially the request for national responses to meet people’s needs and to be inclusive and multisectoral,” said Andrea Boccardi Vidarte. “Being where people are is essential to effectively responding to HIV.”  

In the context of Salvador’s Carnival—internationally recognized for its scale and diversity—health, culture and rights move forward together, strengthening the local response to HIV and reaffirming that HIV prevention and celebration can and should go side by side.