For more than eight years, Moscow, Russia was my home.

As cliche as it is, I learned more about myself in that time than I ever thought possible, met amazing people along the way, and discovered a place that had been mythological in my post-Cold War imagination. As a child of the ’80s, Russians were ‘the enemy’. At moments during my stay there, they took on that persona to a tee. However, that was the exception, and I loved my life in Moscow and wouldn’t trade any of the time I spent there. So many individuals welcomed me as the ‘silly American’, and I miss the daily interaction with them despite the difficulties inherent in contemporary Russian life.

Perhaps that’s why it pains me to hear of how little things have changed in the five years since I left. Russia has the dubious distinction of being one of the few remaining countries in which the HIV epidemic continues to expand. What’s more, it has occupied one of the worst of all statistics as the country with the fastest growing epidemic in the history of the global pandemic. That is not an accolade any country should aspire to and most governments would take action to remedy it quickly.

That hasn’t been the case in Russia. In fact, the opposite holds true.

Primarily fueled by the sharing of unclean injecting equipment and compounded by one of worst tuberculosis epidemics in the world, the Ministry of Health has maintained its hostility towards ‘Western’ or ‘foreign’ evidence-based practices and prevention methods which could save a generation of young Russians and prevent the further spread of HIV. Many small-scale local-level projects were funded not by domestic sources by but international agencies such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Distributing clean paraphernalia and informational materials on safer sex and drug use, providing counseling and social support services to those who had no where else to turn, and delivering training seminars to local-level healthcare professionals to introduce international experiences and human rights-based approaches have helped immensely. Yet, as obvious as it might be, Russia is huge and reaching every corner without governmental support is impossible. Furthermore, as the funding from international sources has dried up, many of those local-level initiatives have had to close and left a gaping hole for those least accepted and cared for in Russian society.

It’s quite simply heartbreaking.

Much of our news in the West focuses on the Russian elections. However, there are many other unheard stories, both of unimaginable determination and heroism, as well as of tragedy and despair. The Andrey Rylkov Foundation has made it their mission to work towards a humane and just approach to drug use and fight for the rights of those who most need it, and listen to and respond to those most ignored. Engaging with drug users, they provide harm reduction services in and around Moscow. They also work to highlight the extreme positions of the Russian government towards drug treatment and harm reduction strategies which have been proven to help prevent HIV. Spend 20 minutes from your day and watch this video about what they do and why.

Is there hope? There must be. Is failure an option? Not really. Life in Russia is not easy. But, working with individuals who are considered social outcasts, undesirable, and many perceive the best solution is to simply ‘let them die’ is unimaginably difficult. But, it’s well-worth the struggle if it improves the conditions for even a few individuals at a time.

So, as insignificant as it may be, I just want to thank Anya and all those who continue to do this type of work. Keep fighting the good fight!