Mildmay International Expands to Eastern Europe to Combat HIV Epidemic

In March 2011, Mildmay International Chief Executive Fi McLachlan travelled to Eastern Europe, where HIV rates were escalating, to lay the groundwork for scaling up the charity’s operations and advancing a more integrated regional HIV response.

Fi visited Estonia and Ukraine, where Mildmay had previously worked and was seeking to return with new programmes aligned with “One Step Beyond,” the strategic plan for 2011–2014. “We have already trained doctors and nurses in Ukraine, as well as drug rehabilitation workers across the region, significant given the number of people with drug problems who are also HIV‑positive,” Fi said.

“With any new programmes, we needed to integrate closely with what hospitals could provide and what the community could offer. I firmly believed there was both need and opportunity for Mildmay to scale up in Eastern Europe and contribute to tackling the epidemic, which was really quite rampant in countries like Ukraine. We had something distinct to offer.”

Mildmay’s business development and resource mobilisation team had two active bids with major institutional donors to fund programmes in Eastern Europe, with further calls for proposals under consideration. If successful, Mildmay planned to recruit a region‑based programme manager and establish an office.

“The purpose of my trip was to build on existing relationships and develop new ones with potential partner agencies—to listen and to learn,” Fi explained. During the visit, she chaired a workshop with Ukrainian HIV agency staff in Kharkiv (Kharkov).

“The HIV response in Eastern Europe was patchy; only around 10 per cent of people who needed antiretroviral treatment in Ukraine received it. Stigma and discrimination remained significant barriers: people didn’t feel confident testing for HIV, and it was difficult to be open about status when reactions could be scathing and dismissive.”

“But there was a will. People recognised HIV was a major issue, especially in some communities. In depressed areas, drug use was high, and intravenous drug use had been a major route of HIV transmission. There was a huge need for training, education and awareness—and for strong linkage to community‑based care.”

Fi described Eastern Europe as “an HIV landscape that is constantly shifting,” and addressed a key question: “You might ask, ‘Why was Mildmay going there?’ There were certainly easier places to work. The reason was a growing epidemic, with too few agencies willing to engage, set up, recruit, and make a distinct contribution. We were prepared to do that.”

Drawing on more than two decades of HIV care, treatment, training and rehabilitation in the UK and Africa, she emphasised the transferability of Mildmay’s experience: “Our work as an independent organisation in partnership with ministries of health would be invaluable as we began similar work in Eastern Europe.”

“During my trip I felt particularly challenged by vulnerable groups: children, commercial sex workers, and people using drugs because life felt hopeless. We could either shirk responsibility or answer our call, as a faith‑based organisation, to reach out, step into that gap, and grapple with difficult issues. We wanted people to get quality HIV services. Our hope was to launch programmes that would make a real difference.”