When the Russian Federation annexed the former Ukrainian Crimean peninsula in March, one of its first reforms targeted drug laws. It abolished a system of Opioid Substitution Therapy and needle-exchange services that supported 806 people. These had been helping prevent HIV levels from increasing among injecting drug users. As 1 December marks World AIDS Day, NGOs in the region are warning that infections will now rise.

Twenty people have already died as a result of the changes. The International HIV/AIDS Alliance in Ukraine temporarily moved 60 patients into Ukrainian-held territory to protect them from a sudden harmful termination in treatment. But it has since lost contact with many other service users as Russia’s hold tightens.