In this crossover episode with AIDS' Existential Moment, recorded during the International AIDS Conference in Montreal, Canada, on July 31st, Jeff Sturchio speaks with Dr. Michel Kazatchkine, Professor of Medicine at the Universite Rene Descartes in Paris, Special Advisor to UNAIDS for Eastern Europe and Central Asia, and a Senior Fellow with the Global Health Centre of the Graduate Institute of International and Development Studies in Geneva. Professor Kazatachkine reviews the interactions of structural determinants of health, stigma and discrimination, and punitive laws that affect people living with HIV and at-risk populations throughout Eastern Europe and Central Asia. He also discusses the remarkable resilience of people in Ukraine in response to the Russian invasion and outlines the health impacts of reconstruction both in Ukraine and among migrant and refugee populations in surrounding countries. Professor Kazatchkine reminds us that health and human rights involve political choices – and also offer political opportunities. If we hope to achieve an end to AIDS as a public health problem by 2030, we need to work with key populations and communities to deliver solutions that they need. Finally, Jeff and Michel discuss the prospects for long-term financing of the HIV response. We need to think differently about how to sustain programs in a multipolar world, particularly to address the needs of middle-income countries. Professor Michel Kazatchkine has dedicated more than 30 years to fighting AIDS and promoting global health as a physician, research, advocate, policy maker, diplomat, and administrator. Among his many other roles, he has directed the French National Research Agency (ANRS), the world’s second largest AIDS research programs; served as France’s global ambassador for HIV/AID and transmissible diseases; led the Global Fund to Fight AIDS, TB, and Malaria; and served as the UN Secretary General’s Special Envoy on HIV/AIDS in Eastern Europe and Central Asia.