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In December 2004 we called for papers that would document the impact on population health and on health systems of the transition from communism in Europe and central Asia.w1 Over the past 18 months, a series of events has focused the eyes of the world on this region. May 2004 saw the historic enlargement of the European Union. In Georgia, Ukraine, and Kyrgyzstan, popular uprisings have led to the removal of autocratic regimes; in Uzbekistan, a similar uprising ended in tragedy. Yet, despite coming to the attention of the world's mass media, this vast region characterised by diversity and shared problems has generated surprisingly few publications on health and health care. We hope that this theme issue—most of it contributed by researchers and authors from the region—will fill some of these gaps and will further stimulate much needed monitoring, research, and debate. One of the key themes in this week's BMJ theme issue is the rising prevalence of HIV/AIDS in some countries of the region. For example, one paper focuses on Ukraine, which has the highest prevalence of HIV infection in Europe (estimated at 1.4% of the population) but lacks any systematic approach to prevention, treatment, or care.1 The authors report how information on the scale and nature of the problem is patchy and is not well known within Ukraine. An accompanying commentary emphasises the need for urgent international action to prevent a potential catastrophe.w2 Non-communicable diseases continue to dominate the overall burden of disease in the region.2 Yet some countries have seen marked reductions in mortality,3 and, although precise explanations for this remain a matter for discussion,w3 it is clear that much can be done to tackle the high toll from cardiovascular disease. As Marquez and Suhrcke note, however, continuing improvement will depend on much more evidence and better use of existing evidence4,5 to inform policy, as well as on the creation of systems to collect data regularly on risk factors for chronic disease.