The report “Healthcare at War: The Impact of Russia’s full-scale Invasion on the Healthcare in Ukraine” is an attempt to assess the impact of Russia’s war on Ukraine’s healthcare system, including people’s health, pharmaceutical market and healthcare services delivery. 

“The Ukrainian healthcare system remained resilient despite devastating methods of warfare used by the Russians. At the same time, we have faced numerous challenges and risks that need to be addressed rapidly. The most alarming are demographic crisis, reduced affordability of medicines, and severely disrupted access to healthcare in the liberated and temporarily occupied territories — said Diana Rusnak, co-author of the report and UHC analyst.

Key findings:

Ukraine has faced an unprecedented migration crisis due to the full-scale Russian invasion. The estimated number of Ukraine’s population by the end of 2022 comprised only around 31.4 million people.

➤ The Government of Ukraine ensured sustainable and stable healthcare funding in 2022, mainly thanks to the steady support of international partners. Such financial and technical support is especially important considering the critical conditions of Ukraine’s economy and the dramatic drop in the GDP by 29.4% in 2022.

➤ The data indicates that Ukraine’s healthcare sector performance, both out- and in-patient specialized care, has been restored almost to its pre-war level by the end of 2022. At the same time, primary healthcare remains in a deep crisis and requires serious support.

➤ The pharmaceutical market has been experiencing a significant decrease since March 2022, and the recovery to the pre-war level was not observed until the very end of the year. Lack of financial resources emerged as a key barrier to purchase necessary medicines reported by many respondents in various surveys conducted in 2022. 

➤ Among the key factors that affected Ukraine’s epidemiological landscape and health system’s performance is physical destruction or damage to the healthcare infrastructure, a significant reduction in the active healthcare personnel, disruptions in the supply chain and data registration and reporting, and shift in the population migration towards central and western regions of Ukraine.

➤ Birth rates face an unprecedented slowdown, and the effects of it will likely persist in the long-run. Surprisingly, maternal and infant mortality in 2022 remained at the level of 2021, suggesting that even in harsh conditions, Ukraine’s healthcare system could provide high-quality services to the population in need. 

➤ Routine childhood vaccination coverage experienced a dramatic drop in 2022, with the most significant decrease for Hepatitis B, BCG (Tuberculosis), MMR (measles) and poliomyelitis vaccines. This is alarming, especially in light of the ongoing polio outbreak in Ukraine and a few measles cases reported in March 2023.

➤ Worsened by a sharp decrease in the remaining Ukrainian population, the number of strokes and myocardial infarctions increased significantly – even considering gaps in surveillance data in the regions at the fighting frontline – indicating a critically higher burden of these conditions. 

➤ TB and HIV surveillance were greatly affected, especially in temporarily occupied territories. TB and HIV programs have been disrupted, impeding access to the life-saving medicines. 

➤ Significant shifts occurred in the healthcare workforce, which shrank by almost 14% by the end of 2022. The exodus of medical professionals should be further investigated, considering multiple factors that could have affected it.

The report was prepared as part of the project implemented by the Agency for Legistative Initiatives and the Ukrainian Healthcare Center (UHC) with the support of the Public Health program of the International Renaissance Foundation.