This war has caused devastation across Ukraine, including to its health system. The violence has destroyed facilities, interrupted supply chains, and displaced millions of people, increasing the risk of disease and the exacerbation of common chronic conditions. It has also coincided with the early stages of a major health system reform in Ukraine, launched in 2017 and aimed at achieving Universal Health Coverage. Central to the reform was the establishment of a national strategic purchasing agency, the National Health Service of Ukraine, to make spending more efficient, and plans to define an explicit package of medical guarantees for all Ukrainians and to strengthen the role of primary health care (PHC) and the general physician (GP), supported by a new national eHealth system.

The health and economic impact of the war has created significant challenges to pursuing planned health reforms and to sustaining any progress that has been made in the reforms thus far. Despite these challenges, however, Ukraine has begun to look to the recovery of its health system and to set priorities for its continued modernization.  On February 3, LSHTM hosted a high-level panel of experts to discuss Ukraine’s health system recovery, to identify key recovery priorities, and identify ways in which the global health community can support these. The panel included Dr. Viktor Liashko, the Minister of Healthcare for Ukraine and Dr. Jarno Habicht, Head of the World Health Organization’s Ukraine Country Office, as well as other high-level experts. The panel was welcomed by Professor Kara Hanson, Dean of the Faculty of Public Health and Policy, who highlighted LSHTM’s support for Ukraine.

The panel highlighted the importance of continuing with recovery efforts despite the ongoing war. As is rare in conflict-affected settings, Ukraine has a legitimate, functioning government in place so the role of the international community should be to support the Ukrainian government as it works simultaneously on crisis response, and health system reform and recovery. They also emphasised the severe impact that the war has had on Ukraine’s recovery, and the difficulty this will create for the government to increase (or even maintain) pre-war levels of spending on health, and for the population to be able to afford out-of-pocket expenses for care or medicines. Aid funding from international partners will continue to be critical.

They identified the following priorities for health system recovery.

1. Ensuring access to health care and medicines free of charge.
2. Continued capacity-building of primary care level health workers with emphasis on screening and treatment cardiovascular disease, cancer, and mental disorders.
3. Expanding and promoting routine vaccination programmes.
4. Supporting digitalisation of health care records and other technological advancements in health care delivery.
5. Adapting health workforce and infrastructure to urgently address newly emerging health care priorities, including mental health, rehabilitation, and forensic science.

In all of these areas the panel welcomed support from the international global health research community in sharing evidence-based best practices. More information on the ongoing reform efforts and priorities going forward can be found here.