UKRAINE: People with chronic diseases face massive challenges in accessing healthcare, according to new WHO survey

One in three households home to at least one person with a chronic condition is unable to secure medication and care.

At the two-month mark of the war in Ukraine, a new WHO survey illustrates the devastating impact of the humanitarian emergency on the health and wellbeing of millions of civilians, and the severe challenges facing the Ukrainian health system. Preliminary results from an ongoing nationwide health needs assessment conducted in partnership with Premise, finds that of the 1,000 households who have responded so far, one in three (30%) that have at least one person with a chronic disease have reported challenges in accessing care for those conditions. The survey also shows that two out of five households (39%) have at least one member with a chronic illness, such as cardiovascular disease, diabetes or cancer. 

Less than a third (30%) of respondents sought out healthcare services recently, and of those, two out of five (39%) cited the security situation as the main reason, while 27% reported no healthcare services were available at all in their area. 

Most households (70%) surveyed are sheltering in their own homes at this time, while one in ten (11%) are staying with friends and family members in relatively safer areas, 8% are on the move within Ukraine and 3% are in a shelter or camp for internally displaced people. 

“Two months into the war, our findings show the urgent need for continued health systems support in Ukraine,” said Dr Jarno Habicht, WHO Representative and Head of the WHO Country Office in Ukraine. “Through our long-standing engagement with the Ministry of Health, national health institutions and our many partners and donors, WHO has been able to reach nearly 7.5 million people over the past eight weeks with life-saving supplies, equipment and medicines. But we are still unable to reach some of the hardest-hit areas in the east where the health system has all but collapsed. We have received reports for instance that nearly all health facilities and hospitals in Luhansk oblast are either damaged or destroyed, and the situation is critical in several others. It is vital that we gain access so we can assess the health needs and move vital supplies into affected areas, including Mariupol. Civilians have a right to health, even in times of war” 

Ukraine’s health system is facing multiple challenges, with the situation growing more dire by the day. The risk of infectious diseases, and increasingly water-borne diseases, is significant, and routine immunization including COVID-19 vaccination is greatly diminished because of the war. Access to reproductive, maternal and antenatal care, as well as mental health care, is severely impacted due to security concerns, restricted mobility, broken supply chains and mass displacement. And healthcare continues to come under attack, with more than 160 verified incidents since 24 February. 

“As the UN’s health agency, WHO is in a unique position to engage in dialogue with all parties to press for, and secure, safe passage for critical health and medical supplies nationwide,” explained Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “Through our Regional and Country Offices, we are constantly in touch with Health Minister Viktor Liashko and Ukrainian health authorities, collectively strategizing to ensure as best we can that health care providers and facilities can continue to function.” 

Working closely with partners on the ground and through the generosity of a range of donors and funders, WHO has to date managed to deliver specialized medical and emergency supplies, deployed medical teams in hard-to-reach areas, and helped minimize disruptions to critical services, including treatment of conditions like HIV, tuberculosis and diabetes, as well as routine immunization and mental health support. 

Together with a range of partners, in the past two months WHO has: 

• Verified 162 attacks on healthcare (as of 21 April). 
• Delivered 300 metric tonnes of emergency and medical supplies and equipment to Ukraine, of which 142 metric tonnes have reached their intended destinations, mostly in the east, south and north of the country where the need is greatest. 
• Delivered enough trauma and emergency supplies to conduct up to 207,000 surgeries. 
• Delivered enough medicines and healthcare equipment to serve 7.45 million people. 
• Delivered 15 diesel generators to meet the energy needs of hospitals and health facilities. 
• Delivered 130,000 COVID-19 rapid antigen tests. WHO had prepositioned many more prior to the outbreak of war. 
• Delivered 1,000 vials of Tocilizumab, to treat severe and life-threatening cases of COVID-19 
• Ordered 20 ambulances to hand over to the Ministry of Health – due to be delivered in the next week. 
• Through the Ukraine Health Cluster, convened 97 international and local partners with health-related activities in 24 oblasts. 
• Delivered trauma and emergency medical supplies to the following oblasts: Kyiv, Cherkasy, Dnipropetrovsk, Zhytomyr, Chernihiv, Sumy, Kharkiv, Poltava, Luhansk, Donetsk, Kherson, Odesa and Zaporizhzhia. 
• Supported or coordinated more than 50 Emergency Medical Teams (EMT) in Ukraine and refugee-hosting countries, for example with direct surgical support and mobile primary healthcare. 
• Run bi-weekly training sessions attended by thousands of Ukrainian healthcare providers on how to handle mass casualties. Topics have included hospital blood transfusions in conflict settings, traumatic limb injuries, emergency nursing care, and essential burns care. 
• Provided support to the Ukrainian Ministry of Health’s Public Health Centre to estimate the antiretroviral needs in Ukraine. The United States President’s Emergency Plan for AIDS Relief (PEPFAR) has funded and, working with partners on the ground, is delivering enough antiretrovirals to treat people living with HIV in Ukraine for up to 12 months. 
• Established three health hubs in western Ukraine to support medical evacuations, and ensured safe medical evacuation of patients, including those suffering from cancer, for treatment outside Ukraine. 
• Put in place contingency plans for medical oxygen given the disruptions to supply that are occurring. 

As of 21 April, WHO has received $26.3 million (58%) against its appeal for $45 million covering the three months from March to May. A further $18 million has been pledged. These funds will enable WHO to reach six million people with healthcare assistance. 

“WHO is grateful to all the governments, individuals, corporations, and organizations contributing to our Ukraine Appeal. We would like to thank Canada, Ireland, Japan, Norway, Switzerland, Novo Nordisk Foundation, European Civil Protection and Humanitarian Aid Operations, Asia-Europe Foundation, and the UN Central Emergency Response Fund for their timely contributions,” said Dr Habicht. “Flexible funding remains critical to enable WHO to deliver urgent life-saving assistance where it’s most needed.” 

According to the UN, more than 12 million people have been forcibly displaced by the Russian invasion: 7.1 million people displaced within Ukraine and more than 5 million refugees outside Ukraine. Another 2.9 million are considering leaving their homes due to the war. 

“Addressing the health impacts of the war in Ukraine and the surrounding countries remains my highest priority,” said Dr Kluge. “During, my recent visit to Ukraine on World Health Day, I was deeply impressed by the resilience of the health workers I met, who are going over and above the call of duty to treat patients and serve their communities, despite the difficult circumstances. I complimented as well the Ministry of Health for their efforts. WHO/Europe is committed to supporting Ukraine now and in the future. As we respond to the immediate humanitarian needs, we must also plan for reconstruction and rehabilitation in parallel. The challenges are formidable, but WHO will work with national authorities and partners every step of the way, striving to achieve health and wellbeing for all.”