OVERVIEW
USAID/Ukraine’s health sector partnerships work to strengthen Ukraine’s health systems; combat infectious diseases such as tuberculosis and HIV/AIDS; address vaccine-preventable diseases; and expand access to mental health, psycho-social, and rehabilitation services. In 2020-2021, USAID also expanded programming to support COVID-19 response and vaccination efforts in the health sector - part of cross-sectoral support from the U.S. Government to address the health, social and economic consequences of COVID in Ukraine since the pandemic began.
Since the onset of Russia’s unprovoked invasion in February 2022, USAID has committed supplemental funds to respond to the health-related impacts of the war, and support the restoration of services, more than doubling our annual support to Ukraine’s health sector to more than $100 million. Throughout the war, USAID has continued to partner with the Government of Ukraine (GOU) to address gaps in essential health services, and build the resilience of health systems and institutions to continue serving the Ukrainian people in the wake of Russia’s invasion.
OBJECTIVES
USAID’s long standing health partnership is helping Ukraine to build a health system that is transparent, efficient, free from corruption, and responsive to the needs of the Ukrainian people. Programs aim to strengthen and rebuild the country’s capacity to respond to high burdens of HIV/AIDS, viral hepatitis C (HCV) co-infection, and multi-drug resistant tuberculosis (MDR-TB); strengthen health security and readiness to address public health threats, including by closing gaps in immunization coverage; advance health reforms to improve efficiency and ensure that more Ukrainians have access to high-quality and affordable health care; and expand access to mental health and rehabilitation services. These objectives remain central to supporting an efficient and effective response to the health impacts of the war.
OUR PROGRAMS
I. COMBATING INFECTIOUS DISEASES AND IMPROVING HEALTH SECURITY
HIV/AIDS: With funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), USAID partners with the Ministry of Health of Ukraine, local government, healthcare facilities, and civil society organizations to eliminate HIV/AIDS as a public health threat. USAID assistance improves HIV service quality, ensures that more Ukrainians know their HIV status, links people living with HIV/AIDS to treatment and care, retains people on treatment, and reduces stigma and discrimination. Since the invasion, USAID has supported facilities and communities in protecting and sustaining services for people living with HIV, and expanded outreach services to reach internally displaced populations, continue HIV case identification, and sustain access to antiretroviral treatment (ART) through activities such as home delivery of antiretroviral medication (ARVs) and providing counseling and adherence support. Following Russia’s full-scale invasion, USAID supported the procurement and delivery of more than 53 million doses, or a year-long supply, of PEPFAR-funded ARVs to ensure that 150,000 PLHIV could remain engaged in treatment.
TUBERCULOSIS: USAID supports Ukraine’s TB control program to mitigate the TB epidemic in Ukraine through early detection, appropriate care, and prevention for people living with TB, drug-resistant tuberculosis (DR-TB) and TB/HIV. Amid Russia’s full-scale invasion, USAID has supported the continuity of treatment in 17 oblasts, helping sustain services and restore services disrupted by the war. USAID collaborates with the MOH Center for Public Health (CPH) to expand the integration of TB services into primary healthcare, while assisting central level authorities in maintaining continuity of TB diagnostics, treatment and support. With large numbers of Ukrainians displaced, USAID is helping to track and support TB patients to continue and complete treatment, providing social, medical and nutritional support to patients in need. USAID is also supporting logistics for essential TB medicines and diagnostics to ensure access to care.
HEALTH SECURITY: USAID is supporting Ukraine’s public health system at the national and regional levels to improve Ukraine’s ability to prevent, detect and respond to public health threats. USAID is helping to strengthen and sustain disease surveillance through support to Ukraine’s laboratory system, including for early detection of outbreaks through active case-finding and wastewater surveillance (a low-cost and non-invasive tool for the detection of infectious disease pathogens). In 2022, USAID donated a mobile laboratory to the MOH to strengthen the identification, diagnosis, and treatment of infectious diseases during the war. USAID supports COVID-19 response capacity by strengthening clinical case management and infection prevention, and supporting oxygen supplies at hospitals. USAID is also supporting Ukraine to implement critical public health reforms to better align with European Union requirements, and building the capacity of newly established Oblast Centers for Disease Control in emergency preparedness & response. To expand coverage of COVID-19 vaccination, USAID is supporting supply chain and logistics for vaccines, training health workers, and supporting demand generation and communications.
IMMUNIZATION: Prior to the COVID-19 pandemic, routine immunization coverage was improving in Ukraine after several years of significant gaps related heavily to vaccine hesitancy. The pandemic led to new challenges in reaching full vaccination coverage, and Russia’s full-scale invasion of Ukraine has made routine vaccinations far more difficult. In partnership with UNICEF, the World Health Organization and CDC, USAID continues supporting vaccination efforts by combating misinformation about vaccines, building vaccine confidence, developing technical capacity of health providers, and supporting the MOH in building strong procurement and supply chain systems. USAID is supporting COVID-19 vaccination mobile teams in targeted oblasts to increase COVID-19 vaccination coverage, promote seasonal flu vaccination, and develop guidelines for pharmacists on vaccine administration and vaccine supply chain management. USAID is also investing in both refinements to the national UkrVac data system to improve data on vaccination coverage, and national cold chain capacity to safely store routine vaccines. In addition, vaccine education for IDPs has been prioritized as evidence has shown that during times of conflict, poor awareness, low disease risk perceptions, and distrust all impact vaccine uptake amongst these populations.
II. SOCIAL SERVICES
MENTAL HEALTH: Across USAID/Ukraine and the Bureau for Humanitarian Assistance combined, USAID has committed nearly $36 million in support for mental health and psychosocial support (MHPSS) since the start of Russia’s full-scale invasion. USAID is working with the MOH and the First Lady’s Office to broaden access to community-based, non-medicalized mental health services for victims of the war. This includes adults and children, IDPs, victims of sexual violence, veterans and members of their families by expanding the availability of evidence-based of mental health services - such as the Common Elements Treatment Approach (CETA), a non-medicalized model introduced by USAID support in 2015 to address mental health conditions among veterans and their families. USAID also supports the Mental Health Gap Action Programme in partnership with WHO, which builds the capacity of the primary healthcare system to manage and link people to mental health services. USAID assistance supports the First Lady of Ukraine’s National Mental Health Initiative, which aims to reach 18 million Ukrainians with MPHSS services.
PHYSICAL REHABILITATION: USAID collaborates with the MOH, Ministry of Social Policy, WHO, and targeted health care facilities to expand access to physical rehabilitation services and assistive technologies for people with disabilities, including those with war injuries. In response to the rapid increase in needs for physical rehabilitation services related to war injuries, USAID adapted ongoing activities active since 2015 to include rehabilitation needs related to acute burns, amputations and trauma care. USAID support in 2022 enabled 657,706 Ukrainians to receive information about rehabilitation services, 91 healthcare providers to be trained in rehabilitation care and 303 patients to access specialty rehabilitation care. USAID also expanded rehabilitation assistance across eight regions of Ukraine, including support for the establishment of a Spinal Cord Injury Department at the First Lviv Territorial Medical Union as part of Lviv’s UNBROKEN initiative to expand access to rehabilitation care nationwide. Assistance towards the creation of assistive technology units (ATU) at regional health facilities will enable quality rehabilitation services and assistive technologies. Eight ATUs will be established and equipped with more than 4,000 assistive technology products, alongside training of providers. In conjunction with this effort, USAID will train 250 university students in clinical rehabilitation, 100 rehabilitation professionals, 140 prosthetics and orthotics specialists and over 70 university faculty.
III. HEALTH REFORM AND SYSTEM RECOVERY
USAID has supported Ukraine to undertake major healthcare system reforms since 2016 to eliminate corruption and informal payments, and make healthcare services more accountable to patients. USAID supported the establishment of the National Health Service of Ukraine in 2017, which today contracts more than 95 percent of all public health facilities to provide government-covered health services, covers more than 33 million Ukrainians (79% of the population), and has helped reduce the prevalence of informal payments for primary healthcare by 65 percent in just three years. USAID also supports Ukraine’s medical Central Procurement Agency, which has saved hundreds of millions of dollars in Ukrainian state funds through transparent, accountable procurement since 2019.
USAID’s ongoing health reform activities have helped Ukraine’s health sector to respond to significant new strains related to the war and ensure continuity of services. USAID’s Health Reform Support activity is helping the MOH to adapt financing and information systems to respond to new needs, protect information systems against cyber threats, and support data-driven national recovery planning. The SAFEMed program has helped to adapt supply chains and manage incoming humanitarian donations to keep medicines flowing to facilities, and avert drug shortages. In the midst of Russia’s invasion of Ukraine, SAFEMed has supported logistics and distribution for medicines, medical equipment, and medical supplies valued at over $400 million to sites across the country - including places like Kherson- helping ensure access to medicines immediately following its liberation by Ukrainian armed forces.
Building on existing programs, USAID is supporting Ukraine’s national health sector recovery plan to restore critical services and reconnect patients to care, in order to mitigate deaths and disease threats arising from war-related disruptions to the health system.
