Ukraine War Sparks Global Health Crisis
Over eight million Ukrainians have fled the country.

Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues.

“The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute.

 “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. 

While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. 

“Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said.

‘Defend Europe’

Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”.

“A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. 

In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare.

At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging.

International food security 

Ukraine food crisis

The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa.

“Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt.

The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. 

The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added.

While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found.

“We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. 

Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked.

The role of international actors 

In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. 

Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. 

Looking forward, international cooperation is also going to be crucial after the war ends.

“[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.”

First priority

Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January.

“Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” 

“We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged.

Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted.

“I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” 

“The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed.

Mental health emergency

People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine.

As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges.

“One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face.

Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.”

The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues.

Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers.

“It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. 

“Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.”

“There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.”

Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter .

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