TEL AVIV – Russia’s invasion of Ukraine will likely have long-lasting impacts on public health in Europe, both directly and in terms of global challenges related to food security and climate.

That was among the key messages from the World Health Organization’s Director-General Dr Tedros Adhanom Ghebreyesus and Regional Director for Europe Hans Kluge at the opening of WHO’s 72nd meeting of the Regional Committee for Europe, taking place for the first time in Israel. 

Tedros warned of steep spikes in COVID-19 cases in Ukraine that could push hospitals to the limit and cause oxygen shortages as winter approaches. He said WHO also is deeply concerned about the potential for the international spread of polio due to gaps in immunization coverage and mass population movement linked to the war.” 

The meeting brought together representatives of 53 countries in WHO’s European Region to set health policies for the coming year. It included delegates from Russia, Ukraine and other former Soviet Union republics in Eastern Europe and Central Asia that are part of the WHO region.  

“COVID-19 and monkeypox are both threats that have arisen from our relationship with nature. This year another threat has cast a shadow over the region which is entirely of human origin: the pall of war,” Tedros told health ministers, referring to the grinding war that has deeply damaged Ukraine’s health infrastructure.

“The Russian Federation’s invasion of Ukraine is having a devastating impact on the physical and mental health of Ukraine’s people, with consequences that will reverberate for many years to come,” said Tedros.

“We are now seeing an increase in cases of COVID-19 in Ukraine,” he said. “We project that transmission could peak in early October, and hospitals could approach their capacity threshold. Oxygen shortages are predicted because major supply sources are in occupied parts of the country.”

Setbacks for refugees, food security and climate 

More than 7.1 million Ukrainians have been recorded across Europe, according to the UN refugee agency.

Another 7 million people have been displaced internally within Ukraine, the refugee agency says, and some 13 million people are estimated to be stranded or unable to leave due to heightened security risks, destruction of bridges and roads, or a lack of resources or information on where to find safety and accommodation.

Kluge said the war is exacerbating already severe global challenges.

“Efforts to push back and to deal with the global climate emergency have been set back because of the revival of burning coal due to gas supply shortages,” he said. “The war in Ukraine has worsened, in fact, global food insecurity.”

As one of the world’s biggest exporters of wheat, sunflower oil and corn, Ukraine has about US$10 billion in grain ready to be exported including 20 million metric tons from last year’s harvest. But Russia’s war there has blocked not only millions of metric tons of Ukrainian grain but also Russian exports of grain and fertilizer.

That has factored into the dire situation the World Food Program is trying to address in the Horn of Africa, where levels of hunger are soaring after back-to-back droughts and the threat of famine looms. “Since the start of the year,” WFP says, “nine million more people have slipped into severe food insecurity across Ethiopia, Kenya and Somalia, leaving 22 million people struggling to find enough food to eat.”

Looking toward winter

Russia’s invasion of Ukraine is having a devastating impact on the physical and mental health of Ukraine’s people, with consequences that will reverberate for many years to come, Tedros said.

“No health system can deliver optimum health to its people under the stress of war,” Tedros said.

“WHO continues to support the Ministry of Health of Ukraine to restore disrupted services, displaced health workers and destroyed infrastructure,” he said, “which is essential not only for the health of Ukraine’s people, but for the country’s resilience and recovery.” 

The new normal

Keynote speakers and delegates agreed the war and COVID-19 pandemic have drastically changed things in the region, prompting Kluge to suggest a “new normal” mindset for all 53 member countries.

“The new normal is a dual track,” he said. “It means that all countries should be able to maintain constant readiness and alert, but without breaking routine disease prevention and control.”

To that end WHO can play a pivotal role, said Sandra Gallina, the European Commission’s director general for health and food safety.

“Working together on common health issues is the only way forward,” she said. “The multilateral approach with the [World Trade Organization] at its core, it’s really crucial. All of us know that we face daunting challenges. The EU will play its part.” 

Monkeypox emergency 

Kluge said there has been a recent decline in new monkeypox cases over the past week in the European region.

“On monkeypox, it seems that we are on a good trajectory, but we have to follow it very closely,” Kluge said.

Tedros said the region accounted for the majority of cases at the beginning of the outbreak, so now “it’s very pleasing to see a sustained decline in most European member states.”

But, he added, “as with COVID-19, a downward trend can be the most dangerous time, if it opens the door to complacency.”

Both WHO officials warned about the new polio outbreak.

“The cases in New York are genetically linked to cases in our European region, which are linked to Afghanistan and Pakistan, where polio is endemic,” Kluge said. “It reminds us that a crisis anywhere quickly becomes a crisis everywhere.”

Kluge was referring, in particular, to a recent US polio case in New York and poliovirus sewage samples in London that both appear to be linked to the first polio case seen in 30 years in Jerusalem, which was identified in March in an ultra-orthodox Jewish community.   

On Friday, New York’s governor declared a state of emergency and launched a booster vaccination campaign to halt the continued spread of the deadly virus, diagnosed in July in a young, unvaccinated Rockland County ultra-orthodox Jewish man, and since  identified in sewage water elsewhere in the state. The UK has also launched a booster campaign. 

Surveillance suggests the virus has continued to spread through parts of the ultra-orthodox Jewish communities across New York, the UK and Israel, where vaccine hesitancy is high.  

New WHO center on digital health to be established in Israel 

During the three day meeting, delegates at the Regional Committee meeting will discuss strategies that health ministries can adopt to better face multiple crises from war, climate and global food insecurity.  

Delegates also will discuss strategies for promoting health through behavioral and cultural insights, access to affordable medicines and ways to address health worker shortages that have become even more severe due to the pandemic, according to the agenda. Researchers are also due to present new data on long COVID in the European region.

Taking a proactive look at ways to improve healthcare and health systems – including through the uptake of new technologies – is a theme for the three-day meeting. At Monday’s conference opening, Israel’s President Isaac Herzog announced the establishment of a new WHO center in Israel focused on digital health – an arena in which Israel has proven to be a leader. 

“Israel is home to countless trailblazing med-tech and health-tech start-ups, pushing the bounds of human imagination,” Herzog said. 

“Together with European and international institutions, we can develop the breakthroughs that will enable people to live healthier and longer lives,” he said. “Israel will be working with the WHO to establish a cutting-edge center for digital health, bringing top-quality and innovative care to every corner of the world.”

Image Credits: WHO, UNICEF.