As Ukraine approaches its third winter since the full-scale invasion, the World Health Organization (WHO) is calling for renewed focus on health in the country. Dr. Hans Henri P. Kluge, WHO Regional Director for Europe, stressed the critical need for sustained health efforts in Ukraine during his sixth visit to the country since early 2022. "Ukraine is facing its most challenging winter yet amid war, making a renewed focus on health essential—from response to recovery and reform," he stated.

Devastating Impact on Healthcare

The ongoing war has severely damaged Ukraine's health infrastructure, with WHO confirming nearly 2,000 attacks on hospitals, health workers, and patients. Compounding this, the country’s energy infrastructure has suffered targeted attacks, leading to power outages that threaten vaccine storage and distribution. If vaccines are compromised, Ukraine could see a resurgence of vaccine-preventable diseases. Additionally, the risk of waterborne and foodborne diseases is increasing as water distribution systems, reliant on uninterrupted power, remain vulnerable.

Power disruptions are a major concern as winter approaches, affecting heating systems and raising the likelihood of respiratory infections such as influenza and COVID-19. WHO is working closely with health authorities to address these issues, including installing generators and heating units in hospitals, particularly in regions near the war’s frontline. Dr. Kluge visited the Chuhuiv Central Hospital in Kharkiv, one of 15 facilities where WHO is installing heating units.

Rising Threat of Antimicrobial Resistance (AMR)

Another pressing health concern is the growing threat of antimicrobial resistance (AMR), particularly as a result of antibiotic misuse in the treatment of war injuries. "Wounds that simply won’t heal due to AMR are a stark warning of the potential for drug-resistant infections to spread beyond Ukraine," warned Dr. Kluge. To tackle this, Ukraine has expanded its capacity to monitor drug-resistant bacteria, with 100 laboratories now conducting surveillance, compared to just three in 2017.

Mental Health Crisis and Other Wintertime Risks

As the war drags on, mental health challenges in Ukraine are escalating. An estimated 10 million people are at risk of developing mental health issues, and the approaching winter is expected to worsen these conditions. The national mental health program, spearheaded by First Lady Olena Zelenska and supported by WHO, has scaled up rapidly, but demand continues to outpace supply.

Access to primary healthcare remains a significant issue, with 8% of households reporting no access to local health facilities. Moreover, more than 80% of households are struggling to obtain necessary medicines, and 6% lack access to essential medications altogether. In response, WHO is prioritizing the expansion of primary healthcare services, particularly in rural and frontline communities. By year’s end, WHO plans to install 40 prefabricated clinics across six regions, ensuring basic health services reach vulnerable populations.

Rehabilitation and Health System Recovery

Dr. Kluge also visited a WHO-supported rehabilitation unit in Poltava, where therapists are providing life-changing services to war victims. Ukraine’s national rehabilitation program has made impressive strides in a short period, but with the war ongoing, the need for prosthetics and physiotherapy continues to rise.

In Kharkiv, health facilities are being refurbished and new services are being added to address noncommunicable diseases such as cardiovascular illnesses and cancers. Despite the devastation, Ukraine’s health reforms—initiated before the war—continue to advance, reflecting the country’s long-term goal of European Union accession.

International Support and Call for Action

As winter approaches, Dr. Kluge emphasized the need for continued support from international donors and partners to help Ukraine weather the ongoing health crisis. "Ukraine’s health system must withstand and overcome the immense challenges of this winter, including attacks on health infrastructure, vaccine-preventable diseases, and AMR," he said. He praised the resilience of Ukraine's healthcare workers and the Ministry of Health, led by Viktor Liashko, for their courage and determination.

"Health is the glue that holds societies together," Dr. Kluge concluded, urging the global community to remain steadfast in supporting Ukraine’s health system through this difficult period.