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Ukraine: Chaos continuing within country's healthcare system?

22 June 2015 Kavita Rainova

Ukraine has been going through some tumultuous times recently both politically and economically, so it will not come as a surprise that the country's healthcare system has also fallen on hard times. The conflict, devaluation of the currency, and economic stagnation have made their mark on the provision of healthcare in the country.

Changes in health ministers
This is easily reflected in the lack of continuity in health sector policy: in the past two years the country has had two health ministers, and one acting interim health minister - Raisa Bogatyrova from 2012 until February 2014, Oleh Musiy from February 2014- October 2014 and Vasiliy Lazorishinets from October 2014 - December 2014, until Georgia's previous health minister, Alexander Kvitashvili, was announced as Ukraine's new health minister in late 2014. And in the last couple of weeks, Mr Kvitashvili's own position has been the subject of intense speculation.

The uncertainty plaguing Ukraine's health system was highlighted in a our blog last year, just around the time that Ukraine's media were speculating on the possible resignation of the then health minister, Oleh Musiy. Almost a year on, the socio-political instability in the country, exacerbated by economic woes, continues to be a major impediment to the consistency of provision of health care. While the aim of reforming and modernising the healthcare system was an ongoing goal in Ukraine for some time, now, in order for these reforms to be introduced and implemented, stability within the Ministry of Health (MoH) and a stable tenure of the health minister are essential.

In the meantime, in addition to a stable political environment, financial resources and sufficient funding are also, of course, of paramount importance for the healthcare system to function and for reforms to be implemented. Funding of the healthcare system in Ukraine, however, seems to be quite far from sufficient judging from the reports periodically circulating in the country's media. Last year in August for instance the Healthcare Committee of Ukraine's Verkhovna Rada (the country's parliament) reported that the budget allocated for that year for the government health programmes was only sufficient to address 20% of the need. Later in the year, the country's MoH reportedly stated that it would be able to pay for less drugs from the state budget in 2015 due to the devaluation of the currency. And this month reports emerged that some of the regional offices of the State Administration of Ukraine on Medicinal Products (SAUMP), the agency which among others is responsible for drug quality control, may have to be closed due to insufficiency of financing, including for paying the salaries of their employees. What these recent developments suggest is that shortages of funding have affected healthcare across several avenues, from provision of medicines to monitoring the quality of drugs on the market. When topped with the drug price increase during a period of economic hardship when peoples' disposable income is falling, the issue of access to medication and medical services becomes more acute.

When taking all of these factors into consideration, it becomes clear that Ukraine has a long road ahead to rebuild and develop its healthcare system. Consistency within the Health Ministry would be the first step towards ensuring the long-term sustainability of the reforms. It is safe to say that Alexander Kvitashvili has got his work cut out for him and the pressure is definitely building up. A few weeks ago a bill was registered in the Verkovna Rada proposing the suspending of Kvitashvili. Since then Kvitashvili has presented the draft reforms to the healthcare system, with the Ukraine's Prime Minister, Arseniy Yatsenyuk, tasking the Ministry of Health to launch the healthcare reforms by September. While it would seem that Kvitashvili may be "in the clear" so to speak for some time being, the pressure would no doubt be mounting on the ex-Georgian Health Minister and current Ukrainian Health Minister to deliver soon.

Kavita Rainova is a life sciences analyst for IHS
Posted 22 June 2015

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