Access to medicines in Ukraine's frontline territories remains a critical issue, as hostilities destroy medical facilities and pharmacies, and constant shelling complicates the logistics of drug supply. Iryna Hab, Pharmacy Coordinator for "Doctors Without Borders" in Ukraine, told UNN how the organization helps provide patients with necessary medications and what challenges it faces while working in wartime conditions.
How does your organization assess the situation with access to medicines in Ukraine's frontline territories?
The international humanitarian medical organization "Doctors Without Borders" operates along the entire front line: in Donetsk, Kharkiv, Sumy, Dnipropetrovsk, Kherson, and Mykolaiv regions. Our mobile clinics and emergency response teams work there. Our doctors, nurses, and pharmacists constantly analyze the situation regarding the provision of medicines to the population.
When we arrive in frontline communities, we see that many medical facilities and pharmacies have been destroyed due to hostilities — partially or completely. Access to vital services and medications for people remaining in these communities is extremely limited.
That is why, after examination by a therapist, we prescribe and provide free medicines to those who need them. As a rule, these are drugs for chronic diseases, painkillers, etc.
Do you record a shortage of vital medicines?
Most often, patients cannot reach the nearest pharmacy due to constant shelling. Many people are forced to stay in shelters and basements most of the time, adapting to extremely difficult living conditions.
It is especially difficult for elderly people who do not dare to evacuate because they do not want to leave their homes and the land where they have lived for decades. They are forced to survive under constant shelling, without the possibility of reaching a pharmacy or outpatient clinic in time.
Our mobile clinics come to such settlements located near the front line and, after a medical examination, provide the necessary medicines.
We have recorded difficult cases where people with epilepsy, asthma, hypertension, and diabetes needed continuous medication, but due to shelling, they were unable to obtain them. We provide such patients with the necessary medications.
Only in 2024, we delivered medicines worth almost half a million euros through mobile clinics, emergency services, and as donations to hospitals.
Have you recorded cases of destruction of pharmacies or medical facilities in frontline regions?
Yes, our teams have repeatedly witnessed attacks on medical facilities.
In April 2024, the "Doctors Without Borders" office in Pokrovsk, Donetsk region, was destroyed as a result of shelling. Along with it, the pharmaceutical warehouse located in the same premises was also destroyed.
To avoid interrupting the work of our ambulance teams, which transport seriously wounded patients from frontline hospitals to more remote facilities in Central and Western Ukraine, we promptly set up a new warehouse in Dnipro and redirected vital medicines there. Thus, we managed to prevent disruptions in logistics chains and ensure the continuous work of our medical teams.
Doctors Without Borders medical teams have been witnessing attacks on medical facilities since April 2022, when we started working in frontline and de-occupied territories.
For example, at the oncology dispensary in Mykolaiv on April 4, 2022, after an attack, our doctors recorded numerous craters in the ground, scattered over a significant area — which is likely the result of the use of cluster munitions.
Over more than three years of full-scale war in Ukraine, Doctors Without Borders teams have witnessed many attacks on hospitals in Kherson, Kurakhove, Selydove, Kostiantynivka.
In some settlements of Donetsk region, our mobile clinics cannot find any intact building that could serve as a clinic, so we set up medical offices in specially prepared transport containers.
Has the logistics of delivering medical drugs to frontline territories changed due to security risks?
Speaking about the beginning of the full-scale invasion, in the first days of the war, it was critically important for us to help the Ministry of Health establish logistical chains for the supply of medicines. Many routes were then blocked due to active hostilities. We organized the supply of medicines from Brussels (Belgium), where one of the operational centers of "Doctors Without Borders" is located, and also delivered ambulances and mobile clinics from another operational center - Geneva (Switzerland).
What are the main difficulties your organization faces when supplying medicines and medical services?
Among the main challenges our organization faces is finding premises for pharmaceutical warehouses that meet the necessary safety conditions and ensure proper storage of medicines. Many medicines require refrigeration, so power outages and attacks on energy infrastructure create additional difficulties.
In addition, there are currently practically no absolutely safe territories in Ukraine - missile and drone attacks occur throughout the country. That is why we try to disperse our medical supplies and not store everything in one place to avoid the risk of complete loss.
Currently, we work mainly with foreign-made medicines - with reliable suppliers who meet high European quality standards. It is critically important for us that all medicines we provide to patients are of high quality and effective.
How do you assess the new regulation of the pharmaceutical market?
We do not participate in the process of developing or implementing new regulations of the pharmaceutical market together with the Ministry of Health.
At the same time, one of the key advocacy areas of "Doctors Without Borders" is the accessibility of medicines. We are convinced that medicines should be accessible not only physically - that is, present on pharmacy shelves - but also affordable. Medicines are not a luxury, and every person, regardless of income level, should have the opportunity to receive the necessary treatment.
Doctors Without Borders has repeatedly publicly called on pharmaceutical corporations and their shareholders to lower prices for a number of important vaccines and medicines.
Some market representatives say that due to the Cabinet of Ministers' resolution, pharmacies in frontline areas may close. Will this complicate the already difficult situation in the frontline territories?
Undoubtedly, the situation near the front line is extremely difficult. And due to the proximity of hostilities, any processes - including the operation of pharmacies - can be disrupted suddenly and unpredictably.