Ukraine is preparing to resume aeromedical evacuation of patients using State Emergency Service aircraft. The government has already approved the procedure for organizing such transportation, which will allow patients to be transported more quickly between hospitals and abroad, in particular to Rzeszów, Poland. At the same time, the state continues preparing airports to resume civil air travel. UNN asked experts whether medical flights could become the beginning of a broader return of aviation and what conditions are necessary for Ukrainian carriers to resume operations.
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The resumption of aeromedical evacuation was announced by Prime Minister Serhii Koretskyi.
This will significantly reduce the time needed to transport between hospitals patients who require urgent specialized medical care, as well as enable Ukrainians to be taken abroad for treatment, in particular under the Medevac Ukraine program. For example, it currently can take 15–16 hours to travel by ground transport from Kharkiv to the evacuation hub in Rzeszów, Poland. By air, the journey can be completed in 2–3 hours
According to him, the new procedure also provides for the transportation of donor organs, medical teams, and necessary equipment.
The evacuation will be coordinated by the Ukrainian Scientific and Practical Center for Emergency and Disaster Medicine of the Ministry of Health, while the State Emergency Service will provide aircraft and crews, taking security and weather conditions into account. The mechanism is expected to become operational by the end of the year.
Does medical evacuation bring the reopening of the skies closer?
The resumption of such transportation is primarily medically significant. At the same time, it raises a broader question: could the organization of specialized flights become one of the practical stages in preparing to restore air travel in Ukraine?
The question of the possibility of gradually resuming flights is also arising against the backdrop of the state's preparations to restore civil air travel. Minister for Restoration, Infrastructure and Transport Mykola Kalashnyk previously reported that risk assessments are being conducted at two state-owned airports and that underground areas and shelters are being prepared. In addition, in western Ukraine, the possibility of using municipal facilities for the first cargo flights is being considered.
Aviation expert Dmytro Voronkov told UNN that aeromedical evacuation is a necessary mechanism for the healthcare system and that its development is consistent with the practice of many countries. According to him, carrying out such flights will require serious organizational and technical work, since in wartime it is impossible to guarantee the complete safety of air transportation. At the same time, he cautioned against directly equating such flights with opening the airspace to civil aviation.
As for the prospects of restoring civil air travel, the experience of organizing such flights will undoubtedly be useful. I would not say that this is already a direct step toward opening civil aviation, but Ukraine will gradually be able to assess its own capabilities, including how feasible it is to resume flights in individual parts of the airspace
In his opinion, if we are talking about the potential restoration of civil air travel, western Ukraine could undoubtedly become a priority area.
This is geographically the most promising part of the country for such a scenario. Resuming flights in this area could be effective and economically viable. I think that this area may develop in the future, but everything will depend on the security situation and the actual ability to ensure the safety of flights
Military expert Bohdan Dolintse shares a similar view. He emphasizes that the key difference lies in the status of the aircraft and the nature of the missions: medical evacuation will be carried out by state aviation, not commercial carriers.
I would not directly link the resumption of aeromedical evacuation to preparations for the return of civil aviation. First and foremost, it should be understood that the aircraft involved in such missions belong to what is known as state aviation. They are not part of the civil air transport system, so the requirements, procedures, and organization of their flights are different
At the same time, according to him, the experience gained could potentially prove useful for other areas of aviation activity.
Undoubtedly, the decisions, practical experience, and interaction protocols developed while organizing aeromedical evacuation could in the future serve as a foundation for the development of other aviation sectors in Ukraine
Thus, the experts interviewed by UNN agree that medical flights are not the immediate first stage in reopening civilian airspace. However, they could become part of a broader process of restoring the country's aviation capabilities—provided that flights are properly organized, routes and flight zones are defined, and coordination with military structures is ensured.
Ukrainian airlines must return to their home market
Restoring aviation activity in Ukraine is not only a matter of flight safety and airport readiness. No less important is who exactly will be able to use this infrastructure once the airspace is reopened. Ukrainian airlines, which were forced to relocate their operations abroad after the beginning of the full-scale invasion, should be given the opportunity to return to their home market first and participate in the restoration of air links.
Indeed, some Ukrainian carriers continue to operate abroad, fulfill international contracts, and retain their aircraft and specialists. From 2022 to 2025, enterprises in the aviation sector paid nearly UAH 27 billion in taxes and fees to the state budget. In addition, the international activities of airlines ensure the inflow of foreign currency into Ukraine.
The aviation business needs legal certainty
The return of Ukrainian carriers requires more than simply reopening airports and airspace. The state must resolve a number of problems the sector has faced during the war. These include rising aircraft maintenance costs, difficulties with financing and insurance, the need to maintain international certification, as well as tax disputes that create additional risks for carriers.
One of the most pressing problems remains the classification of payments for the use of aircraft and helicopters leased from foreign companies as royalties. Since 2024, tax authorities and the Economic Security Bureau have begun treating payments for the lease of aircraft from nonresidents as royalties. This led to the opening of criminal proceedings against Ukrainian airlines. Industry representatives consider this approach controversial and emphasize that leasing an airplane or helicopter and paying royalties have different economic substance and legal regulation.
For air carriers, this uncertainty means additional legal and financial risks precisely at a time when they need to prepare to resume operations. Leasing is a common way of building an aircraft fleet: a significant portion of Ukrainian airlines' aircraft is operated under lease agreements.
The Ministry of Finance has already been working on developing a unified approach to taxing lease payments made to nonresidents and preparing a comprehensive tax consultation. For the market, it is important that this issue be regulated clearly and consistently, and that law enforcement not create additional obstacles to the operation of airlines.
Ukraine prepares to restore air connections: will domestic carriers be able to return05.10.26, 13:48