Pharmaceuticals at war: "Doctors Without Borders" told whether there is a chance for access to medicines near the front

Access to medicines in the frontline territories of Ukraine remains a critical problem, as hostilities destroy medical facilities and pharmacies, and constant shelling complicates the logistics of drug supplies. Iryna Gab, pharmaceutical coordinator of Doctors Without Borders in Ukraine, told UNN how the organization helps provide patients with the necessary drugs and what challenges it faces while working in war conditions.

How does your organization assess the situation with access to medicines in the frontline territories of Ukraine?

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 teams operate there. Our doctors, nurses and pharmacists are constantly analyzing the situation with the provision of medicines to the population.

When we arrive in frontline communities, we see that many medical facilities and pharmacies have been destroyed as a result of hostilities - partially or completely. Access to vital services and medicines for people who remain in these communities is extremely limited.

That is why, after an examination by a therapist, we prescribe and provide free medicines to those who need them. As a rule, these are drugs for the treatment of chronic diseases, painkillers, etc.

Do you record a shortage of vital drugs?

Most often, patients cannot get to 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 on which they have lived for decades. They are forced to survive under constant shelling, without the opportunity to get to a pharmacy or outpatient clinic in time.

Our mobile clinics come to such settlements located near the front line and provide the necessary medicines after a medical examination.

We have recorded difficult cases when people with epilepsy, asthma, hypertension, diabetes needed constant medication, but could not get it due to shelling. We provide such patients with the necessary medicines.

In 2024 alone, we have transferred medicines worth almost half a million euros through mobile clinics, emergency services, as well as in the form of 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 room was also destroyed.

In order not to interrupt the work of our ambulance teams, which transport seriously wounded patients from frontline hospitals to more remote facilities in Central and Western Ukraine, we quickly 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 operation of our medical teams.

Medical teams of Doctors Without Borders have witnessed attacks on medical facilities since April 2022, when we started working in frontline and deoccupied territories.

For example, in the Mykolaiv Oncology Dispensary on April 4, 2022, after the attack, our doctors recorded numerous craters in the ground, scattered over a large area - which is probably the result of the use of cluster munitions.

For more than three years of the full-scale war in Ukraine, Doctors Without Borders teams have witnessed many attacks on hospitals in Kherson, Kurakhovo, Selydove, and Kostiantynivka.

In some settlements of Donetsk region, our mobile clinics cannot find a single surviving building that could serve as a clinic, so we equip medical offices in specially prepared transport containers.

Has the logistics of delivering medical supplies to the frontline territories changed due to security risks?

If we talk about the beginning of the full-scale invasion, in the first days of the war it was critical for us to help the Ministry of Health establish logistical supply chains 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 facing our organization is finding premises for pharmaceutical warehouses that would meet the necessary safety conditions and ensure proper storage of medicines. Many drugs require storage in refrigerators, so power outages and attacks on energy infrastructure create additional difficulties.

In addition, there are currently practically no completely safe territories in Ukraine - missile and drone attacks occur throughout the country. That is why we are trying to disperse stocks of medicines 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 that meet high European quality standards. It is critical for us that all drugs that 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 availability of medicines. We are convinced that medicines should be available not only physically - that is, be present on pharmacy shelves - but also affordable. Medicines are not a luxury, and everyone, regardless of income, should be able to get the necessary treatment.

Doctors Without Borders has repeatedly publicly called on pharmaceutical corporations and their shareholders to lower prices on a number of important vaccines and medicines.

Some market representatives say that due to the resolution of the Cabinet of Ministers, pharmacies in the frontline areas may close. Will this complicate the already difficult situation in the frontline territories?

Of course, the situation near the front line is extremely difficult. And due to the approach of hostilities, any processes - including the work of pharmacies - can be disrupted suddenly and unpredictably.