June 14, 2019

Ulana Suprun speaks on health care amidst Russia’s war against Ukraine


Ukraine’s acting minister of health, Dr. Ulana Suprun, spoke at the 72nd session of the World Health Assembly (WHA) in Geneva on May 21. Below is the text of her address (as delivered). Source: Ministry of Health of Ukraine.

The transformation of Ukraine’s health care system has been a hallmark of change in our country. Over the last two and a half years, the path to universal health coverage and attaining SDG 3 [Sustainable Development Goals regarding good health and well-being] in Ukraine was built by redefining how health care services are financed by creating the National Health Service of Ukraine, a single payer system.

In just over a year, 27.6 million patients signed declarations with a family doctor of their choice. Over 1,900 primary care facilities and almost 25,000 doctors have joined the new system, making patient-centered medicine a reality. Multiple surveys show patient satisfaction with their family doctors at over 70 percent and disapproval in the single digits. Family doctor’s salaries have doubled and, in some cases, tripled or quadrupled. The system is built on a digital solution, where e-health is the source for billing, health data and quality assurance.

I have been asked, how has Ukraine made this transformation a reality? One of the reasons behind our success is our team’s ability to say “no” to business as usual. Corruption schemes and rent seeking behavior will no longer siphon billions from the state budget to the detriment of patient care. With evidence-based medicine, we said no to privileged medical paternalism and created a network of state financed angiography centers around the country, reducing deaths from myocardial infarctions by 20 percent. In the past, people who required stents would have paid out of pocket. We achieved change because we believe in letting the truth have its day.

And the truth is, we have implemented these reforms while the Russian Federation has invaded and waged war against Ukraine.

Consider the following: what if you were forced to leave your home and all you could take was one suitcase, what would you take? Over 1.5 million Ukrainians were forced to make just such a decision when Russia annexed Crimea and invaded eastern Ukraine in 2014.

What if you found your name on a list of people to be liquidated by Russian secret services, the FSB? Hundreds of Ukrainians today live with a price on their heads, a price put there by the Kremlin.

What if over 70 of your citizens were kidnapped and tried in kangaroo courts on trumped-up charges and sent to penal colonies in Siberia? That’s what happened to filmmaker Oleh Sentsov from Crimea and dozens of Crimean Tatars.

While the world’s media parrots the lies promoted by the Kremlin’s industrial lying machine, almost every day, a Ukrainian soldier dies on the frontlines of Russia’s war against Europe, a war that has taken the lives of 13,000 people.

What if 24 members of your navy were taken prisoners of war by the Russian navy while sailing through international waters, guaranteed passage according to internationally recognized rules and treaties? Is this not a clear act of aggression?

Handing out Russian passports on occupied Ukrainian territory, forcefully or not, is another act of aggression. And requiring the presence of a Russian passport to receive health care is a human rights violation.

Everyone assembled in this room must find the will to say “no” to doing business as usual. The United Nations should not tolerate the presence of the Russian Federation on the Security Council until they decide to rejoin the international rules-based system, beginning with withdrawing their troops and command structures from occupied territories of Ukraine’s Donbas and Crimea and freeing all Ukrainian prisoners of war and political prisoners.

Member countries of the WHO and other international organizations must be willing to say “no” to Russian money flooding western banks otherwise you risk becoming hostages of the Kremlin.

The sanctions regime must be kept in place and expanded otherwise you risk rewarding behavior that annuls the benefits society gains from peace and prosperity and threatens the implementation of SDG 16 – promotion of peace and inclusive societies. Dividing the world into spheres of influence should not be how we organize international affairs in the 21st century.

The sovereignty of Ukraine belongs to the people of Ukraine and the fate of Ukraine will be decided by Ukrainians, not by foreign capitals.

Allowing imperialistic authoritarian states to act with impunity shortens lifespans in Ukraine and around the world. We will continue to defend those values that have enabled global peace and prosperity.

The past five years have shown that Ukraine is a reliable and trusted partner for the world community. Together we are stronger.