On February 24, 2026, Ukraine marks four years of full-scale war — four years of unprecedented strain on the country, its healthcare system, and millions of families. During this time, millions have been displaced, thousands of medical facilities damaged or destroyed, and uninterrupted access to treatment, prevention, and care has become a matter of survival.

In such conditions, maintaining control over HIV, tuberculosis, and viral hepatitis — while expanding support for people with substance use disorders, veterans, internally displaced persons, and frontline communities — required more than emergency response. It required systemic resilience.

Over four years of full-scale war, the Alliance for Public Health, together with government institutions, international partners, and community networks, ensured continuity of lifesaving services, deployed mobile clinics to frontline villages, scaled digital and telemedicine solutions, strengthened humanitarian response, and reinforced institutional capacity across Ukraine’s public health system.

This report is not only about crisis response. It is about resilience, innovation, and shared responsibility. It demonstrates how, even under bombardment, epidemic control can be preserved, millions of people supported, and the foundation of a modern, adaptive, and future-ready health system built for Ukraine.

X-ray technician Maria travels to de-occupied and frontline settlements in the Kherson region of Ukraine – places where hospitals are destroyed, pharmacies are closed, transport links are severed, and mobile connection is often unavailable. She is a member of a mobile medical team for a tuberculosis screening project in the Kherson region where the risk of tuberculosis remains one of the highest in the country  due to the war, forced displacement, and interrupted treatment.

For Maria, joining this project was no accident. She has worked in medicine her entire life. While workplaces and conditions have changed, her desire to be useful and to learn has remained constant. When she heard about the launch of mobile TB screening in frontline communities, she had no doubts. “I knew it would be difficult there. But if not us, then who?” says Maria. She applied, underwent the necessary training, mastered modern diagnostic equipment, and became part of a team working where the traditional healthcare system is not yet functioning and accessible.

In 2024, the tuberculosis incidence rate in the Kherson region increased approximately 1.5 times. This isn’t surprising given that  diagnosis has been delayed by the war. During each trip, suspected cases of TB are identified that would have otherwise gone undetected without screening. Early detection allows treatment to start on time, to prevent severe complications and to receive better treatment outcomes.

At 6:00 AM, Kherson is still in semi-darkness. The air is cold and tense – the way it only feels on the frontier of war. Maria closes her front door, checks her backpack, and gets into the car. Another mission lies ahead.

Just as the team is about to leave the city, an air raid siren cuts through the silence. Alerts appear on their phones, warning of a possible drone attack. The team turns back and takes shelter, following established safety procedures. Only after the all-clear signal do they set off on the road. “You quickly learn to distinguish sounds here – an ‘outgoing’ shot from an ‘incoming’ hit or an interception. Your fear never truly disappears,” Maria admits.

Working alongside her are radiologist Lyubomir and nurse Valentyna. Each of them understands that they need to balance  risk and necessity on every trip. In frontline conditions, it is not just the number of patients examined that matters, but also preserving equipment and ensuring the safety of the staff by choosing the right route to avoid becoming a target. They must make constant judgement calls and  quick decisions on the go, under the sound of sirens and explosions.

Even a short drive through the Kherson region carries risks. The team navigates carefully, balancing speed and safety to reach people cut off from medical care.

The journey takes over five hours navigating broken roads, missing signs and destroyed bridges. But the specialists reach even the most remote villages – sometimes covering 150–200 km one way. They bring with them not only modern equipment but also a chance for diagnosis and treatment.

The mobile brigade reached their intended destination around noon. People are already waiting. For many, this is their first medical examination since the start of the war. “We have been waiting for you for a long time,” says an older woman as she enters the room.

In these communities, medicine is provided in nearly impossible circumstances. There is only one paramedic serving  several villages. In the Kherson region, these are mostly older paramedics working at the limit of their capacity in the realities of war and without full medical support. In winter, the centers are unheated. There is no electricity, and in some places, not even water. In such conditions, regular check-ups or early diagnostics are effectively a luxury. That is why the arrival of the medical team is more than a service. It is their lifeline, an opportunity to save health and even lives.

The portable X-ray is set up. The reception begins. Every patient is interviewed, examined. The images are analyzed in Kherson. In case of suspected tuberculosis, people are referred for further in-depth medical examination.

• Over five hundred people pass through the mobile screening clinic in the Kherson region every month for many, it is the first medical examination after the war started. Without such trips, these communities would remain outside the healthcare system.
• In the second half year of 2025, the mobile team systematically covered 37 settlements in 17 rural communities, conducting X-ray screening for 1,771 people. 22 sputum tests using GeneXpert  were performed, 12 patients were referred for further examination with suspected tuberculosis, and 1 case of active TB was confirmed.

These people are residents of frontline communities whose regular access to medicine was interrupted by the war. They are mostly pensioners and people with limited mobility.

Mykola, 75, local resident, pensioner Mykola is among the first to arrive. He says he heard about the medics’ arrival from the village head. The last time he saw a doctor was before the full-scale invasion when the district hospital was still operating. Then came occupation, shelling, and destroyed roads. He has neither the strength nor the desire to travel anywhere. For him, this examination is a chance to check on his health.

Olena, 36, displaced person Olena has lived in the village for two years with her two children – she fled another district of Kherson after shelling. She feels fine but decided to get checked “for peace of mind.” She says she is most afraid not of the disease, but of not being able to get treatment if she falls ill. Maria explains how aid is provided under this project, reassures her, and says that no one will be left alone with a diagnosis. After the examination, Olena exhales: “At least now I know everything is in order.”

Petro, 62, local resident, working on house restoration Petro is a pensioner but still works on clearing rubble and repairing houses after shelling. He says he is constantly working in dust and in the cold, often without proper nutrition. He knows little about tuberculosis but heard that the disease “likes such conditions.” He doesn’t panic but takes it seriously: “If there is something, it’s better to know now.” For him, the arrival of the mobile brigade is an opportunity to undergo TB screening without traveling to Kherson.

Towards evening, the team sets off back to Kherson. Ahead is darkness, a road without lights, and another five-hour journey. Maria is tired but calm. “It’s not extraordinary. It’s just work that someone has to do,” she says.

The mobile tuberculosis screening project in the Kherson region is implemented by the ICF “Alliance for Public Health” in partnership with the Phthisiopulmonology Medical Center of the Kherson Regional Council, with the support of Frontline AIDS and financial support by SIDA.

Every X-ray image is not just an examination, but a chance to break the chain of tuberculosis transmission in communities where treatment has been interrupted by war, displacement, and a lack of access to medicine. It is thanks to international support and partnerships that such mobile teams can work regularly rather than occasionally to maintain continuity of care, even in frontline regions.

“Thank you for coming,” a woman says as she leaves, holding Maria’s hand tightly. This phrase captures the entire essence of frontline medicine. Where war has destroyed hospitals and aid routes, people are still waiting. And someone must reach them with vital equipment, knowledge, and life-saving medicine to stop the spread of tuberculosis during the war.

Photo: Oleksandr Andryushchenko

Brussels, 13 January 2025

This week, commuters across the Brussels metro are invited to reflect on the real-world impact of global health investment. A commitment from the European Commission of €800 million to the Global Fund could help save up to 1.2 million lives – roughly equivalent to the entire population of Brussels – making clear how vast and human the impact of this investment would be in the fight against AIDS, tuberculosis, and malaria. The campaign is led by Friends of the Global Fund Europe, ONE Campaign, Alliance for Public Health, Global Health Advocates, and Aidsfonds, as part of a broader joint appeal endorsed by 330 organisations across Europe and beyond. Together, they are calling on the European Commission to demonstrate leadership in global health by committing €800 million to the Global Fund ahead of its next Board meeting in February.

1.2 million lives

A €800 million EU contribution could help save up to 1.2 million lives, unlock billions in economic returns and strengthen health systems worldwide. This investment would support countries to better prevent and respond to outbreaks, accelerate innovation, uphold human rights and gender equality, and build resilient health systems capable of adapting to climate change. It would also help communities transition towards long-term self-reliance – delivering impact far beyond health alone.

Funding not yet committed

Despite its longstanding role as a champion of global health, the European Commission did not pledge at the Global Fund replenishment summit that took place last November, on the side of the G20 Summit in Johannesburg. Without sufficient investment, prevention slows, treatment is delayed, and lives are lost. In February, the Global Fund will hold its Board meeting, where country allocations will be decided – announcing a pledge before the Board meeting is critical to enabling the Global Fund to allocate resources on time and to prevent interruptions to country programmes.

As COVID-19 showed, diseases know no borders. Supporting the most affected countries helps protect everyone, inside and outside of Europe.

Why the Global Fund matters

Created in 2002 with the support of the European Commission, the Global Fund to fight AIDS, Tuberculosis and Malaria is a unique partnership that mobilizes and invests resources worldwide to end three of the deadliest infectious diseases and strengthen health systems. To date, the Global Fund has saved 70 million lives, transforming communities once devastated by these diseases. Its impact goes beyond health – keeping children in school, strengthening economies, and enabling communities to plan for a healthier, more secure future.

Europe can make this impact. Now is the moment to act, for a safer world for us all.

Quotes

Kasia Lemanska, EU Representative, Aidsfonds: “€800 million is not an abstract number. It represents up to 1.2 million lives saved – roughly the equivalent of everyone living in Brussels. This campaign shows, in the most tangible terms, what is at stake for millions of people around the world.”

Héloïse Levallois, Policy & Advocacy Senior Manager – EU Institutions, ONE Campaign: “The Global Fund shows what collective action delivers: over 70 million lives saved since 2002. But this progress is fragile. At a time of slowing health financing and deep aid cuts, a €800 million EU pledge is a strategic choice that protects lives, strengthens economies and reinforces Europe’s global leadership.”

Hélène Berger, Executive Director, Friends of the Global Fund Europe: “The Global Fund is a unique partnership model, bringing together governments, communities, the private sector, civil society and many more stakeholders to deliver transformative impact that reaches far beyond the fight against the three diseases. Committing to the Global Fund represents both a strategic choice and an act of global solidarity at a moment when the world needs it most.”

Antonio Gambini, Advocacy and Policy Officer, Global Health Advocates: “President von der Leyen said in her SOTEU address last September that Europe must take the lead on global health. This political ambition has to translate into actual concrete financial commitments, equivalent to the EU’s fair share of 800m€, which will help sustain the vital work carried out by the Global Fund to eradicate HIV, TB, and malaria.”

Inna Gavrylova, Senior PR & Communications Manager, Alliance for Public Health: “From our work on the frontlines in Ukraine and across Eastern Europe and Central Asia, we see every day how Global Fund support saves lives. This is why the EU’s €800 million commitment is urgently needed. As a key donor, the EU’s pledge will determine whether lifesaving HIV and TB services continue without interruption. Without timely funding, essential services risk interruption, and the consequences for the most vulnerable populations can be devastating.”

Further information:

• The €800M campaign: https://aidsfonds.org/wp-content/uploads/2025/02/Updated-Collective-Financial-Ask-Global-Fund.pdf
• Methodology: The estimate of ~1.2 million lives is a proportional calculation based on the Global Fund Investment Case (US$18bn → ~23m additional lives saved). Results are indicative and will vary with the EUR–USD exchange rate used.

Lead organizations:

• Friends of the Global Fund Europe: Advocates for strong European leadership and investment in the Global Fund and global health initiatives. https://friendseurope.org/
• ONE Campaign: A global movement campaigning to end extreme poverty and preventable disease, particularly in Africa. https://www.one.org/us/
• Alliance for Public Health: Works to strengthen public health systems and fight epidemics in Eastern Europe and Central Asia. https://aph.org.ua/en/home/
• Global Health Advocates: Promotes policies and resources to improve health and fight poverty worldwide. https://www.ghadvocates.eu/
• Aidsfonds: Dedicated to ending AIDS by funding research, prevention, and care programs globally. https://aidsfonds.org/

As the year comes to an end, we just want to say thank you for being with us.
For 25 years, the Alliance for Public Health has been standing side by side with people and communities: through change, crisis, and moments of hope. And we’ll keep moving forward together.
Wishing you peaceful holidays, time to rest, and renewed strength for the year ahead, for you, your loved ones, and the communities we care about.
We also express our deep gratitude to the Armed Forces of Ukraine, who every day defend not only our country, but also the values of freedom, dignity, and peace.

Today, at APH office, we had the honor of receiving the Bethlehem Peace Light, kindly brought to us by Plast as part of the traditional pre-Christmas events. This symbolic flame carries a message of goodness, support, and unity.

Andriy Klepikov, Executive Director of the Alliance for Public Health, thanked the Plast members for carrying out this important mission and for preserving the tradition. He noted that the Light is a symbol of goodness and faith – not only faith in God but also faith in Ukraine’s victory. Everyone had the opportunity to light their own candle from the Bethlehem Light, feeling the warmth and power of this tradition.

Plast is the largest youth organization in Ukraine, and we greatly value our collaboration with youth movements that spread light, hope, and goodness.

The Peace Light inspires us to continue our mission – supporting health and strengthening communities. This borderless symbol of goodness resonates deeply with our global goal: healthy communities for all.

On December 10, the world marks International Human Rights Day — the anniversary of the adoption of the Universal Declaration of Human Rights, which proclaimed that all human beings are born free and equal in dignity and rights. Yet in reality, for millions of people these words still do not fully work due to barriers, stigma, and discrimination: rights are declared, but the ability to exercise them and effective protection are still not guaranteed.

Human rights are about everyday realities: the ability to seek services or assistance without fear, to receive quality and timely care, and to overcome obstacles on the way to basic needs — health, safety, and dignity. However, even where the right to health is formally recognized, equal treatment and fair conditions are often not ensured. Stigma, discrimination in healthcare settings, difficulties in interactions with law enforcement, and delays in treatment frequently result in people being unable to receive timely assistance and defend their rights. In such situations, human rights violations have direct consequences for health and life.

Despite the fact that the principles of equality and non-discrimination are enshrined in international documents, for many people rights still remain declarations without real protection mechanisms. Where there is no protection, rights themselves lose their power.

Even when a person formally has a right, without the ability to defend it, that right remains vulnerable. Human rights protection is not an abstract concept, but concrete actions: the ability to file a complaint, receive legal support, restore violated rights, and hold perpetrators accountable. It is precisely this that determines whether a right becomes a real tool of safety and dignity or remains just a line in a document.

The consequences of human rights violations in the field of healthcare are similar across many countries: delays or denial of treatment leading to higher risks of complications, chronic illness and premature death; deterioration of mental health due to stigma, exclusion and constant fear of seeking help; deepening social inequality; and erosion of trust in healthcare systems, which reduces access to prevention, testing and treatment and undermines public health overall.

International Human Rights Day reminds us every year that rights do not work automatically. When a person cannot exercise their rights or lacks real protection, civil society often becomes the crucial link that turns rights into real assistance.

In Ukraine and in 13 other countries of Eastern Europe and Central Asia (EECA), Alliance for Public Health is implementing the REAct (Rights – Evidence – Action) system — a tool for documenting human rights violations affecting key communities vulnerable to HIV and tuberculosis.

Since the launch of the system in 2019, with the support of 202 non-governmental organizations and 360 REActors, more than 35,000 cases of human rights violations against representatives of key communities have been registered.

Despite different national contexts, the typical violations remain strikingly similar: stigma and discrimination in healthcare settings, denial of services, breaches of confidentiality, poor quality medical care, and unlawful actions by law enforcement.

Paralegals from partner organizations not only document these cases, but also provide paralegal консультації, accompany people in overcoming barriers to accessing services, and assist in protecting their rights.

These services are critically important, as they make it possible to restore violated rights, receive necessary assistance, and mitigate the impact of discrimination on people’s lives and health. Overcoming barriers to access is not an abstract goal, but a concrete step toward real protection of dignity and safety.

Today, on International Human Rights Day, we once again emphasize: rights must be not just loud words, but a real mechanism of action and protection.

ICF “Alliance for Public Health” expresses sincere gratitude to all partner organizations, every REActor, for their daily dedication, professionalism, and principled stance in defense of human rights, as well as to all clients — for their trust, courage to seek help, and resilience in these extremely challenging times.

330 organisations from around the world — including Alliance for Public Health and more than 140 Ukrainian civil society, community, and public health organisations — are calling on the European Commission to confirm a €800 million pledge to the Global Fund ahead of the February 2026 Board Meeting.

On November 21, donors fell short of the Global Fund’s USD 18 billion replenishment target. While the global context is challenging, the gap is deeply concerning: HIV, TB and malaria programmes are already under pressure from shrinking overseas development assistance and growing humanitarian needs.

A timely and ambitious pledge from the European Commission is critical to:

• enable the Global Fund to allocate resources on time
• prevent interruptions to lifesaving country programmes
• unlock approximately €400 million in US matching funds
• uphold Europe’s leadership in global health

For Ukraine, the stakes are especially clear. Even amid full-scale war, Global Fund support keeps HIV and TB services operational despite missile strikes, displacement, and damaged health infrastructure. Mobile teams reach frontline areas; digital tools and innovations are deployed in real time; communities, doctors and outreach workers continue saving lives under extraordinary conditions.

Ukraine’s experience underscores a simple truth: investing in global health is a matter of global security, resilience, and shared values.

A stronger outcome is still possible — and the European Commission and EU Member States can play a decisive role.

Read the full statement and the list of 330 signatories:

Alliance for Public Health received a Letter of Appreciation from the Commander of the Medical Forces of the Armed Forces of Ukraine, Major General of the Medical Service Anatolii Petrovych Kazmirchuk.

We sincerely thank him for this honorable recognition of our work in testing servicemen for HIV and viral hepatitis, as well as diagnosing tuberculosis and other respiratory diseases using specially equipped mobile clinics.

Special thanks to Serhii Oleksandrovych Morhun, Head of the Sanitary-Epidemiological Department of the Medical Forces Command of the Armed Forces of Ukraine, for his fruitful collaboration.

We continue to work together for Victory!