How Resilience in Ukraine’s Health System Is Maintained During the War

In early June, Andriy Klepikov, Executive Director of the Alliance for Public Health, spoke at a high-level conference on sustainable development in Hamburg, which brought together leading representatives of international policy, business, academia, and civil society.

During the roundtable discussion ” Harnessing the Power of Public Private Partnerships for Sustainable Investments in Global Health”, he shared practical lessons from implementing prevention and treatment programs in wartime Ukraine.

Key message: Support for Ukraine from international donors is not just aid – it is an investment in resilience.

In his speech, Klepikov emphasized that thanks to the support of international donors – particularly the Global Fund – Ukraine managed to avoid the anticipated spikes in HIV and TB incidence following the full-scale invasion.

“Almost everyone predicted a sharp increase in new cases. But that didn’t happen – not by chance, but thanks to daily hard work, flexibility, adaptability, innovation, and a strategic response to the war’s challenges,” he said.

Under the immense pressure of war, Ukraine’s healthcare system was forced to transform.

Ukrainian Innovations: From Static to Dynamic, from Traditional to Digital

Andriy Klepikov highlighted how the Ukrainian experience shows that adaptation and innovation are key to service continuity, using the work of the Alliance for Public Health as an example:

Mobile Clinics: By introducing mobile medical services, Ukraine ensures access to care in remote areas and near the front lines. A short video illustrates the work of Ukrainian mobile health teams: “Dmytro and Yulia Face the Frontlines of War to Deliver

Lifesaving Care in Ukraine”
Digital Solutions: Tools like the digital social worker TWIIN have enabled 24/7 support, continuing service delivery even during air raids.
Flexibility and focus on vulnerable populations: Programs have been redesigned to respond most effectively to the needs of key populations whose vulnerability has significantly increased during the war. Since February 2022, over 1.6 million Ukrainians have received support from the Alliance for Public Health.
Learn more in the Alliance’s three-year wartime health report: “No Pause in the Response.”

Ukrainian Experience as a Model for Challenging Contexts

Klepikov drew attention to a striking fact: 36 countries funded by the Global Fund are classified as operating in Challenging Operating Environments (COEs) – roughly one in three. Programs in these countries, including Ukraine, are proving globally effective, impactful, and resilient.

“This is not just a unique experience – it is a comparative advantage of the Global Fund over other international aid mechanisms,” he stressed.

While the conference focused on long-term sustainability, Klepikov emphasized a critical perspective: for Ukraine, sustainability is a matter of survival, here and now. And yet, the Ukrainian case also demonstrates long-term resilience in the harshest of conditions.

“We have passed the crash test. With the Global Fund’s support, the health system –including HIV and TB response – has held strong. That’s what true sustainability looks like.”

Example of Systemic and Institutional Resilience Amid Full-Scale War

A notable achievement that exemplifies systemic resilience and institutional maturity during wartime, made possible through Global Fund support and the unique regional iSoS partnership, is this:
In 2025, the Public Health Center of the Ministry of Health of Ukraine became the first institution in Ukraine and the Eastern Europe and Central Asia (EECA) region to receive international certification for ISO 22301 – the global standard for business continuity in public health – despite ongoing threats, shelling, and wartime instability.