Tetiana Deshko, Director of International Programs at the Alliance for Public Health, Ukraine, on March 7, 2025, participated in the Health Security and Emergency Preparedness hearing for the Second European Programme of Work (EPW2), attended by over 5,000 participants. This hearing, organized by the WHO Regional Office for Europe, serves as a critical platform for shaping the future health security agenda in the region. It provides an opportunity for WHO Member States, development partners, civil society, and technical networks to collaborate in addressing the growing health risks from pandemics, climate change, and conflicts, with a focus on health security as a central priority.
Tetiana’s intervention provided critical insights into the challenges faced by vulnerable populations in conflict zones and the essential role of civil society organizations in ensuring continued access to healthcare during emergencies.
Vulnerabilities in Conflict: Who is Most Affected?
During the hearing, Tetiana was asked to identify the most vulnerable groups in emergency situations, particularly during conflicts. She highlighted that those already vulnerable in everyday life become even more at risk during crises, especially if they rely on life-saving treatments like ART (antiretroviral therapy) or OAT (opioid agonist therapy).
In her response, Tetiana explained:
“People who take regular medication, like ART or OAT, are at increased risk when supply chains are disrupted. During the war in Ukraine, OAT patients on occupied territories were often cut off from their life-saving daily medication, and many died as a result.”
She also pointed to other vulnerable groups, such as displaced populations, people living in frontline areas, and individuals who have developed disabilities due to the war.
The Role of Civil Society Organizations: Key Lessons Learned
Tetiana also discussed the vital role that civil society organizations (CSOs) have played in providing health services during the ongoing war in Ukraine. She shared several key lessons learned from their efforts to ensure continued access to healthcare in highly polarized and conflict-affected areas.
She shared four practical lessons that could be applied in other conflict zones:
1. Mobile Health Services
“In areas where there is no health infrastructure left, mobile health services are crucial,” said Tetiana. Since December 2022, mobile clinics have been reaching annually over 10,000 people in 200 villages across six frontline regions in Ukraine. These clinics provide primary healthcare, integrate HIV, TB, and STI testing with other health screenings, such as ECG and ultrasound.
2. Long-Acting Treatments
Long-acting treatments for opioid dependence, such as LADB, and for HIV prevention, like CAB-LA, have been critical in serving mobile populations. These treatments reduce the burden on the healthcare system and ensure continuity of care for those who are most in need.
3. Digital Tools
Digital solutions, including telemedicine and AI-powered digital assistants, have been pivotal in maintaining contact with displaced individuals. “During the first 18 months of the war, our HelpNOW service provided on average 100 consultations per day, linking patients to treatment in their new locations,” explained Tetiana. Digital tools also helped distribute harm reduction commodities and HIV tests, reaching a growing number of people online.
4. Mental Health Support
Addressing mental health has been an essential part of the response. Tetiana revealed that surveys showed 34% of drug-resistant TB patients had depression and required psychiatric care. In addition, mental health challenges have been widespread among internally displaced people (IDPs). “In our latest ongoing studies, we’ve learned that 50% of men, in anticipation of conscription, avoid seeking healthcare, and IDP women have suicidal thoughts that they don’t know how to address,” she said.
Looking Ahead: Building Resilience Post-Conflict
Tetiana’s comments emphasized that the lessons learned from Ukraine’s experience will not only help manage the ongoing health emergency but will also contribute to building a more resilient and efficient healthcare system for the future. Civil society organizations, mobile healthcare, long-acting treatments, digital tools, and mental health support are all integral to ensuring that health systems are better equipped to handle future challenges—whether in conflict zones or in other emergencies.
In her closing remarks, Tetiana stressed:
“These innovations and strategies should not stop once the war ends. They must continue in post-conflict recovery to ensure equitable access to healthcare for all, especially the most vulnerable.”
By focusing on innovative solutions and coordinated efforts, Ukraine’s response to the health crisis can serve as a model for other regions facing similar challenges.
WHO Regional Office for Europe and EPW2
The WHO Regional Office for Europe is currently developing the European Programme of Work 2 (EPW2) to set a shared health agenda for the WHO European Region (2025–2030), with health security as a central priority. The upcoming Health Security Hearing, guided by the Preparedness 2.0 strategy (2024– 2029), aims to bring together WHO Member States, development partners, civil society, and technical networks to shape the region’s health security vision by addressing emerging trends for a safer, more resilient future.
Health security is a growing concern as the likelihood of zoonosis-driven pandemics is forecasted to triple, and climate change and conflicts heighten the risks. By 2100, nearly 500,000 people in the EU and UK may face yearly river flooding under 3°C warming. The hearing will provide an important opportunity for leaders to address these challenges, strengthen health systems, and integrate health security into national frameworks to ensure sustainable development and economic stability.
Tetiana’s insights underscore the critical importance of collaboration, innovation, and resilience in the face of ongoing crises and future health challenges.