MULTILATERAL HEALTH RESPONSE IN UKRAINE: WORLD HEALTH ORGANIZATION.

The World Health Organization (WHO) has maintained a presence in Ukraine since before the February 2022 invasion, first working on health sector reforms before responding to the COVID-19 pandemic. The Journal spoke with Dr. Jarno Habicht, WHO representative in Ukraine and head of the WHO country office, about the period of reform and pandemic response, WHO's activities in war time including as lead of the health cluster, and systems strengthening in a time of attacks on health facilities and personnel.

Journal of International Affairs (JIA): To start, provide a brief overview of WHO's activities in Ukraine, both on the coordinating side and on the service delivery side as well.

Dr. Jarno Habicht (JH): When we look at what WHO has been doing since the 24th of February 2022, our focus in the early days was on much of the humanitarian response, because the humanitarian needs were great.

Gradually, we have moved to work on three tracks. To summarize, we work on the response, we work in recovery, and we work on reforms. For the response, the last year has been busy, for the team to reach 8.4 million people, now it is more than 9 million people and more than 10,000 health care workers, from mass casualty management to laboratory technologies and techniques and addressing a number of public health matters that reach millions of people in Ukraine with various materials. Related to this is communication, so that people know about public health, know about the risks and how to manage that as well. We have been delivering more than 3,000 metric tons of supplies, from ambulances to very specific supplies, such as trauma care and medicines, especially for chronic diseases. That has kept us busy on the humanitarian side.

But, as I said, the recovery has started fast. Where the health system is resilient, including building back the primary care centers that have been attacked. Today, based on our monitoring, we have verified more than 1,000 attacks on health. At the same time, we see how people go back to their homes in both contested and liberated areas, how doctors start to work again, how health services are available. The recovery is already starting now, and it is not only about physically building back the buildings but actually getting the health system to function and services to be available, from vaccination programs to actually managing chronic diseases.

Finally, the third track is about reform. Ukraine started health sector reforms in 2016 and 2017, setting up various institutions and building a new health system, from health financing to primary care, from digital health to increased transparency in procurement. All of this has also continued, so that is why I am saying that in many parts of the world, when the war starts, everything else stops. But in Ukraine, what is unique is that we really see the aspiration for the reforms continuing, in spite of all the pressure: recovery that starts as soon as possible and the response which gradually has moved more to the east and south, where the hostilities are the greatest. These are the three tracks that have been keeping us busy.

JIA: In the humanitarian space, who are some of the critical partners or collaborating organizations or institutions, for coordination on the ground both at the local level and also at the national or international levels?

JH: We have been working with our own team, first of all, so we are now over 250 personnel on the ground. We were a smaller team of 100 people around the 24th of February 2022, and what is very important is that all of our work has continued with national authorities and with local authorities, as well as with the community. For WHO, during the COVID-19 response, our role has been not only policy advice and dialogue or broader technical assistance, but also very much on the ground. What is happening in the hospitals? What happens in the primary care centers? How do we work in public health for disease surveillance? This has continued with all of our work, but scaled up.

Second, we work through many of our partners, including volunteers who have been helping to deliver supplies and medicines to the front line. We work with other organizations, humanitarian organizations that also benefit from WHO supplies while they have their own doctors and nurses in the front line. This is another stream.

The third, which is very important, is the health cluster, and so as a cluster lead...