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““I am very grateful to our health care workers for their heroism,which they show every day while saving the lives of Ukrainians undershelling. Today, more than ever, we need support from internationalinstitutions, aimed at protecting lives and health of people aroundthe world. We are grateful for the support provided by WHO toensure the provision of health services and supply of medicaldevices. And we stay in constant contact with the Regional Officeliterally 24 hours per day”.VIKTOR LIASHKO, Minister of Health of Ukraine“We thank the WHO, alongside other members of the UN countryteam, for its leading role and commitment to preserving andensuring that essential health services remain available in Ukraine.We reiterate that health care services, workers and patients are nota target and must all be protected from harm. We call on all partiesto abide by international humanitarian law to protect civilians andcivilian infrastructure”.OSNAT LUBRANI, UN Resident & Humanitarian Coordinator inUkraine“Especially at this time of Russia’s war of aggression against Ukrainesince end of February, health must remain a priority. This lies at thecore of WHO’s mandate. We have placed our trust in the capacitiesof WHO. By our collaboration, we will ensure that lifesavingmedical supplies and medical health services, including sexualand reproductive health, remain available for those in need both inUkraine and the neighboring countries.”.SUSANNE FRIES-GAIER, Director for Humanitarian Assistance in theGerman Foreign Office“USAID has been one of Ukraine’s largest supporters for threedecades, increasing our assistance since the start of Russia’s fullscale war. We continue to work jointly with WHO and other partnersto mitigate the effects of the war and to address wider health needsin Ukraine and in neighboring countries receiving refugees. Healthcare is essential, and we remain steadfast in our commitment tohelping Ukraine strengthen its health care systems and deliver careto the most vulnerable, during the war and in the post-war period”.JAMES HOPE, Mission Director, USAID/Ukraine WHO / Andrei KrepkihMakariv, Ukraine6

RESPONSE IN UKRAINEWHO’s response in UkraineSaving lives is the priority of WHO’s response inUkraine. WHO works to ensure time-critical, lifesavingmultisectoral assistance, non-discriminatory accessto emergency and essential health services andpriority prevention programmes, and laying thefoundation for longer-term health systems recoveryand strengthening. WHOThe following four specific objectives have beendefined for WHO’s response in Ukraine:SPECIFIC OBJECTIVE 1: Access to emergency andcritical medical care is strengthenedAssist the Emergency Medical Services (EMS) indelivering emergency medical care to the conflictaffected population, including wounded/traumaaffected individuals and those with severe COVID-19and noncommunicable diseases (NCDs), prioritizingvulnerable groups, e.g. people with disabilities, olderpersons and children.SPECIFIC OBJECTIVE 2: Infectious diseases areprevented and responded toReduce infectious disease transmission andhospitalization by supporting the health care system,including immunization activities and supporting theCOVID-19 national response.Members of the IMT meeting with health authorities in OdessaA coordinated, people-centered, andcomprehensive WHO responseWhen the Ukraine crisis was categorised as aGrade 3 emergency (the highest level) on 25February 2022, WHO upgraded the UkraineIncident Management Team (IMT). Led by theWHO Representative and supported by theIMT leadership, the whole Ukraine countryoffice team has acted since the start of theemergency response to provide the necessarysupport to the Ukrainian people. The commandcontrol-coordination structure of the IMT hasensured a coordinated, people-centred andcomprehensive response by WHO and partners,in close collaboration with the Ministry of Healthand local health authorities. Through a huband-spoke system, the IMT covers the whole ofUkraine, enabling a context-specific response.SPECIFIC OBJECTIVE 3: Emergency healthinformation and surveillance for evidence-baseddecision making in health are reinforcedHealth information system produces regular, timelyand accurate data on health status, threats, healthresources, service availability and health systemperformance.SPECIFIC OBJECTIVE 4: Effective coordination ofhumanitarian interventions in the health sector isensuredStrengthen health sector coordination to addressthe needs of vulnerable people, provide improvedaccess to quality health care services, and allow foradequate preparation and response capacities forongoing and new emergencies.7

1Specific objective 1Access to emergency and critical medicalcare is strengthened8381 consultations11 821 consultations 11 839 patients 1750 patients 310 000 people99 medical evacuationsprovided by WHO-coordinated EmergencyMedical Teams (EMTs)by mental health and psychosocialsupport services supported by WHOtreated with trauma and emergencysurgery kits (TESK)patients supported with rehabilitation kitswith NCDs supported with NCD kits (NCDK)by 4 EMTs with WHO support 1 253 000 patientstreated with interagency emergency healthsupply kits (IEHK)WHO AND PARTNER ACTIVITIESService deliveryEmergency and critical medical care Supported the coordination of more than 80Emergency Medical Teams (EMTs) across Ukraine,Poland and the Republic of Moldova with theprovision of teams supporting emergency andprimary health care, inpatient and specialistsurgical care and rehabilitation, and patienttransfer and Medevac assistance. Established a dedicated Trauma & Rehabilitationoperational working group to support thecoordination of international organizationsproviding EMT activities across 13 oblasts. Supported Ukraine’s MoH efforts to establishthree health hubs in western Ukraine to supportthe emergency medical services (EMS) medicalevacuations and ensure the safe passage of patientsfrom east to west, including those with cancer, fortreatment outside Ukraine. Supported the EMS to coordinate and facilitatepatient transfer and Medevac operations in closecooperation with the European Commission(SANTE /ECHO) and international organizations supporting ambulance transfer from Ukraine toRzeszow airport in Poland.Distributed close to 700 sets of personal protectiveequipment to referral hospitals and emergencymedical service teams in 9 priority oblasts.In cooperation with the Academy of FamilyMedicines in Ukraine (AFMU), launched a project toensure affordability and accessibility of the primaryhealth care services in emergency settings andaddress the burden of NCDs through mobile healthunits (MHU) in the Kyiv region. Sixteen primaryhealth care workers including doctors engaged inthe work of MHUs.From 1–30 June 2022, AFMU operated eight MHUsand provided 1240 outpatient consultations inpriority areas of Kyiv oblast; 79% of the patientshad chronic diseases and conditions (NCDs), 75%had a diagnosed cardiovascular disease (CVDs) ofwhom 37% had hypertension that required medicalattention.MHU distributed WHO NCD kits to cover thepopulation of 10 000 for three months.8

WHO / Viktor MoskaliukWHO gave the MoH of Ukraine 20 all-terrain ambulances able to function in even themost damaged and inaccessible areas. On 08 May 2022, WHO Director-General Dr Tedroshanded over a donation of 20 all-terrain ambulances to Ukraine Ministry of Health DeputyMinister Iryna Mykychak.Trauma and rehabilitation The WHO Rehabilitation team has worked with theMoH and the Ministry of Veteran Affairs to agreeon a national concept for Spinal Cord & TraumaticBrain Injury Rehabilitation. Specialist rehabilitationequipment, consumables and assistivetechnologies have been deployed to increase thecurrent bed capacity by an additional 20 beds.Health worker training Worked with the Ukraine MoH on preparedness forvarious technological and industrial hazards thatcould pose a risk to health during the conflict, suchas sites storing or producing industrial chemicalsand nuclear plants; trained 1500 health careproviders on chemical exposure and 1300 healthcare providers on mass casualties. Provided training courses for health care providerson hospital blood transfusions in conflict settings,management of traumatic limb injuries, emergencynursing care, and essential burns care.Results 8381 consultations (60% female, of whom 1% werepregnant) were provided by the international EMTs.- 10% of the consultations were considered tobe directly related to the war, while 48% wereconsidered to be indirectly related.- 11% of the consultations were trauma-related,while 15% were infectious disease-related, withacute respiratory infections representing thehighest morbidity. More than 500 patients have been supported withMedevac to various European Union (EU) hospitalsas part of an agreed pathway between the MoHand the European Commission (SANTE /ECHO).This includes patients requiring specialist care forinjuries sustained directly from the war, and otherhealth issues impacted by the war, such as cancertreatments, etc. 99 patients have been evacuated from Ukraine toRzeszow airport by the four international EMTs(CADUS: international patient transfer and Medevacfocal point, Global Response Management,Samaritan’s Purse, and International RescueTeam.e, and International Rescue Team).What’s next? In close partnership with the MoH EMT focal pointfrom the Centre of Disaster Medicine, WHO willhelp to establish a national EMT Coordination Unitto improve preparedness planning of emergencyand critical care, and patient transfer and Medevacactivities. WHO will support the development of agreedprocesses, technical guidance, provision of staffand staff capacity building through training andmentorship for the National EMT Coordination Unit.This will aim to strengthen national capacity as thefirst line of response mechanism. WHO will work with the MoH to increase surgesupport and capacity in terms of equipment,specialist expertise and training, and staffing forrehabilitation (including assisted technologies),specialist burn care, and spinal cord andtraumatic brain injury care provision to reduce the9

dependence on international Medevac. WHO will continue international support to thenational EMS system, and will work to establishadditional patient transfer and Medevac hubs forthe safe and timely movement of patients from theeast to the west, to improve patient outcomes anddecrease the impact of morbidities associated withwar injuries. WHO will continue its effort to help the MoHdevelop national capacity with the futuredevelopment of Type 1 all-hazard mobile healthteams, who are best placed to ensure the provisionof not only emergency but also primary healthcare (including the provision of mental health andpsychosocial support) in territories that are newlyliberated or those that have restricted access. Health supplies Established a logistics hub and air bridge ofessential supplies by 2 March 2022. As of 30 June, WHO has delivered 654 metrictonnes of medical supplies to Ukraine comprisingtrauma and emergency surgery supplies (TESKs),interagency emergency medical supplies (IEHKs),blood transfusion materials, essential medicines,and other critical supplies, including body bags,ambulances, power generators, refrigerators andother equipment. Of these 654 metric tonnes of medical supplies432 have reached their intended destinations inUkraine; 222 MT are in transit. 15 diesel generators have been delivered to meetthe energy needs of hospitals and health facilities. A pressure swing absorption (PSA) oxygen plant hasbeen built to serve the medical oxygen needs of ahospital in Kyiv oblast. Prepositioned contingency stocks of emergencymedical kits in Odeska and Poltava to supportdelivery efforts in these oblasts. Preparationsare underway to open a sub-office in Vinnytsyato support emergency assistance to internallydisplaced communities. As part of overall preparedness measures toprevent, detect and respond to cholera, WHOhas prepositioned 5000 rapid diagnostic tests inUkraine. 50 kits of six assistive technology products (AT6),comprising elbow crutches, axilla crutches,walking frames, walking sticks, wheelchairs forhospital transportation, and toilet/bath chairs,were delivered to hospitals in eastern Ukraine (Kharkiv, Zaporizhzhya, Mykolayiv, Dnipropetrovskand Poltava oblasts) to support acute traumacare. The delivery of the AT6 kits was approvedby the MoH of Ukraine and synchronized withthe delivery of external fixators (frames used insurgeries to stabilize broken bones). The kits wereaccompanied with Ukrainian-language instructionsfor prescribing, fitting, and training on the use ofthe supplied assistive products.Five charter flights from the WHO stock centre inDubai to Warsaw, Poland, transported specialistWHO kits, diesel generators, pharmaceutical fridgesand freezers, and equipped ambulances. DeliveredWHO kits included:- 717 Interagency Emergency Health Kits (IEHK)- 2069 Trauma Emergency Surgery Kits (TESK)- 31 NCD Kits (NCDK)- 52 consignments with regular flights transportingmedicines and medical kits.Medicines, medical kits (IEHK, TESK), generators,and various rehabilitation products (wheelchairs,crutches etc.) delivered by road intrucks.20 Ambulances delivered.50 Rehabilitation kits delivered.Efforts are ongoing to deliver medical suppliesfrom the WHO supply and logistics base in Lvivto affected oblasts amidst fuel shortages, limitedwarehouse capacity, and security restrictions dueto ongoing military operations. Delivery of lifesaving supplies to hard-to-reach locations remainsa priority for WHO.Guidelines on donations of urgently neededsupplies to support the emergency responsein Ukraine and neighbouring countries areavailable on WHO’s website: Medical supplydonations for Ukraine. WHO continues to engagewith governments, private organizations, andbiomedical and shipping companies to securemedical supply donations.Results Based on WHO’s comprehensive approach and anestimation of the number of possible victims of warinjuries, the supplies to the Ukrainian health systemso far are estimated to have the following impact:- 11 839 patients treated with TESK- 310 000 people affected with NCDs supportedwith NCDK- 1 253 000 patients treated through IEHK- 1750 patients supported with rehabilitation kits(wheelchairs, walking crutches, walking framesand shower chairs.10

Quick response and novel approaches under challenging conditionsWHO Operations Support & Logistics (OSL)managed to access Chernihiv in March, despiteit still being under bomb attacks. The OSL teamchanged the mode of transportation four timesto meet the increasing danger associated withmovement. In the end, several small vans deliveredthe WHO goods (TESK and IEHK modules) toChernihiv successfully and safely.The team managed to cover Severodonetsk'sneeds (Luhansk oblast) twice before it became toodangerous for movement. TESK and IEHK modulessuccessfully reached Luhansk oblast, controlled bythe Government of Ukraine.Kramatorsk (Donetsk oblast) was reached by theOSL team within the first month of response.432 metric tonnes of medical supplies and equipment delivered by WHO have reached their intended destinations by30 June 2022WHO has delivered trauma and emergency medical supplies to the following oblasts (districts): Cherkasy, Chernihiv, Chernivtsi,Dnipropetrovsk, Donetsk, Ivano-Frankivsk, Kharkiv, Kherson, Khmelnytskyi, Kirovohrad, Kyiv, Luhansk, Lviv, Mykolaiv, Odesa, Poltava, Rivne,Sumy, Ternopil, Vinnytsia, Volyn, Zakarpatska, Zaporizhzhia and Zhytomyr.WHO continues to call for safe passage to deliver life-saving supplies, medicines, and humanitarian assistance.VOLYN14.8 MTL’VIV13.6 MTZAKARPATSKA1.2 MTZHYTOMYR1.1 MTCHERNIHIV14.1 MTSUMY30.5 MTZHYTOMYR5.0 MTKYIV110.6 MTKHMEL’NYTS’KYITERNOPIL’ 0.5 MT1.2 MTIVANO-FRANKIVS’K1.3 MTVINNYTSIA8.5 MTPOLTAVA5.5 MTKHARKIV35.5 MTLUHANS’K16.5 MTCHERKASY10 MTKIROVOHRAD7.3 MTCHERNIVTSI1.0 MTODESA0.87 MTDNIPROPETROVS’K60.1 MTMYKOLAIV28.4 MTDONETS’K16.5 MTZAPORIZHZHIA23.8 MTKHERSON11.0 MTStock that was still in warehouses as of 30 June is not included in the distribution overviewMT Metric tonnesThe value cannot be represented accurately to scale11

What’s next? Transition from bringing WHO emergency kits tobulk items delivery Strengthen emergency medical response bysupplying ambulances, WHO trauma kits Establish a pipeline for the supply of rehabilitationkits Transition to national procurement to supportrebuilding the Ukrainian economy Support MoH on rehabilitation of health careinfrastructures and sustain mobile health services Cover the gap left by Global Fund partners inproviding HIV treatment in the Eastern part ofUkraine Increase mobility and presence of OSL teamsin oblasts of Ukraine, providing proper needsassessments and access possibilities Continue coordination of Health Cluster initiativesfrom an OSL perspective.Mental health and psychosocial support Provided technical support and guidance forplanning and launching First Lady of Ukraine OlenaZelenska’s mental health and psychosocial supportinitiative to address the needs of people affected bythe war in Ukraine. Developed a framework for Prioritized MultisectoralMental Health and Psychosocial Actions in Ukrainejointly with the MoH of Ukraine and the MentalHealth and Psychosocial Support TechnicalWorking Group (MHPSS TWG), and with supportfrom the IASC Mental Health and PsychosocialSupport (MHPSS) Reference Group. 21 Community Mental Health Teams supported byWHO and providing long-term care for people withsevere mental health conditions before 24 February2022 were additionally trained in the managementof stress-related mental health conditions, andcontinued to provide care to their clients inchallenging new circumstances. Mobilized a group of partners engaged in capacitybuilding of primary health care workers, using theWHO mhGAP Intervention Guide to develop anonline course which will rapidly address growingdemand, and make mental health services availablein primary health care facilities in the near future. Chaired the MHPSS TWG at the national level andsupported four new sub-groups at the oblast level(Lviv, Zakarpattia, Chernivtsy, Odeska). Since 24February 2022, the number of partners has risen to270.Results 11 821 consultations by mental health andpsychosocial support services have been providedto the affected population. Through chairing the MHPSS TWG, WHO hasprovided technical support to partners andfacilitated the coordination of the response tomultiple needs of the affected population. WHO / WHO UkraineOn the 30th of April, WHO delivered vital medical and emergency supplies toZaporizhzhia,

When the Ukraine crisis was categorised as a Grade 3 emergency (the highest level) on 25 February 2022, WHO upgraded the Ukraine Incident Management Team (IMT). Led by the WHO Representative and supported by the IMT leadership, the whole Ukraine country office team has acted since the start of the emergency response to provide the necessary