Military operations had a serious impact on the entire healthcare system of Ukraine, including routine immunization. In the photo: the child receives a vaccination against poliomyelitis. Interview | Ukraine: WHO helps to prevent gaps in the immunization of the population in the context of conflict Healthcare The full -scale invasion of Russia dealt a serious blow to the healthcare system of Ukraine, including immunization programs. Despite the destroyed infrastructure, the movement of millions of people and attacks on medical institutions, routine vaccination continues in the country. In an interview with the UN news service, an immunization specialist in the Ukrainian representative office of the World Health Organization Yevgeny Grechuha told how WHO supports Ukraine and how a reduction in financing complicates this work. 62 ~ The UN news service: how the ongoing conflict influenced the programs of immunization and the epidemiocracy in the country ? 60 ~/Strong > 60 > Evgeny Grechuha: Before we talk about the influence of war, it is worth mentioning the pandemic, because it has affected the immunization programs for immunization programs The world led to a decrease in coverage and the formation of significant gaps. Nevertheless, among the inhabitants of Ukraine after the Covid-19, significant progress was observed in the restoration of routine immunization. By the end of 2021, on a number of antigens, the coverage reached the recommended WHO. However, despite this, the country is faced with consequences such as historically low coverage. In 2021, for example, a flash of polio occurred. WHO has also dealt with these problems in the last three years. Since the beginning of a full -scale invasion, military operations have had a serious impact on the entire healthcare system, including routine immunization. Vaccines supply chains were broken, infrastructure was destroyed, millions of people were forced to leave their homes – about 7 million became refugees abroad, more than 5 million – internally moved faces. Among them were medical workers, including those who provided services near the front line and in rural areas. ~ 60 > In addition, from the beginning of the WHO invasion, they recorded more than 2300 attacks on healthcare institutions of Ukraine. Almost 40 percent of them fell on primary health care institutions that provide vaccination services. This is the direct influence of war on immunization programs. We see this in the statistics that is available on the WHO website: coverage has decreased sharply, especially in the regions of the front line, in temporarily occupied territories, as well as in areas subjected to constant shelling. 62 ~ now, in 2024–2025, we are already observing the outbreaks of preventive diseases – measles, whooping cough – which were not in 2021–2022. This is a direct consequence of the current situation. except for the indicators of coverage and epidemic, there are other problems. For example, attacks on energy infrastructure, which violate the power supply of medical facilities, including refrigeration chambers for storing vaccines. There is not a single region of Ukraine that would not suffer from attacks. Another example in the framework of a holistic approach to healthcare is the influence of war on rabies. Martial law, hunting for infected animals and other factors complicate epidemiological supervision. The war affects not only vaccination among people, but also the health of animals, as well as the environment. This is a larger effect. ~ 60 > UN news service: how WHO is working to eliminate these problems and restoration services ?~ 60 > eg: Despite all the difficulties, it is worth paying tribute to the national immunization program. For example, a 2021 polio flash was officially closed in 2023. Ukraine conducted three additional vaccination campaigns against measles, poliomyelitis and whooping cough. With the support of partners, the storage refrigerator system was modernized. The country has adopted a new immunization strategy, new approaches have been introduced, for example, vaccination based on pharmacies. Despite financial difficulties, the Ministry of Health and the Government were able to ensure the presence of doses of vaccinations, and in 2024, despite the adverse conditions, it was possible to maintain routine vaccination programs. 62 ~~ 60 > 62 > 62 > 62 > 62 > 62 > 62 ~ 62WHO provides both direct and indirect support to these efforts. We provide technical recommendations, help with the development of a strategy, update the law, evaluate the performance indicators, epidemiological ballots, and so on. We also provide indirect support – the purchase of generators for medical facilities, training of employees, including the new immunization unit. Extreme work does not stop public health reform. Our activities are built as part of a strategy for cooperation with the government in three areas: response, restoration and reform. This allows you to not only respond to urgent requests, but strategically plan the work. 60 ~ p > UN news service: what specific difficulties are experienced by displaced families and children ? how can the WHO help and the WHO can help Partners ? 60 ~ p > eg: one of the reasons why the national strategy was developed was the need to provide access to immunization for isolated and hard -to -reach communities. This is part of our mandate-supporting the system of primary health care, focused on humans. One of the first steps was the implementation of the principle according to which every resident of Ukraine can receive help, including vaccination, in any healthcare institution throughout the country. 62 ~ ~ 60 > 62 > 62 > 62 > 62 > 62 >In different ways, she supported these efforts, in particular, thanks to partners such as the EU and the United States, mobile brigades working with internally moved persons, including near the front line, were deployed. Modular clinics were also deployed in areas where hospitals were destroyed, especially at the border and on the front line. Thus, the WHO is working in two directions: on the one hand, humanitarian aid, for example, the delivery of medicines, on the other hand, support the national immunization program in the affected areas. ~ 60 >~ 60 > last year 29 modular medical facilities were installed – mainly in eight subronite regions. Each such institution can carry out up to 50 thousand consultations per year. ~ 60 > UN news service: Is there a problem with discretion about vaccines or a negative attitude of people, as we see in some countries ?EG: Yes, this is a good question. Such a problem exists in different countries. To cope with this, we use a systematic approach, including behavioral and cultural studies. We completed the latest study a few months ago. We analyze the barriers that prevent vaccination among internal immigrants, the rural population and inhabitants of hard -to -reach areas. The reasons vary by regions: for example, near the front, the main problem is closed hospitals or destroyed infrastructure; In rural areas – the physical inaccessibility of medical institutions. we use a scientific approach to understand various barriers. And it would be not true to argue that Ukraine does not face problems. They are, and we are working on them together with national partners. ~ 60 >~ 60 > UN news service: whether the recent > abbreviations of humanitarian Financing to work WHO in the country ?~ 60 >~ 60 > 62 > 62 > 62 > 62 > 62 ~ 62EG: US financing played a key role in supporting many programs, especially in terms of restoration and supply, including through the HIV and other directions. As for the immunization, together with projects financed by the US external assistance, we organized visiting vaccination sessions for internal immigrants and rural residents in eight regions. It was the contribution of American taxpayers. Also, with their help, a refrigerator of storage was modernized. So it cannot be said that the reduction in financing did not affect the work in any way. but it continues, technical assistance is maintained, although its scale is changing. If earlier we supported all directions and satisfied all the requests of the government, now we are sitting together at the negotiating table, set priorities and determine what is critical and what can be postponed. ~ > 62 > 62 > 62 > 62 > 62 > 62 > 62 > 62 > 62UN news service: in conclusion – what is your main goal and how this work affects people’s lives ? 60 > EG: from the point of view of immunization, our goal is to cover everyone without ignoring. This is the basic principle of national strategy. Everyone has the right and the opportunity to get vaccinated – regardless of age, status, beliefs. This applies not only to children, but also for adults – we are introducing the approach to the provision of services throughout life. ~ 60 > we are talking not only about regions where, thanks to the security situation, we can carry out more events, but also about those where combat operations continue. People remaining in the front -line areas are also the inhabitants of Ukraine, and we are obliged to support them. 60 > how our studies showed when a person is worried about his direct security and his loved ones, it is also difficult to think about healthcare. This is difficult to explain if he himself did not worry about this. But we are worried about it – we are here and did not stop working for a day. We do our best to provide people with better possible medical help. and people trust the WHO. We have visited every corner of the country: our motorcons deliver assistance throughout the territory, including the injured regions. And at the same time, we are already thinking about restoration after the end of the conflict, that is, not only about reaction here and now, but about the reforms of the system.