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CONTEXT
Nearly four years after the February 2022 escalation, Ukraine faces a protracted war which has devastated lives and essential systems. Civilian casualties exceed 49 000, with 3.68 million internally displaced people (IDPs) and 6.9 million refugees across Europe. Renewed offensives in Sumy, Kharkiv and Donetsk have triggered further displacement.
Attacks on health care are widespread and severe. Ukraine accounts for approximately 45% of all attacks on health care reported globally since February 2022, with more than 2769 confirmed attacks resulting in 224 deaths and 896 injuries among health workers and patients. Facilities operate beyond surge capacity with workforce depletion and infrastructure damage.
Energy infrastructure has been systematically targeted, forcing hospitals to rely on generators and jeopardizing vaccine and blood product cold chains, heating, electricity and water supplies. WHO estimates that 150 000 to 250 000 hospitalized patients in frontline regions could be affected by energy and water failures during winter.
Public health risks remain elevated. Reduced immunization access and weakened surveillance have increased epidemic risks, with measles outbreaks and rises in hepatitis A and rabies cases. A mental health crisis affects an estimated 10 million people. Noncommunicable diseases account for a large share of consultations. Affordability of medicines remains a major barrier, and rehabilitation needs far exceed service capacity.
The health system is increasingly fragile. Workforce loss due to displacement, conscription and casualties has reduced service coverage in frontline areas. Many facilities are damaged or operating at reduced capacity, with supply chains frequently disrupted.
The 2026 outlook remains concerning. Without sustained support, health needs will remain acute. Disease outbreak risks persist amid degraded surveillance. Interagency planning indicates 10.8 million people may be in need, with 4.1 million requiring health assistance. The burden of noncommunicable diseases and mental health conditions is expected to worsen. At the same time, international financing for Ukraine’s health response has declined, while humanitarian and health needs remain acute, making sustained support in 2026 critical to prevent further deterioration of essential services.