Back
Automatically translated version. May contain inaccuracies compared to the original.
Will there be drug shortages after the warehouse shellings, how long to wait for flu vaccines, will there be enough money for healthcare until the end of the year?
Health Minister Viktor Liashko in an interview with LB.ua discusses the shelling of pharmaceutical warehouses, flu vaccines, the budget of the Medical Guarantees Program, what's happening with healthcare workers in the country, and how the Ministry of Health is responding.
Here you will also learn what the minister apologized for to the medical community.
Flu vaccines, whether there will be drug shortages, whether there will be enough money for healthcare until the end of the year
So we can cover as much as possible, I'll start with a blitz. How ready are our hospitals for another winter?
About 80 percent. If we talk about the capable network – about 95%. Will there be problems? There will, because there is always the autonomy of a healthcare facility – this is not an alternative permanent mode of operation.
Usually there are generators, boiler houses, wells, something can happen, but potentially they are ready. Right now we are checking with additional spontaneous site visits to eliminate the human factor.
Do we have drug reserves, including in hospitals, so there won't be interruptions, especially considering the warehouse shellings?
The hardest question, because now I will say that yes, tomorrow there will be another shelling and it may not be so.
At the time of the interview I know that we are diversifying risks, simplifying conditions so suppliers can contract other warehouses, not only the ones they’ve always been licensed for, so that as many medicines as possible are distributed across the territory rather than stored in one or two warehouses in Ukraine.
Recently a huge Teva warehouse was hit and burned, where, as I understand, an incredible amount of medicines were stored. Already in pharmacies we hear from people that they are starting to look for medicines to have a stock. Can you, as minister of health, without whipping up panic but honestly warning, say whether to expect interruptions, especially for people with chronic conditions who must take a drug daily, for example—could there be potential supply gaps for such drugs, or should they stock up for a period?
You shouldn't stock up; the biggest problem arises when people start buying medicines they don't need today. That increases demand and uneven supply leads to not only a crisis from shelling but also a crisis of unpredictable consumption. That can lead to medicines not being delivered to pharmacies on time or as planned, even if they should be.
Minister of Health of Ukraine Viktor Liashko
We guarantee that even with shelling we are finding ways to deliver medicines to pharmacies. If it's not available today, it will be in a day or three.
When someone chooses 10 packs instead of the one they need, that can create a shortage at certain times, but we will respond quickly.
Again, appealing to the market: always state the correct deadlines you expect. Don't try to please; as managers we must know in order to properly moderate the situation in the pharmaceutical market.
A certain medical basket has been formed that exists in healthcare facilities to meet needs.
Flu vaccines. If you look at the dashboard of the Public Health Center, influenza is among the top ten causes of death in Ukrainians. Last year we had a pitiful percentage of people, especially in vulnerable groups, vaccinated. There was a gold rush for doses because few doses arrived and we wrote about it. What will we have this season?
400 plus thousands of doses. We'll see how people get vaccinated. We are already awaiting the first deliveries for laboratory checks to say: "Here is the vaccine, let's vaccinate."
What about risk groups? Medics were the first to go down when flu arrived. Are there possibly humanitarian deliveries of flu vaccines this season for healthcare workers?
This is a complex issue. Employers can purchase and vaccinate their staff. Additionally, as the Ministry of Health we are working with an international organization that for the last three years supplied us with 20–30,000 doses of vaccine and we prioritized appeals to the security and defense forces, and whoever wanted their servicemen vaccinated received doses for them and for healthcare workers. This year they also promise supplies, but so far it's a promise.
We don't yet have official confirmation, so we have some alternative options for working with healthcare workers and servicemen.
Minister of Health of Ukraine Viktor Liashko and LB.ua health editor Iryna Andreytsiv
When we talk about the Medical Guarantees Program 2026, it's already September, four months remain until the end of the year. How much of the 191 billion budget have we already used?
We are spending everything as planned, except for the Affordable Medicines program; compared to how we started in January, we are significantly exceeding spending because we predictably expanded the program, understanding where there is a potential funding source that will cover this deficit.
So there won't be a situation where in September or October we will be scrambling for money?
There is money in the Medical Guarantees Program; it's in the budget. We are talking about the single treasury account; the prime minister appealed when opening the session in the Verkhovna Rada to MPs to vote for all financial beacons, the Ukraine Facility, and the IMF so that the funds planned in the budget arrive in the single treasury account. That may be the only problem. The Ministry of Health and the NHSU will not introduce any transfers or coefficients in November and December. This is for those tracking dashboards.
About winter. Recently your colleague, Social Policy Minister Denys Ulyutin, said that last year social facilities agreed with medical institutions on temporary accommodation for people who had nowhere to go. Could such a scenario happen this year, or is it being worked out, perhaps for people with limited mobility?
Healthcare facilities are a key task so they can provide medical care in any crisis. We monitor free hospital beds of surgical and therapeutic profiles to manage the situation, because we have many medical evacuations for military patients and evacuations from areas subject to forced evacuation. First are severe patients, people with limited mobility who will need medical care. We are working in that direction. Can healthcare facilities lend a hand? Yes, but they should not be the only backup option. We also coordinated with the Ministry of Social Policy. We even introduced a separate package funded by the Ministry of Social Policy through the National Health Service of Ukraine.
Evacuation of people with limited mobility from border communities
At first it was for one month when a person is evacuated, and we understand that to find housing they will temporarily stay until receiving housing for internally displaced persons; they may end up in a hospital.
Then we extended the stay to two months, now we control it, and at the same time we are developing a nursing care package, because when we once assessed the country's bed fund before the reform and compared it with EU countries, ours was significantly larger than in EU countries, even neighboring ones.
But if we go to Poland and look at the bed fund in medical institutions and the bed fund for nursing care, we'll see it's separated there and did not enter the nursing care statistics.
The issue of nursing care, given the severe patients we have, severe injuries after shellings, severe injuries among servicemen, progression of some diseases of old age, what you might call Alzheimer's dementia—these are issues we must already frankly discuss with society, the Ministry of Finance, and the budget committee.
Will this be, for example, part of the Medical Guarantees Program 2027?
When the government approves the budget, we'll be ready to communicate that.
"We prepared the system for this"
Priorities 2026 – healthy heart, cardiovascular diseases, the screening program 40 plus. Cardiovascular diseases were the top cause of death five years ago as well. Do we see a decrease over five years, or at least not an increase?
Do we see positive changes? I do. Will we get the results we want—reduced mortality and disability over five years? Potentially yes. But five years wasn't enough because we were preparing the healthcare system, launching screening 40+, and expanding the Affordable Medicines program. You can't defeat a disease with only one healthcare system.
It's a social contract, a comprehensive approach. Comprehensive programs have been launched. We included healthy heart issues in changes to school nutrition. In menus and recipe books to ensure healthy nutrition and change eating habits, we excluded salty foods that can lead to high blood pressure and added vegetables, fruits, and so on.
The healthcare system launched a number of things: screening, infrastructure development; recently we installed about 90 anthropographic units and across the country we have 98 reperfusion centers capable of placing stents when vessels are narrowed.
The Affordable Medicines program today covers all medicines included in cardiovascular treatment protocols.
There is a comprehensive program. Now it's a matter of implementation and tracking results. If you look at my interviews at the start of the invasion, we forecasted and see: heart attacks and strokes are becoming younger. We record heart attacks and strokes at ages that 10 years ago were rare, exceptional cases. When we saw the dynamics in guys and girls who were in the ATO, they are having heart attacks and strokes at younger ages.
We prepared the system for this. Territorial accessibility, stenting within the golden hour—heart attacks and strokes should be covered.
Work of a pharmacy participating in the 'Affordable Medicines' program in Zaporizhzhia.
Covered and is it covered—equal sign?
Probably not yet, but it's much more covered.
You mentioned 90 additional angiographs—are they operating at full capacity? We've repeatedly seen and heard from doctors—this isn't new to you—when the Ministry of Health provided equipment and it just sits collecting dust or operates at a low percentage.
90% of the equipment works effectively and doesn't gather dust. There's an issue with 10%, those are nuances. When we looked at the map and saw spots where angiographs needed to be placed—I'll cite the north of Chernihiv and Sumy regions as an example—I traveled there, we had a discussion where to place an angiograph and have a team that can do stenting, because travel time to Sumy or Chernihiv is long given the roads.
We chose Shostka, installed and purchased an angiograph, asked the local government to prepare premises, the problem was resolved, the angiograph was launched, but during that time military actions and shelling of Shostka caused the team to relocate somewhat. So because of these 10% we cannot fully say it works 24/7 as it should.
I understand what you mean: CT, MRI, and the queues that form. There is equipment and it's operational, there are teams, we see in the electronic health system the number of recorded cases – it doesn't satisfy us. Why do people say there are three- to four-month waits for CT, when we look and see five to six CT studies per day? It should be for your level roughly 15–16 or 40 if it's a regional hospital.
Performing MRI at the Sumy Regional Clinical Hospital
There are questions of human factors, informal payments, and business that installed equipment on the premises of communal or state facilities. We proposed: "We'll adopt a legislative initiative to prohibit private CTs from taking payments directly from individuals, only through the hospital." We were supported. There are alternative options. For example, a business operating in state or communal facilities can sign directly with the National Health Service and provide services under the Medical Guarantees Program. I think this will be one option to resolve the issue in 2027 year.
At the same time the digital team led by Mariia Karchevych is developing separate booking for CT and MRI so a person anywhere in the country can see where there is a queue for CT and MRI.
There's also the issue not only of free slots but of doctors capable of interpreting the studies. What do we see about medical staff in the country? When I prepared for this conversation, I privately asked doctors from different hospitals about their issues. The most acute was the issue of nurses and orderlies.
To finish on CT and MRI: maybe there aren't radiologists everywhere to interpret; we allowed outsourcing of that service. This is a global trend. A technician performs the scan, a doctor on outsourcing interprets the data that comes to the facility, and the patient doesn't need to travel.
If you look at nationwide trends, we're doing well compared to EU figures. But when you go to a particular community—there's a problem. It's not so much the number of staff as their distribution across Ukraine. Sometimes some hospitals have many specialists, while nearby or remote hospitals lack them.
In Poland an obstetrician-gynecologist working in a maternity ward handles 200–250 births per doctor; here it's 30–40 per doctor. That's the national average. That affects tariffs. If there are, say, 10 obstetricians who handle 30 births per year, no tariff will be sufficient for the facility to pay adequate salaries to the obstetrician, nurses, and junior staff. And quite often, when we analyze why salaries are low, examples like that emerge.
A patient at a family doctor's appointment.
Family doctors: we have a regulated workload of 1800 declarations per person. Active declarations are plus/minus 30 million. Family doctors – 25 000. On average a family doctor has 1100–1200 declarations. Mathematically we have a surplus of doctors. But if you visit a community, you see the problem: either there is no doctor or he has already taken too many declarations. Sometimes a doctor says: "I don't want to work full-time and take 1800," everyone has their reasons.
Where and whether there is a shortage of doctors
For example, I see incredible burnout and disillusionment among family doctors with how things are going—how comfortable and appreciated they feel. This isn't large-number statistics. But for the first time in many years I see such a trend among family doctors especially, like 'I'll photograph my resignation letter, I'm done, I won't work in the public program anymore'.
By big-number statistics we don't see changes in the percentage of people leaving the profession versus those returning. This dynamic has always been within 10–15% considering temporarily occupied territories and many people who had to leave the country due to the invasion.
We saw an outflow in past years and then stabilization. Do we see trends in discussions with associations, forums, meetings, and regional visits? Yes. Some leave the profession, some say as a private entrepreneur who joined the reform I won't work with the NHS anymore.
Let's be frank. The issue is how doctors and society treat doctors. We see negative trends despite the fact that as authorities we try to communicate positively about doctors' work. A few things prevent us from changing that negative image.
First—presence of informal payments in healthcare. Often this is tied to martial law when people want to buy some indulgence to avoid something. This can involve medical commissions or disability assessments that replaced former medical-psychological commissions.
There is a problem often highlighted by law enforcement and a certain distrust of people in white coats, although those who might sell something are a small percentage in the system.
Minister of Health of Ukraine Viktor Liashko
I ask you to still treat doctors like your relatives and close ones, because these are people doing their work, treating patients, staying in Ukraine, and they also have many problems society doesn't see and that we usually don't speak about publicly.
When you talk about negativity toward doctors, if we recall the case of throwing a medical manager into the trash, the Ministry of Health was silent for the first few days. You didn't at least come out with a public condemnation.
I admit, sometimes a person must acknowledge mistakes. For us it was important to understand what happened, but we should have condemned what occurred. In particular, I as minister and the Ministry of Health should have.
So I apologize to the entire medical community for not responding to that case. Since then we respond to all cases not only with public statements but with actions; we work with law enforcement if needed, and we initiated a bill that increases criminal liability for violence against medical workers. We supported a parliamentary bill that further expanded its scope. We analyze the pains in the healthcare system and how to solve them.
For example.
Salaries. The key task of the reform was what? To remove the ministry from salary-setting policies. The official was removed; the market should regulate it. After five years the main complaint to the Ministry of Health is: salaries.
Second: we continue to work politically by regions and local governments. Recently a well-known professor wrote that hospital consolidation leads to… and listed all the problems in the healthcare system. Reading that message I immediately thought of Lviv, the first TMO, Unbroken, which thanks to consolidation forms the largest pool of funds from the National Health Service.
When the veterans' hospital was merged into the Poltava Regional Hospital people blocked the road; I personally went. Now when I visit the veterans' hospital which became a full three-story rehabilitation center, people say: thank you for the conditions and admit they were wrong then. Rules in the state are written the same for everyone. In some places salaries are much higher than the market, and in others the base 20,000 as prescribed in the resolution.
Poltava Regional Hospital of Restorative Treatment and Diagnostics.
Approximately what percentage have above 20, and which have the base?
I'm not ready to say now. The average doctor's salary across all high-level figures is 27 000 UAH. But in the comments people will surely say they earn 20 000 or even less, that the general director took advantage of the option where if 85% of the pool goes only to salaries, he can pay less than 20. This case needs investigation: what kind of hospital is it and why there are no inflows from the NHS for the services they provide.
Our law on state financial medical guarantees envisages 5% of GDP, but that amount has never arrived in all these years.
Because we finance the security and defense forces. Is it enough? As minister of health I'll say no.
If we talk about the 2026 year, we were ready even not at 5%, but if there had been 250 billion UAH, the Medical Guarantees Program would have had completely different approaches to funding certain packages. We received 191 billion UAH.
Again returning to Poland. We look at how family doctors work there and what doctors earn. To immediately give such salaries as in Poland is technically impossible—those are astronomical figures. But we looked at the average market salary in Poland and doctors' salaries. What coefficient is needed. In our country the coefficient to the national average should be X2.
To do that, we need to add 92 billion UAH to the Medical Guarantees Program. Then the average across the economy as of, say, June 2026 year would lead us to salaries that are X2 the economy average—that would be the baseline salary level for everyone.
Do we have 92 billion UAH? Probably not.
"Reducing the network for the sake of reduction is a road to nowhere"
Does it make sense then to reduce the network paid for by the state among those working in the Medical Guarantees Program? Perhaps where it's not emergency care, introduce longer queues and by that achieve the conditional X2 you spoke of?
Reducing the network for the sake of reducing the network is a road to nowhere.
Viktor Liashko, Minister of Health of Ukraine
I'm not saying for the sake of reduction. If we understand it's large and ineffective, and we want doctors to receive livable salaries in these conditions… We won't be able to say much about fighting informal payments either; it's all interconnected. A head of a department at a large hospital told me they already lack operating room nurses. Maybe it's sensible not to make such broad promises but to narrow them in some areas.
If we talk about the Medical Guarantees Program, it was made to state what the government can finance this year. We contracted for this year, for the first half-year, surgical services—those with fewer than 150 operations in six months, only for half a year—to see the number of facilities and surgeons performing operations but without a large surgical load. A certain number of facilities were designated and we worked with each. For example, hospitals appeared with eight surgeons and two operations per week. The hospital should exist and provide surgery, but should there be eight surgeons?
This forces us to work on regulating the number of specialists that should be in each facility.
But they are already specified in NHSU conditions.
It is written that a hospital must be able to provide 24/7 emergency reception for strokes, heart attacks, and other pathologies, but no more. Our task is where to transfer the doctor so he still wants to continue.
We don't want him to lose his specialty.
We talk more about doctors because people deal with them more often, but without nurses the medical system won't work, especially given where we started—nursing care. Nurses conduct operations, prepare operating rooms, assist, and perform procedures. In many developed countries they are a separate profession, not just the doctor's assistant as here. What about our nurses? How big is the shortage? When we talk about launching nursing care, even for that we need nurses who will take it on.
We created a capable network. Three years have passed. Each hospital outlined development plans; the state wrote plans for maintaining hospital districts. A few months ago we met in Lviv and showed an analysis in Lviv region of the capable network: the depth of services, how many doctors per 10 000 population, how many nurses and doctors, comparing them with European countries.
Indeed we have fewer nurses per doctor and nurses per patient than EU countries. If they are taken as one unit, we have 0,7. About 30% less for sure; we need to think how to solve it.
When we looked globally with the Ministry team about what to set as a goal, I said I take education for myself. Trends in technology development today and what's happening in hospitals indicate a multidisciplinary team where the nurse is a full-fledged team member. If bachelor's programs in medical universities don't have practical university hospitals or clinics where the new doctor and nurse will learn to work in a team, the crisis will worsen.
The key task for the team is to prioritize pay for middle medical staff and junior medical staff. If this issue isn't addressed by facility managers, as a state we'll again be forced to return to some measures. Adopt an educational model or the old one in healthcare where certain requirements are issued, they say the minimum salary must be such, we understand the workload and will centrally impose it. Is that an exit? Probably not. We need dialogue with all CEOs and negotiate, because I have many discussions with successful, average, and unsuccessful healthcare facilities. The unsuccessful ones don't always listen.
A nurse inserts an IV drip for a patient, Kyiv City Hospital.
Am I right from conversations with many clinicians and managers that a successful medical facility today in Ukraine can only be successful if NHSU funds are not the only source of income? Only when a facility works with grants, research, clinical trials, paid services plus NHSU—only by combining funding sources.
You can work exclusively with the NHSU and be successful.
Give a few examples of those.
There are many facilities.
National Cancer Institute. Average nurse salary 35 000 UAH, I think. The national average is 30. They operate exclusively on program funds.
In comments you'll say it's because oncology is prioritized. Let's pick another.
Veterans' Hospital in Vynnyky, Lviv region, where Volodymyr Krasiokha moved from Voznesensk. Sources are attracted for infrastructure matters. Infrastructure, local governments, and the ministry through public investment projects support it. Yevhen Meshko, Mukachevo.
Many facilities are changing and showing results. With the medical reform we carried out decentralization and administrative-territorial reform. Are there problems with tariffs? Yes.
But when there is a justified tariff problem, like with cardiac surgery, we raised it two-and-a-half times, launched it, and still heard from the Academy of Medical Sciences that tariffs weren't justified. We had a big meeting with them, discussed, closed it with the NHSU, recalculated. Then our Association of Cardiac Surgeons assembled; we presented what we were ready to do. They said: "Okay." We increased the tariff, provided scheduled stenting and stents. You provide the service without hints that the state doesn't cover it. Did everything work immediately? No, but today the number of planned stentings, urgency, and positive feedback are increasing.
Postoperative ward at the Lviv Regional Veterans' Hospital.
Are there still things in the system that force a person to buy a stent? Yes, there are, but they should be reported to the NHSU hotline or the Ministry of Health hotline so we can investigate.
I personally submitted a complaint to the Ministry of Health; there's been almost no reply for half a year.
If you think every appeal to us can be handled immediately, that's not the case—the volume is huge. But we can combine appeals. If a signal comes from you and from me about the same service or hospital, it gets prioritized and that hospital will get automated NHSU monitoring or a commission review.
To finalize this part of the conversation, name roughly three to five of your priorities for 2027.
Material situation of medical workers;
Drugs: the 'Affordable Medicines' program, centralized procurement, procurement of medicines from the Medical Guarantees Program in facilities to increase patient access to medicines.
Medical infrastructure. Close gaps that local governments cannot close.
The next two parts of the conversation will be over the coming days.
Document: PDF proof of the original version of the news item "Ляшко: Реформа прибрала державу з формування зарплат. За 5 років топ претензія до МОЗ - зарплати (видео)". It records the publication content at the moment of the first scan, the preservation date and the source: LB.ua.
