First covid, now war: Many of us associated the invasion of Ukraine with the pandemic not yet over and the lack of time to recover from one tragedy before falling into another. But in truth, Ukraine, even before the coronavirus emergency, was already facing outbreaks that are hard to imagine for a country bordering Europe: HIV, drug-resistant tuberculosis, hepatitis C, poliomyelitis. Diseases that require constant pharmacological treatment and well-equipped health structures, which have become impossible to find in the besieged Ukrainian cities.
According to leaders of non-profit organizations, the WHO and the United Nations, the conflict threatens to undo decades of effort and progress in the fight against these infections. Ukraine and neighboring countries hosting refugees risk becoming the epicenter of new and less new health emergencies, in addition to CoViD-19.
Skipped vaccines. At least 64 attacks since the invasion of Ukraine have targeted hospitals and other medical facilities. Those who remain tend to the injured and sick with a light supply of life-saving drugs (such as insulin), oxygen deprivation, lung ventilators and defibrillators, as long as water and electricity are not available. have not been cut.
Half of Ukraine’s three million refugees are children, and children under the age of six may have missed routine vaccinations or may not know their vaccination status. In Ukraine, only 80% of children in 2021 were vaccinated against poliomyelitis: at the end of last year, a few cases of poliomyelitis were recorded in the country, because vaccination coverage is too low for herd immunity. In Europe, overall coverage is 94% and poliomyelitis was officially eradicated in 2002.
Measles in Ukraine also still poses a health risk, as double-dose vaccination coverage is stuck at 82% (the minimum target for herd immunity is 95%). Speaking of vaccines, with only 36% of the population immunized, Ukraine has one of the lowest covid vaccination coverage rates on the European continent. In February 2022, a national vaccination campaign was launched, brutally halted by the war.
Respiratory infections. The overcrowded shelters and precarious hygienic conditions in which displaced people are forced to survive provide an ideal breeding ground for respiratory diseases such as covid, pneumonia and tuberculosis: in Ukraine, tuberculosis is still a problem of important public health, with about 30,000 new cases per year as well as one of the highest incidences of drug-resistant tuberculosis, a disease which affected 29% of new cases in 2018 and which is mainly prevalent in the male population, which remained in the cities to fight. Ukraine also has one of the highest prevalences of TB and HIV co-infections.
HIV. For UNAIDS, at the end of 2020, there were 260,000 people in Ukraine affected by HIV: in the country, the virus that causes AIDS affects approximately 1% of the population between 15 and 49 years old (in Italy 0, 4%) and only 69% are aware of their state of health; only 57% were receiving antiretroviral treatment. The country is making progress in treatment and diagnosis but the conflict, with the breakdown of medical supplies and the destruction of health networks, could set back the clock by 10 years.
More than one in four cases of HIV in Ukraine affect the approximately 350,000 people who inject drugs. Before the war, health policies had led to 17,000 drug addicts receiving substitution therapies for opiate addiction, such as methadone or buprenorphine. It is now believed that stocks of these drugs are running out and that many Ukrainian refugees are heading to countries that depend on Russia for the supply of drugs. Opioid substitution therapy is illegal in Russia.
Diseases of poverty. Life in the besieged communities favors the spread of cholera and diarrheal diseases (from Mariupol, for weeks without water or electricity, there are testimonies of people forced to drink the water left in the radiators so as not to die of thirst) . And among the citizens suffering from chronic illnesses forced to interrupt their treatment, we cannot forget those suffering from hepatitis C: a disease that is generally treatable but which affects approximately 5% of the Ukrainian population due to the lack of access to drugs and diagnostic tests. It was like that before the occupation of the country, now the situation has certainly worsened.