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Eight Years of Driving Change: Voices from Ukraine’s Path to Safe and Affordable Medicines

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August 06, 2025

Eight Years of Driving Change: Voices from Ukraine’s Path to Safe and Affordable Medicines

For eight years, the Safe, Affordable, and Effective Medicines (SAFEMed) for Ukrainians Activity partnered with the Government of Ukraine to strengthen the country’s pharmaceutical system and expand access to affordable, life-saving medicines. Through bold reforms, digital innovation, and strategic partnerships, SAFEMed helped build the foundation for a more resilient, transparent, and equitable health system.

But behind the policy reforms and systems change are the people whose lives were directly impacted—health workers, patients, drivers, advocates, and many more who stood on the frontlines of progress.

Their voices tell the real story of transformation. Captured through a photo exhibit in Kyiv, these testimonials reflect the heart of Ukraine’s journey toward health for all.

Access and Affordability Close to Home

Launched in 2017, Ukraine’s Affordable Medicines Program has now reached more than 5.6 million people with free or low-cost medications. With support from SAFEMed, what began as a pilot is now a nationwide commitment to health equity—delivered through e-prescriptions, mobile pharmacies, and thousands of service points across the country.

Public awareness campaigns by the Ministry of Health and the National Health Service of Ukraine—supported by SAFEMed—have reached over 7.75 million contacts , connecting families with the care they need, closer to home.

“People shouldn’t have to save money at the expense of their health. The Affordable Medicines Program makes that possible. I remember when the program was first introduced, it was hard to believe it would work. But then patients with bronchial asthma started receiving expensive medications for free—and that was impressive.”—Tetiana Maznichenko, family doctor at the Bucha Primary Health Care Center.
“The Affordable Medicines Program is truly great. It significantly reduces the financial burden on patients—a vital support, especially for pensioners, internally displaced persons, and people with chronic diseases.—Tetiana Maznichenko, family doctor at the Bucha Primary Health Care Center
“I continue using the Affordable Medicines Program, which I first learned about many years ago in Avdiivka. Back then, I was prescribed medications through an electronic prescription—and here, it works the same way. In my case, these are medications for high blood pressure and blood thinners. I take them daily, and without this program, it would be very difficult. I don’t remember exactly how I first heard about it, I just know I contacted my doctor and got my prescriptions without any issues. I’m sincerely grateful for this program. It truly helps, especially us pensioners.”—Nina Hostieva, an internally displaced person and patient, Bucha.

Systems that Save Lives

Health is built on systems—supply chains, data flows, policies, and logistics that move medicines from warehouses to the people who need them. SAFEMed’s work across every link in that chain—from TB treatment to HIV deliveries—proves that when systems work, lives are saved. These voices illustrate the human impact of a stronger, more connected health infrastructure.

“This year, we had our first patient diagnosed with tuberculosis. She quickly started treatment, and we immediately received a call informing us that we could provide her with the necessary medicines. Since then, the medications have been arriving regularly.  It’s very convenient. Before, we had to travel to Boyarka, but now everything is delivered directly to us. The patient no longer has to travel either, she simply comes to the clinic and receives her treatment. We are grateful for this support, as it improves the quality of life for our patients.”—Halyna Korol, Head Nurse, Kyiv Region
“I drive around Kyiv and the surrounding region, visiting up to 15 locations a day. I can cover up to 600 kilometers. The routes are long, but the most important thing is to deliver the medicines on time so that patients receive the treatment they need.”—Pavlo Dubrovnyi, Driver at FM Logistics 
“I’ve been living with HIV since 2017. Fortunately, I’ve never experienced interruptions in treatment—there have always been people and organizations who helped me access my medications on time. I’m registered in Kyiv, where I regularly receive my medicine for free through a government program every few months. It’s important to know that the system works and that you’re not left alone. All my needs—from routine consultations to lab tests and medication—are fully and timely met. That gives me a sense of confidence and peace of mind. I’m grateful for this support.”—Andrii Tytarenko, person living with HIV.

In partnership with the Center of Public Health and the private sector, SAFEMed developed and implemented a last-mile delivery model for medicines to treat HIV, tuberculosis, and viral hepatitis. The pilot project, launched in Odesa region in 2019, now supports 500 health facilities across 10 regions. Between March 2021 and June 2025, medicines worth over UAH 280 million (~USD 8.3 million) were delivered. In recognition of this work, SAFEMed received the 2021 Supply Chain Innovation Award.

Innovation, Data, and Local Leadership

SAFEMed invested in tools that drive smart decision-making. By strengthening Ukraine’s national health information system and access to reliable information and analytics on the pharmaceutical market, SAFEMed helped partners collect and use real-time data to monitor performance, optimize procurement, and better serve patients.

“Harnessing data is fundamental to navigating the complexities of health service delivery, ensuring equitable access, and optimizing resource allocation.”—Iryna Gorlova, SMD CEO
“The establishment of the State Control Authority will be a positive step forward. In this process, we all agree that procedures must be carefully and competently designed, with a clear commitment to transparency, impartiality, and importantly, a system of checks and balances should be in place. We clearly remember when inadequate planning and decision making of earlier times directly impacted patient access. Today, I’m encouraged to see that patients have a voice in this initiative.”—Inna Ivanenko Head of the Patients of Ukraine Charitable Foundation

“The Health Technology Assessment (HTA) procedure introduced in Ukraine is a positive and necessary tool that influences the selection of medicines and promotes the efficient use of public funds. We like to see continued strengthening of the system, especially in the context of rare (orphan) oncology medicines. These are extremely expensive and require a separate, more flexible approach. It is important that the HTA procedure in Ukraine covers all categories of medicines, including orphan drugs, as this directly affects the lives of patients with rare diseases.”—Tetiana Kulesha, Chair of the Board, Civil Society Union “Orphan Diseases of Ukraine”. Photo by Oleksandr Tsybin

Whether supporting health technology assessments for rare diseases or upgrading warehousing and equipment—like electric forklifts or cold chain infrastructure for vaccines—the Activity prioritized evidence-based systems that improve outcomes and build trust.

“When we saw that only 14% of villages in the Cherkasy region had access to stationary pharmacies, it became clear: most people were forced to search for even the most basic medicines. Thanks to the MOH’s initiative, we were able to launch a critical solution—mobile pharmacies. For us, this is not about business or profit—it’s about people. We took on this social initiative as a matter of civic responsibility. It wasn’t an easy project. We were among the first in Ukraine to start outfitting pharmacy vehicles from scratch. There were no ready-made solutions—we had to figure out how to maintain temperature control, protect the medicines from dust and moisture, and organize the space in a way that was comfortable for pharmacists.”—Valentyna Nikolenko General Director, of the Cherkasy Regional Municipal Enterprise “Pharmacy”
“Today, mobile pharmacies carry a full range of medicines, including those available under the “Affordable Medicines” Program. Most importantly, patients in even the most remote villages receive the medications they need — on time and without unnecessary barriers. This is about real access and the care that people can feel.”—Valentyna Nikolenko General Director, of the Cherkasy Regional Municipal Enterprise “Pharmacy”

The first mobile pharmacy started operating in the frontline Kharkiv region in early 2024, followed by launches in 17 other regions. SAFEMed provides legal and coordination support to the Ministry of Health for the rollout of this initiative. SAFEMed also supported a national communication campaign to raise awareness about mobile pharmacies, reaching 1.5 million Ukrainians.

Building Resilience at Every Level

SAFEMed, together with the LA Law Firm, provided expert support in implementing key legislative changes in the regulation of medicinal products. Their joint work included policy development, reforming public procurement, launching the reimbursement program, transitioning to electronic prescriptions, and harmonizing legislation with the best world practices. SAFEMed and LA jointly laid the legal groundwork to ensure timely access for Ukrainian patients to quality and safe medicines. 

“SAFEMed’s involvement in drafting numerous bylaws under the new Ukrainian Law on Medicinal Products brings Ukrainian legislation closer to international standards every day. The new regulations have laid the foundation for implementing many initiatives, including the Affordable Medicines Program, the use of managed entry agreements, and the introduction of the HTA function.”—Dmytro Aleshko, Co-founder and Partner of LA Law Firm
“Cooperation with SAFEMed has enabled profound changes in the legal framework of the pharmaceutical sector — from launching the reimbursement program and electronic prescriptions to establishing transparent procurement through the Medical Procurement of Ukraine. Together, we’ve laid a strong foundation for the further development of Ukraine’s healthcare system. I am confident that its resilience and effectiveness will be positively evaluated for decades to come.”—Dmytro Aleshko, Co-founder and Partner of LA Law Firm
“Acquiring our own warehouse facilities was a major step in the transformation of MPU into a full-cycle agency. This became possible thanks to strong support from our partners, particularly SAFEMed, which assisted throughout the entire process — from developing an action plan and conducting a comprehensive logistics audit to addressing legal, audit, and financial matters. The logistics audit helped identify bottlenecks in storage, inventory management, and staff coordination, and provided recommendations for optimizing and automating operations in line with international standards. With SAFEMed’s support, we upgraded our equipment — adding electric forklifts and carts — which reduced loading and unloading times from three hours to just one, speeding up the delivery of medicines from suppliers to patients. As a result, the warehouse’s throughput capacity has increased to 300 pallets per month, with the goal of reaching 500. This allows for faster and more efficient delivery of medical products across Ukraine.”—Andrii Tokarchuk, Head of the “Medpostachannya” Branch
“SAFEMed plays a key role in supporting pharmaceutical reform in Ukraine. One of the most impactful aspects has been regulatory development. This includes the creation of transparent and clear procedures for the registration of medicines, which has significantly simplified the entry of new drugs to the market. Another important area is the improvement of pricing and procurement systems. These efforts help reduce the cost of medicines and increase their accessibility for patients.”—Vitalii Hordiienko, CEO of SONA-PHARM

SAFEMed was instrumental in the founding of the Medical Procurement of Ukraine (MPU) and has supported the institution from the very beginning on its path toward becoming a full-cycle agency. One of the key areas of collaboration was SAFEMed’s support in the integration of the former state-owned enterprise Ukrmedpostach into MPU, which ultimately led to the establishment of the “Medpostachannya” branch and the acquisition of in-house warehouse capacity.

Patients and Providers at the Center

Since the beginning of the full-scale war, SAFEMed has supported the Ministry of Health in building an effective system for receiving, tracking, and distributing humanitarian aid. 

Thanks to this, over 12,800 tons of medical goods — worth more than UAH 20.5 billion (~USD 500 million) — have been delivered to hospitals across Ukraine. This includes more than 26,000 pallets of medicines, equipment, generators, ambulances, medical furniture, and other critically needed supplies. 

With support from SAFEMed, over 4.8 million doses of routine immunization vaccines were delivered by 2024, protecting children across the country.

“This forklift changed our lives. Before, to unload heavy equipment—like a diesel generator weighing over one and a half tons—we had to call in special vehicles: tow trucks and cranes. It was extra cost and hassle. Now, we can do everything ourselves—quickly and safely.”—Vitalii Alekseiev, Head of the Warehouse at the Mykolaiv Regional Medical Supply Base
“For us, this is a huge support. In times like these, when every minute and every hryvnia counts, equipment like this is a real lifesaver. We’re sincerely grateful to the US government and SAFEMed—not just for the forklift, but for helping us work better and ensuring that hospitals across the region get what they need without delay.”—Vitalii Alekseiev, Head of the Warehouse at the Mykolaiv Regional Medical Supply Base
“Immunization is one of the most effective public health interventions, saving millions of lives every year. The logistics and cold chain system is a critical component in ensuring that patients receive high-quality and safe vaccines. When rCDCs took over vaccine supply management at the regional level in 2022, we received substantial support from international partners to upgrade equipment, train staff, and launch warehouse operations and vaccine delivery. Ensuring a proper cold chain system in Lviv region helped restore public trust not only in the immunization process but also in the government’s ability to provide reliable logistics for storing immunobiological products. In turn, this has strengthened overall confidence in vaccination itself.”—Nataliia Ivanchenko, Director General of the Lviv Regional Center for Disease Control and Prevention (rCDC)
“One mother came back just to thank us after her child received the measles vaccine. She felt relief knowing her daughter was protected, especially since many children at her school remained unvaccinated and at higher risk. Vaccination is a powerful investment in both mental and physical health.”—Ihor Zastavnyi, co-founder and family doctor at a private outpatient clinic in Lviv Region: 

A Foundation for the Future

From launching Ukraine’s first independent pharmaceutical regulator to developing the country’s national reimbursement program, SAFEMed played a pivotal role in shaping sustainable, patient-centered reforms.

Legal, policy, and procurement systems now reflect international best practices—ensuring better access, better quality, and better value for patients. As Ukraine looks ahead, the foundations built by SAFEMed will remain a durable platform for continued progress.

“This legacy belongs not just to the SAFEMed team, but to the people of Ukraine—whose resilience and vision for the future have made every reform possible.”

—Rebecca Kohler, SAFEMed Chief of Party, MSH

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