Eight Years of SAFEMed: Building a More Resilient Health System in Ukraine

One of the primary measures of a resilient health system is its ability to adapt to changing circumstances while continuing to meet the needs of the people it serves. In Ukraine, the national health system has faced an extraordinary test of this capacity for adaptation in recent years, as Russia’s ongoing invasion repeatedly threatens to disrupt health services and cut off millions of patients from essential medicines. But thanks to sustained investments in building and modernizing transparent and efficient pharmaceutical systems through eight years of collaboration with the Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity, the country’s health system has been able to adapt and respond. This foundation helped ensure uninterrupted access to care, kept critical services online, and saved countless lives.

On August 14, SAFEMed—implemented by Management Sciences for Health (MSH) with US government funding—marked its eighth anniversary with an event at the American University Kyiv. Nearly 100 leaders from across government, the health sector, civil society, and the international community gathered to reflect on progress and honor a partnership that has fundamentally changed how Ukraine delivers health care to its people.

One of the most transformative accomplishments occurred in 2017, during SAFEMed’s first year: the launch of the Affordable Medicines Program, which provides access to essential prescription medicines for chronic conditions at little to no cost for patients. What began with coverage for cardiovascular disease, diabetes, and asthma now serves 5.6 million patients across 18 disease categories. More than 15,700 pharmacies are enrolled, and more than 74 million electronic prescriptions have been issued. The program has generated approximately $580 million in reimbursement savings, ensuring that patients receive quality-assured medications regardless of their economic circumstances.

Another significant milestone was the creation of Medical Procurement of Ukraine (MPU), which has modernized how the country procures medicines and medical supplies. “The greatest assistance we have received from SAFEMed is the support in creating a state-owned enterprise to oversee Ukraine’s purchases,” noted Mykhailo Radutskyi, Chair of the Verkhovna Rada Committee on National Health. “This made it possible for people to receive high-quality medicines, ensured their affordability, and, most importantly, allowed the state to save significant funds without reducing support for our citizens.” Since 2018, MPU has achieved nearly $260 million in savings for the central government budget, reducing out-of-pocket costs for patients.

Despite these significant gains for millions of Ukrainians, people in remote and war-affected areas often struggle to access essential medications. “Only 14 percent of villages in the Cherkasy region had access to stationary pharmacies, meaning most people were forced to search for even the most basic medicines,” says Valentyna Nikolenko, General Director of the Cherkasy Regional Municipal Enterprise Pharmacy. As one of the pioneers of Ukraine’s launch of mobile pharmacies, which began with SAFEMed advisory support in early 2024, Valentyna’s is one of 15 stories featured during the anniversary event in a powerful photo exhibition highlighting the human stories behind systemic reforms.

“It wasn’t an easy project,” reflects Valentyna, recalling the early days of the efforts to launch the first mobile pharmacy in Cherkasy. “We were among the first in Ukraine to start outfitting pharmacy vehicles from scratch. 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. There were no ready-made solutions.”

Thanks to innovative problem-solving and sustained coordination efforts, today, mobile pharmacy routes cover more than 1,000 settlements across 17 regions, serving patients who previously had limited access to the medicines they need. “For us, this is not about business or profit—it’s about people,” Valentyna explains. “We took on this social initiative as a matter of civic responsibility.”

“We are passing on to Ukraine sustainable institutional capacity, digital tools, and a team of professionals who will continue this important work of achieving even more open and fair access to treatment for every citizen.”

—Rebecca Kohler, SAFEMed Chief of Party, MSH

Valentyna’s words capture the spirit of SAFEMed’s work: practical solutions born from urgency, scaled through leadership and collaboration, and sustained by an unwavering commitment to deliver quality care for the people of Ukraine. “When we started in 2017, we dreamed of a system where patients, even in the most remote corners of Ukraine, would have equal access to quality treatment. Today, we can see these changes clearly,” says MSH’s Rebecca Kohler, SAFEMed’s Chief of Party. “We are passing on to Ukraine sustainable institutional capacity, digital tools, and a team of professionals who will continue this important work of achieving even more open and fair access to treatment for every citizen.”

These achievements are more than policy reforms; they’re lifesaving adaptations that demonstrate Ukraine’s capacity to build sustainable, patient-centered systems that will endure long beyond the lifespan of a single program or partnership.