- In 2015-2020 in the Ukrainian health “invested” more than $950 million dollars, but the lion’s share of the money “passed” medicine.
- $ 7.5 million allocated for the implementation of e-health eHealth. The result: funds allegedly spent, and the output of Ukraine has received a half-assed system.
- More than $ 50 million went to the program of development of system of public health system and epidemic safety. The result: the old system was destroyed completely, and a new one was never built.
- More than $ 15 million program is aimed at regulation of the pharmaceutical industry. The result: funds spent exclusively on the development and lobbying of draft laws.
- 29.7 million USD – for the development and implementation of a new system of financing of Ukrainian health care. Summary: under the threat of financial collapse has put the country’s health system.
- More than $ 2.6 million. on the development of civil society in health care. Summary: the formation of a very narrow circle “pseudopatients” organizations engaged in lobbying activities.
Who and how “finished off” medicine in Ukraine
Now our health care is in critical condition. Completely unprepared and not able to cope with the challenges of the 2020 pandemic, which is superimposed on the scheduled from 1 April to radically change the system of financing of the sector at a critically low level of funding.
So, the global transformation of healthcare, which takes place in Ukraine, were required to attract significant investment and financial resources. Us these funds are abundantly given in the form of technical assistance projects.
The total volume of technical assistance in 2015-2020 in the Ukrainian health care amounted to the enormous sum of over $950 million dollars, of which about $270 million – funds Global drug Fund, and $680 million – other donors, international organizations and countries.
With proper prudent and effective use of these tools could help to upgrade the material base of our hospitals, introducing modern management processes, train medical personnel, i.e. to prepare the medicine to the acceptance of the challenge of a global pandemic coronavirus infection.
However, instead of benefit to the state and society, technical assistance projects have become a financial source separate groups, which use them to provide lobbying their interests and media attacks on the leadership of the state and industry.
Where “left” money for medicine
Funding of lobbying, information and political campaign runs officially through the inclusion of necessary directions in the technical assistance projects (development of projects of strategic documents, laws and normative legal acts and the process of advocating for their adoption), as well as informally – through the formation of appropriate financial sources due to the simple misappropriation of donor funds.
These funds became the basis for the construction of the system of external control of the health of our country, which right now does not able to make and implement effective management decisions nor the Ministry of health nor the parliamentary Committee.
MOZ and medcomtech simply deprived of subjectivity. Each Department Moza is the executor of a project of technical assistance, and staff receive an additional financial reward just because they legalize the documents prepared by external “experts”. Also, our MPs are not representatives of the interests of the people and the real subject of the legislative initiative, but simply the signatories of the bills that they are prepared for external “experts” running and execute commands of their donors.
Got medicine for $950 million in foreign aid
- More than $7.5 million technical assistance (excluding $6.2 million of the World Bank, which has not yet been allocated) has been and will be spent on projects related to implementing e-health eHealth.
As a result, we got unfinished e-health system that doesn’t support half of the options that are required to implement new financing mechanisms that are not clear in whose ownership it is unclear who and handling. In this data (including personal data of patients) are not only protected from third party interference and not validierung and are of questionable correctness.
Now in the almost 1.7 million of the “left” of patient records where there is even a pregnant male. And this information in the past year the state has funded nearly 20 billion UAH, and this year should Fund 72 billion UAH.
It is practical as eHealth is the main reason for the cancellation in 2019, the implementation of the project “free diagnostics” and the main obstacle to the introduction this year of a truly effective mechanism of remuneration for medical institutions for each treated case “money follow the patient”. And because of the lack of sane business model of functioning of e-health further content to just lay on the budgets and so financially insolvent state and municipal medical institutions and pharmacies.
- $29.7 mln technical assistance focused on the development and implementation of a new system of financing of Ukrainian health care.
The result was developed and adopted the law and implemented state system of single-channel health financing through a single buyer of medical services (similar to the UK) for which the state is not in the near future there will be necessary budget resources. For its future implementation it became clear that the state can direct the centralized procurement of medical services through a single buyer no more than 30% of the required funding, which de facto turned a single-channel system three-channel financing (state budget, local budgets, funds of the patient), for which there is no legislative support.
In addition, developed economically unjustified tariffs in 2-4 times less than the actual cost of medical services. As a result, the moment of the practical implementation it turned out that the system of funding is inefficient and requires a radical revision. All interventions at the organizational and methodological support of the implementation of a new system of financing the regions has proved ineffective.
The pilot project “free diagnosis” has been cancelled due to lack of preparation, a pilot project of implementing a new Finance system in Poltava region and pilot project funding the provision of tertiary services institutions would lose a fight was started with a serious delay and passed with questionable results.
Before the beginning of mass introduction of a new mechanism, the regions and health facilities were not ready to work in new conditions. As a result, the continued implementation of the threatened financial collapse of the entire health system of the country.
- More than $5.5 million of technical assistance aimed at the development and information support of immunization programmes.
As a result, we have the lowest vaccination coverage in Europe, the large and growing number of macinskaia. Increasing because of the policies established in immunization.
On the one hand, the forced transfer of us, only in Europe (and against the recommendations of the Who), with acellular to whole cell vaccine, characterized by a much large amount of reactogenicity and adverse reactions. And on the other, is belief of parents that become vaccinisation due to the real problems of their child after vaccination, their chattering and insults with accusations of mental retardation from the “agents of change” (receiving funds for information campaigns on the part of the recipients of technical assistance).
- More than $15 million technical assistance program aimed at regulation of the pharmaceutical industry.
These funds are spent exclusively on the development and lobbying of draft laws, as well as information support for their adoption.
The result is the formation in the public consciousness the perception of Russian pharmaceutical companies (who only really can provide the necessary medicines to the population of Ukraine in the period of the pandemic coronavirus infection) the image of the enemy and the pharmaceutical mafia.
The implementation is unique from the point of view of the neglect of the national interests of the mechanism for international procurement, in which 26 billion UAH of budget funds were withdrawn from the Ukrainian pharmaceutical market and the actions of the Ukrainian legislation and placed under the absolute disposal of the international organizations. Attempt to spend through Parliament the bill on parallel import, in fact, opens the way for falsification in our pharmaceutical market, bypassing state control and regulation.
The attempt to radically change the regulatory system of the pharmaceutical market and to centralize it (medical, pharmaceutical, and technological aspects of regulation) into a single regulatory authority that are contrary to the Ukrainian realities and carries significant corruption, lobbyist, and management risks. Blockade of the formation of a qualitatively new, efficient and modern legislative framework of the pharmaceutical industry in the form of a new law “On medicines”, fully harmonized with the European legislation.
- More than $50 million on the program of development of system of public health system and epidemic safety.
In the result of pre-existing effective system of public health and epidemiological safety, on the basis of SES were destroyed, without creating adequate alternatives. Created to replace its system of Centers for public health – demonstrated its complete failure in the face of the pandemic.
One of the reasons she had to be based not on centralized administrative management (SES had the administrative hierarchy of the regional SES under the control of the sanitary doctors of regions), and on economic and information management principles on the basis of decentralization, in which the TSGS is subordinate to the Ministry of health and manages the system possessing information and directing the financial flows of the order required his services, as TSGS in the regions of regional subordination and in the regions were to be transferred to all laboratories infection control.
On the one hand, this has led to the destruction of the system because the regions do not see the need to Fund the extra for the function, and on the other hand it turned out that the Ministry of health does not have the ability to carry out and coordinate the conducting of anti-epidemic measures at the regional level – he just doesn’t have the coordination mechanisms with the regions and management of a network of medical institutions in the regions.
In addition, with the collapse of the SES was lost experienced and competent staff, instead of which the system CGS hired new employees on the principle of personal devotion, without knowledge and experience. Ukraine met the pandemic coronavirus infection without a system of epidemiological protection, with huge holes in the legislative and normative-legal regulation in this sphere, and even without the chief health officer – a person who by law have to declare the epidemic and to give suggestions on the organization of quarantine. Simply put – nothing!!!
- More than $2.6 million on the development of civil society in health care
As a result, instead of creating a system of social support and promote the interests of patients, and assistance to public organizations that integrate and provide real assistance to a wide range of patients, was the formation of a very narrow circle “pseudopatients” organizations that are not providing real help to patients, but engaged in lobbying activities and the implementation of a customized information campaigns.