Viktor Liashko: What is expected from new health minister?

The Verkhovna Rada has appointed Viktor Liashko, the former deputy health minister and chief sanitary doctor, as the new minister of health. Some 262 MPs voted for his candidacy, and he will be the fourth minister of health in the two years of Volodymyr Zelensky's presidency. Liashko said that his main task was to "overcome the epidemic of coronavirus disease and its consequences, which will accompany us for at least the first five years." In this context, he set a rather ambitious goal - to fully vaccinate five million people in his first hundred days in office. To achieve this goal, 50,000 vaccinations per day will be required. The near future will show whether such a promise by the minister is attainable or not, but so far it must be stated that within three months of the vaccination campaign in Ukraine less than one million citizens received the first dose of the vaccine. Liashko also promised to prepare the healthcare system for the next infectious challenges during the summer, when the morbidity is expected to decline.

But of course, there are still many tasks facing the newly appointed minister, from continuing health care reform to developing health education. What do medical experts think about this?

Pavlo Kovtoniuk

In a comment to Ukrinform, Pavlo Kovtoniuk, a co-founder of the Ukrainian Public Health Center and deputy minister of health in 2016-2019, named the three highest priority challenges for the new minister. First, it is a difficult situation with COVID-19. "The last wave was very difficult, and the next one will be even harder. At the same time, vaccination did not start so normally. The very important task for the new minister is to make up for lost time in the vaccination campaign. This is the number one priority not only for the minister of health, but for the entire government and the entire country. But in addition to vaccination, we need to return to the development of the public health system now - to build the capacity to respond to subsequent pandemics. Now the priority is to put out the COVID-19 fire, but during this wave it is necessary to build a new system in parallel," Kovtoniuk said.

Secondly, it is necessary to continue the reform, which was left out of the attention of the previous minister. According to him, now every medical institution solves its problems independently: someone uses its opportunities and things are going better there, but in most institutions, nothing changes. "This is because no one in the country is taking on the role of leader - the reform has been forgotten. In the previous composition of the Ministry of Health, there was not even a person who would be responsible for it. During this time, the National Health Service of Ukraine suffered greatly, which instead of developing and strengthening was forced to fight for survival and repel attacks by people who wanted to take control of the budget for the program of medical guarantees (UAH 130 billion). The new minister needs to do two things: invest heavily in the National Health Service of Ukraine, both financially and in terms of staff, and actively help communities to re-adjust their hospitals to the new system so that hospitals learn to be successful - this includes training, retraining, re-planning networks," Kovtoniuk said.

In addition, in his opinion, it is necessary to expand the list of drugs in the program "Affordable Medicines," which has stopped developing. It is necessary to improve service packages of the program of medical guarantees, tariff formation approaches, further develop the eHealth system, and continue changes in medical education. "The only reform that has continued is the changes in transplantation. We see the first results, but so far this is not a systemic change, but an initiative of individual doctors and hospitals - there is still a lot to be done," Kovtoniuk said.

Thirdly, the drug procurement system has also suffered under previous ministers. "The Medychni Zakupivli [Medical Procurement] state enterprise did not develop, but was engaged in repelling attacks and attempts to bring the purchase of drugs back to the Ministry of Health. Medychni Zakupivli must finally review and streamline all programs," the expert said.

Yulia Brykulska, head of NGO Medical Leaders, emphasized that the minister's first task should be to create a strong team of deputy ministers and to attract new people - consultants, activists, volunteers working on one big idea.

Yulia Brykulska

She dwells on the issue of communication, which failed under the previous minister. "Maksym Stepanov's group of PR people worked very well, but they worked for him personally. I wouldn't say it was a well-thought-out communication campaign for the community. We also see a failed vaccination campaign, both purchasing and communication components. Therefore, these points need to be corrected in the first place," Brykulska said.

She also emphasized the need to create a program to support hospitals. "These should not be stories about the Ministry of Health raising salaries, because within our health care system, the Ministry of Health has nothing to do with doctors' salaries. Do not deceive doctors, but determine where exactly the Ministry of Health can help. This may be communication with local authorities, the allocation of additional funds for the program of medical guarantees, assistance with the purchase of equipment. My colleagues and I also believe that the next minister should not come up with any know-how and look for 'his own way,' because it does not lead to anything. It is worth continuing the course for European integration, comparing the best practices implemented in Europe, in particular in the quality of medical services, medical education, in order to implement them successfully in Ukraine," the expert said.

Yevhen Naishtetyk

Yevhen Naishtetyk, the founder of the investment company in the field of medical and biological startups Lorton Investments, predicted what Mr. Liashko may or may not do as a minister. He believes that Liashko has a number of advantages compared to the last eight health ministers and acting health ministers. "First of all, his career took place in the Ukrainian health care system, and he worked with the Ministry of Health bureaucracy. He is energetic, young, intelligent, without a mania of greatness, and he is able to negotiate," Naishtetyk said.

He believes that the new minister will most likely be able to move from the deadlock of digitization of medical records, however, significant improvements in health care should not be expected. "Conflicts with procurement agencies and international organizations will most likely disappear. Vaccination against COVID will most likely move from the deadlock. We will not see market tariffs, and doctors' salaries will not grow," he said.

Yulia Horban, Kyiv