Dear Mr. Stepanov,

Public procurement of medicines for 38 health programs financed from the state budget of Ukraine must have started in February-March 2020 but failed.
According to public information from SE “Medical Procurement of Ukraine”, medicines for seriously ill patients will run out in three months. In September medicines will not be available for:

• newborns with respiratory disorders;
• oncology children;
• people living with HIV.

Other categories of patients with inevitable death in case of therapy discontinuation are also endangered. We talk about patients with orphan diseases, patients suffering with hemophilia, patients with blood cancer and other severe chronic diseases.

More than 24-hour break in life-long treatment for 130 000 people with HIV means daily progressive increase of the number of patients with failed treatment regimens, which require urgent switch to another life-long treatment regimens with medicines ten times more expensive and unavailable in the national medical stocks.

Procurement of stents for treatment of infarction in about 40 000 Ukrainians has not yet started. Hospitals will not be able to provide infarction treatment services free of charge, while such service has been identified as a priority for the health care system.

This will reverse the situation back when bribes for life will be demanded from patients who would otherwise die in 4 hours.

Socially important information on the availability of state-procured medicines and medical devices for all nosologies is not published, which makes it increasingly difficult for patients’ organizations to seek additional funding to procure medicines for patients who may die because of treatment discontinuation.

State budget 2020 allocates the unprecedented amount of funding for state pharmaceutical procurement programs: UAH 9.8 billion. These budget funds are not used, start of procurement procedures is blocked for five months, two of which you are working in the capacity of Health Minister.

SE “Medical Procurement of Ukraine” and international organizations assigned by COM Resolution No 298 and MoH Order No 589 for pharmaceutical procurement cannot initiate the procurement procedures until MoH Ukraine adopts 8 orders, whose drafts have been long ago developed and submitted to MoH and until agreements with international organizations specified by the COM Resolution are signed with the Health Ministry.
If procurement procedures start tomorrow, which is not possible, the first lots of medicines can be delivered to patients only in the first half of 2021: procurement procedures last from 2 to 4 months and also time is needed for delivery and for manufacturing of some medications.

Adoption of the COM Resolution No 350 of May 6, 2020 specifying the list of medicines procured by the state budget can be considered as a positive fact against the background of the complete failure of the public procurement process.

At the same time, the adopted Resolution affects the legal relations during financial and logistical operations and was not an obstacle to the start of tender procedures, which could be initiated in accordance with the approved passports of the budget programs. Passport on implementation of the budget program KPKVK 2301400 has just been forwarded from the Health Ministry to the Ministry of Finance under pressure from the patients’ organizations and we expect from the Ministry of Finance to understand this crisis situation and meet the 10-day regulatory deadlines.

Available pharmaceutical stocks by various nosologies will run out with different pace and the most critical situation is expected in the end of September – early October.

We request the officials involved in decision-making and the Health Ministry to:

• immediately publish socially significant information on the residual stocks of medicines and medical devices for the programs funded by the state budget;
• seek humanitarian assistance from donor organizations for supply of medicines in the period of artificially created shortage;
• immediately unblock centralized procurements by signing legal acts (Annex 1 attached) required for the procurement initiation;
• Select specialized international organizations, conclude agreements with them and provide them and the legally assigned procurement agent SE “Medical Procurement of Ukraine” the order and funds for procurements.

Inna Ivanenko, Executive Director of the CF “Patients of Ukraine;
Olga Kudinenko, Founder of the CF “Tabletochki”;
Dmytro Sherembei, Chairman of the Coordination Council of CO 100% “Life Network”;
Nina Astaforova-Yatsenko, Head of the CF “Children with Hemophilia”.