Statement to the WHO Europe Regional Committee Special Meeting on 10 May 2022
This statement has been submitted by the European Cancer Organisation, in our capacity as a Non-State Actor at WHO/Europe.
This intervention has been written in cooperation with participants in the ECO-ASCO Special Network on the Impact of the War in Ukraine on Cancer and its Steering Committee which is co-chaired by the President of the European Cancer Organisation, Andreas Charalambous, and includes over 300 organisation representatives including medical societies, patient organisations, cancer centres, charities, foundations and the healthcare industry across the world that immediately responded to the Russian invasion of Ukraine and can viewed here.
More information for Ukrainian cancer patients and those trying to help them: www.onco-help.org
We support the convening of today’s special meeting of WHO Europe member countries. We urge the meeting be taken as an opportunity to highlight, discuss and coordinate actions addressing the healthcare needs that the war is having in Ukraine and across the wider European region. The sense of concern and urgency is shared by the European and international cancer community.
Ukrainian cancer patients, and their care, have been drastically impacted by Russia’s invasion. This includes:
- The bombing and destruction of healthcare facilities, including hospitals (with subsequent loss of critical health infrastructure);
- The deterioration of medical supply lines to areas of need across Ukraine;
- The displacement of millions of Ukrainian citizens, including adults and children with cancer, their caregivers and healthcare professionals;
- The creation of enormous trauma to citizens, including those already suffering the distress associated with cancer;
- The substantial pressure on health services across the European region, including in countries neighbouring Ukraine, as governments make significant efforts to meet the humanitarian needs of those displaced by the invasion of Ukraine;
- The repeated transgressions against numerous internationally established principles, a prominent example being medical neutrality, the principle of non-interference with medical services in times of armed conflict.
The European Cancer Organisation (ECO) and the American Society of Clinical Oncology (ASCO) Special Network on the Impact of the War in Ukraine on Cancer takes the occasion of today’s Special Meeting of the WHO Europe Regional Committee to highlight a range of needs that can be more fully met through inter-governmental attention and response.
- Meeting the needs of Ukrainian cancer patients in transit
Ukrainian citizens with cancer fleeing from areas under attack and seeking safety and security in another country require very rapid, proactive support. Information about how to access medical and supportive care in another country must be made immediately available to them upon arrival and in their native language. Those working directly with refugees from the war in Ukraine should be made aware of the many resources now available online to help meet this need, including, but not limited to www.onco-help.org (and www.onko-help.org).
Ongoing attention is also required to ensure appropriate health screening for those leaving fleeing Ukraine and arriving elsewhere. This can greatly increase the speed with which individual health needs are identified and addressed. Technological and legal barriers to the transfer of patient data, such as clinical records, from Ukraine to the patient’s new host country, should be identified and removed/mitigated as much as is possible.
Participants within our Special Network also advise us of obstacles in the evacuation of cancer patients with critical care needs from Ukraine. These include very fragmentary approaches between countries in the way that such movements are enabled according to national rules and requirements. We call for urgent action to streamline and coordinate procedures to allow more people to reach the help they need in a timely way.
Our Special Network has identified a significant and pressing need to improve the mental health support provided to those leaving Ukraine. We are also conscious of a wide range of partner organisations ready to assist should a fuller strategy by governmental and aid organisations enable this.
- Tackling medical supply shortages
Immediate efforts must be made to ensure the ongoing provision of medical supplies to healthcare facilities in Ukraine. We are aware of strong responses by agencies such as the WHO, European Commission and many other actors, including cancer patient organisations, relief agencies and the healthcare industry, to address these concerns. We commend all who are addressing this issue for their dedication and the results they have achieved so far. Nevertheless, the intelligence we are gathering from different cancer centres and organisations in Ukraine reveals that crucial life-saving and life-extending needs remain to be addressed. These include the supply of many generic cancer medicines essential to standard care, as well as items necessary for the maintenance of other cancer treatment modalities such as single-use surgery tools.
Radiotherapy treatment is also affected by the war, yet its continuity is strategic for optimal cancer care. Maintaining radiotherapy capacity in Ukraine and neighbouring countries has particular and complex needs requiring large, fixed equipment with patients attending daily over several weeks, ideally without interruptions. It is also accompanied by very particular human resource needs.
Rapid attention of the WHO, EU and governments to these matters is required. This includes finding ways to improve the information flow and understanding of all actions being taken. Further, while we firmly support the WHO Essential Medicines List as an excellent starting place for ensuring preservation of critical medicine supply, it should not be taken as the limit of medicine supply. Many vital, life-saving and life-extending treatments for cancer will otherwise not be made available to Ukrainian cancer patients.
Further strategies are also urgently required to guard against any potential exploitation of the present situation by black marketeers.
In collaboration with the WHO, and with many participant organisations within our Special Network, we are giving close consideration to the consequential medical supply challenges of the countries neighbouring Ukraine. We will provide further information on this in a report that we are preparing based on data intelligence we are gathering in the region.
- Civil society: a resource to be enabled
Civil society organisations are a strong force, providing precious support, rapid responses and ensuring humanity prevails in this present devastating situation in Ukraine. They can often respond with great speed to reported gaps in care provision and take a hands-on approach to helping individuals in need, overcoming obstacles and achieving better care for those suffering from the impact of the war in Ukraine. We urge governments to give serious and high-priority consideration to ways in which the work of these organisations (many of which are made up of volunteers) can be supported through this crisis to deliver what others are not providing at this time. This might include the resourcing of defined liaison points to better enable efficient communication between all organisations in responding to emergency health needs in Ukraine. We believe that the WHO and/or other agencies could have a further coordinating role in this regard, reducing the risk of the Ukraine Ministry of Health being potentially overwhelmed.
- Assist Professional Qualification Recognition
Our Special Network is also aware that many of the millions who have departed Ukraine hold professional qualifications in healthcare vocations but are not fully able to contribute these skills to their hosting country’s health service, due to issues with professional qualification recognition. We urge an early resolution of such problems so that these trained professionals can contribute their skills to the healthcare effort.
More than ever, this is a time for health solidarity
The invasion of Ukraine by Russia, and its consequent impacts on healthcare delivery in Ukraine and neighbouring countries, underpins an imperative to the conscience of all European nations to deepen cooperation and ensure joint endeavour in meeting these critical new needs which our Special Network has identified. The warm welcome of Ukrainian citizens by its neighbouring countries to the West and South and by other countries beyond, has been inspirational.
But health service capacities are finite in any country, and the war has placed not only unprecedented strain on the healthcare services in Ukraine, but has also created tremendous challenges for the healthcare services in other countries who are trying to help displaced cancer patients and their families. The war has also amplified already-existing inequalities in access to optimal healthcare in surrounding countries, inevitably leading to increased inequities. For this reason, all countries in Europe must unite together in the pooling of health service capacity and resources, prioritising actions according to the countries neighbouring Ukraine which have the greatest support needs. For example, Moldova is hosting the highest Ukrainian refugees per capita at present, while Poland has received more refugees from Ukraine than all other European countries combined. The United Nations High Commissioner for Refugees (UNHCR) estimates 857,846 Ukrainians have fled to Romania, 557,001 to Hungary and 391,592 to Slovakia.
We appeal urgently to national government representatives attending and participating in the WHO Europe Regional Committee special meeting on 10 May to vigorously expand their joint commitments in this area, cooperating actively with all stakeholders, to meet the healthcare needs resulting from the invasion of Ukraine, and make early preparations for the build back of Ukrainian health services into the future.
The ECO-ASCO Special Network on the Impact of the War in Ukraine on Cancer is standing ready and available to the WHO, governments and others as a resource to connect stakeholders and the international and Ukrainian healthcare NGOs who are working tirelessly to address the emergency in Ukraine.
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