Olga Stefanyshyna is emerging as a key leader in Ukraine’s response to the global COVID-19 pandemic and a leading voice on health care policy for the nation.
She is a member of parliament, serving on the health committee, and elected in 2019 as part of singer Syvatoslav Vakarchuk’s 20-lawmaker faction in the 423-member Verkhovna Rada. At age 37, she has already been a deputy health minister under Ulana Suprun, led the Patients of Ukraine assistance organization, and worked for the All-Ukrainian Network of People Living with HIV.
Right now, she’s worried that the Ministry of Health will return to the darkest days of corruption under Raisa Bohatyrova, the health minister who served under Viktor Yanukovych, the kleptocratic president overthrown by the EuroMaidan Revolution in 2014.
If her fears are true, it will mean that Ukraine will squander much of its $4.2 billion health care budget, nearly 10 percent of state spending, on overpriced and uncompetitive purchases of vaccines and medicines that enrich corrupt state bureaucrats.
The Ministry of Health did not immediately respond to a request for comment about its procurement policy and hasn’t responded to several Kyiv Post requests on the subject in the recent past.
“Now those people who are in the ministry, in a majority of cases, they didn’t come to improve the system. They came for their own interests. There are people who worked in the ministry when Raisa Bohatyrova and Yanukovych were there,” she said. “These are people who took part in the tendering system of the Ministry of Health when up to 40 percent of the procurement fund was stolen in the tenders.”
Bohatyrova fled the country and faced Western sanctions and fraud charges, but she is believed to be back in Ukraine, no longer facing formal allegations. She could not be located for comment.
To end the Yanukovych-era corruption, international organizations took over state purchases of medicine and vaccines until a new state enterprise, Medical Procurement of Ukraine, started working under Suprun, the health minister from 2016 to 2019.
But under Health Minister Maksym Stepanov, who became the fourth minister in the last year on March 30, the ministry reverted for its first major purchase to an internal tendering committee, the discredited scheme under which up to 40% of taxpayer money was spent on supplies at inflated prices, Stefanyshyna said.
‘Epic failure’ in buying expensive Chinese gear
To supply doctors and medical workers with special clothing to protect them from becoming infected with the coronavirus, Medical Procurement of Ukraine held a competitive tender that ended with its recommendation that the ministry purchase 90,000 suits for $800,000 from a Ukrainian maker.
But the Ministry of Health rejected the contract, deciding to revive the tainted and uncompetitive internal tendering committee, and ended up paying nearly twice as much to import Chinese suits – 71,347 for $1.3 million. It’s a suspicious purchase. The Ministry of Health’s justification that the Ukrainian suits didn’t meet safety standards is bogus, Stefanyshyna said.
And to add insult to injury, only 40% of the 71,347 Chinese units had arrived by May 20, she said. “We don’t know where the rest is now. They’re not delivered to Ukrainian hospitals yet and it was a month and a half ago when the tender took place.”
This flawed foray into state purchases under Stepanov should be a wake-up call to return to the transparent, competitive, and effective purchases organized by Medical Procurement of Ukraine or international organizations, she said. In a May 19 briefing, Stepanov said that he would continue to use the state enterprise Medical Procurement of Ukraine or international organizations for the supply of medicines.
She called the Chinese suits fiasco an “epic fail in procurement” and worries that the Ministry of Health will misuse the simplified purchasing procedures designed to speed the purchase of needed equipment and medicine.
Other scandals are breaking out with the Ministry of Health’s desire to purchase a specific type of Ukrainian artificial lung ventilator without giving parliament “any explanation” for the choice, she said.
Yet another “managerial epic fail,” she said, were the delays in getting state bonuses to physicians in a timely manner to triple their salaries. If the average physician makes $350 a month in Ukraine, the bonus would bring the pay up to $1,050 monthly, still extremely low by Western standards.
But much more is at stake, including a 10 billion hryvnia ($375 million) procurement budget that hasn’t yet been spent.
“There is a risk that the Ministry of Health will take all the money back through the ministry and make these procurements through the tendering committee and this will be a scandal and be a sign that all the corrupt schemes can come back to the ministry as well,” Stefanyshyna said. “Before international procurements were introduced in Ukraine, all ministers appointed to their chairs were appointed based on their possibility to earn money on procurements for themselves. That practice should not come back to Ukraine. We will do our best to stop the Ministry of Health from going back to Bohatyrova’s times.”
Too early to judge whether COVID-19 has peaked
Stefanyshyna authored legislation signed into law by President Volodymyr Zelensky that would significantly increase testing for the coronavirus. Ukraine ranked 107th among nation in testing rates in a recent study, far too low for Ukraine to understand the spread of the virus and develop an effective public policy response.
“Ukraine is now in the situation where we don’t know the real statistics of COVID-19,” Stefanyshyna said. “The testing is one of the lowest in the world.”
Widespread testing is needed to understand how far the virus has spread. Ukraine, moreover, has announced that it will start mass antibodies testing – a separate procedure to identify who might have been infected and recovered, presumably meaning they have immunity to the virus for at least some time.
Because of the current lack of testing, “we don’t know the real statistics of COVID-19,” Stefanyshyna said. “If testing is not available for the majority of people, we cannot understand the real spread (of the coronavirus) in Ukraine.”
Under the legislation she authored, not only those with COVID-19 symptoms will be tested, but also those who may have come into contact with coronavirus-infected people as well as those in occupations, such as group homes, who come into contact with large numbers of patients or residents. She said the new law simply follows World Health Organization and U.S. Centers for Disease Control recommendations.
She said that government statistics show that 70 percent of hospitals have enough protective gear and that there is no shortage of working artificial lung ventilators.
But she’s not sure that she trusts either claim. “It’s very difficult to see the real picture,” she said.
On the plus side, she said, “the government introduced the lockdown quite early, which helped no doubt influenced its spread” and prevented Italian-scale infections and deaths, with more than 226,000 infections and 32,000 deaths in the nation of 60 million people. Ukraine, with less than 40 million people, has fewer than 20,000 infections and 600 deaths.
While Ukraine can be forgiven for being unprepared like most other nations, the time for excuses has run out, she said.
“We are now in May when the epidemic is almost a half-year-old, and the government of Ukraine still hasn’t provided enough suits or gowns for doctors in Ukraine,” she said. Instead, donations and volunteers, as well as international organizations and non-governmental organizations such as Patients of Ukraine, have helped fill the void not only for protective gear but also for ventilators.
Also, on the minus side of the equation, she said, the government imposed medically useless quarantine restrictions – such as no visits to outdoor parks, no outdoor sports – that only irritated the public and made them less likely to comply with other restrictions. She also noted that some cities sprayed disinfectant on streets, another “silly” response.
She said that an easing of the lockdown restrictions should be better coordinated. If people are allowed to return to work, she said, public transportation should also be reopened so they can do so. Ukraine’s ban on public transportation was stricter than most nations, she said, and lasted longer, with the three metro systems in the nation – in Kyiv, Kharkiv, and Dnipro – still not open. The subways could open up on May 25 if certain infection benchmarks are met, the government said.
The way ahead
She said “it’s still difficult to say” whether Ukraine’s infections have peaked or the nation has “flattened the curve” and will start to experience a sustained decline in COVID-19 cases. “We didn’t have any dramatic improvement in the last weeks so it’s more or less stable,” she said.
Of course, much depends on the virus and how people behave.
Some experts believe that the coronavirus will ease in summer but flare up again in autumn.
Until a vaccine or effective treatment is found, Stefanyshyna said, the government will have to be engaged daily in deciding the right balance between ending restrictions and protecting public health.
“We should learn to live with this,” she said. “Every day you should see the statistics. You should see how the virus behaves and take managerial decisions every day, because if you make it very liberal, you will see what is happening in Russia now (with a huge spike in infections and deaths). When you don’t take any measures to control the virus, it can be very damaging for the health care system and people.”
Precisely because people are sensing the danger has passed with the warmer weather and easing of movement restrictions, now is the time for vigilance, she said.
“Now it’s very important that the government should see in the statistics and continue explaining to people that it’s quite dangerous.”
Kyiv Post staff writer Igor Kossov contributed to this story.
