Ukraine One-12 months Report

INTRODUCTION

Russia’s invasion of Ukraine on Feb. 24, 2022, unleashed a stage of struggling upon the Ukrainian those that few thought would ever be seen once more in Europe. Eight million individuals fled Ukraine, and an estimated 5 million extra had been internally displaced. One 12 months later, the humanitarian disaster and human tragedy deepen as ongoing Russian assaults on civilian electrical energy infrastructure, properties, and well being amenities proceed to kill and injure individuals and trigger widespread, huge psychological trauma.

The onset of conflict basically altered the established order in Ukrainian society, creating a direct hole in important well being companies on which Direct Reduction focuses. The necessity for well being companies spiked on the similar second the capability to offer companies was diminished as hospitals and different well being amenities had been focused, tens of millions of individuals fled their properties, and accessible sources had been redirected from well being companies to defending Ukraine’s territory and folks.

Direct Reduction responded instantly and has continued an in depth, high-tempo, high-volume operation over the previous 12 months. The group’s help to Ukraine detailed on this report has been the most important response in its 75-year historical past – all with personal sources, made potential by the extraordinary participation of people, organizations, and companies globally.

Individuals from greater than 83 international locations – together with Russia and Belarus – and all 50 U.S. states and 5 U.S. territories have contributed to Direct Reduction’s humanitarian response in assist of the Ukrainian individuals. Direct Reduction understands that donor assist channeled to the group was for the individuals of Ukraine.

This report was written each for individuals who have so generously participated in Direct Reduction’s response and for the Ukrainian individuals on whose behalf the generosity was prolonged, to assist them perceive our actions over the previous 12 months and our plans transferring ahead.

Since Feb. 24, 2022, Direct Reduction has delivered greater than 2.4 million lbs. – over 1,200 tons – of drugs and medical provides to Ukraine, averaging a supply each different day for the previous 350 or so days. Every merchandise delivered was requested and authorized previous to it being despatched.

The medical materials offered has included 235 million outlined each day doses of prescription medicines and therapies for a broad vary of frequent circumstances and likewise specialised care, corresponding to for cancers. Big portions of medical provides starting from battlefield tourniquets and physique luggage to prenatal nutritional vitamins even have been furnished.

The wholesale worth of the merchandise delivered $763 million and displays the worth of prescription medicines acquired by donation in Europe, the place costs for sure merchandise are as a lot as 70% decrease than comparable merchandise bought in the US.

As the primary and solely U.S. nonprofit to change into accredited to distribute prescribed drugs in all 50 states that additionally works internationally, Direct Reduction engages intently with the healthcare business, encouraging firms to contribute the drugs and provides they manufacture to individuals who can’t purchase them. Greater than 69 firms have stepped up with contributions of their merchandise which are wanted by individuals in Ukraine.

Direct Reduction additionally has disbursed $24.9 million in monetary assist to native healthcare organizations offering care in Ukraine and others in international locations, together with Poland and Slovakia, which have opened their doorways to Ukrainian refugees.

That funding has lined remedy prices for greater than 266,000 Ukrainian refugees in Poland, offered psychological well being look after near 25,000 Ukrainian refugees in Slovakia, and funded rehabilitation packages centered on working with amputees, occupational remedy, speech remedy, and psychosocial assist. Direct Reduction can also be offering funding to assist Ukraine’s nationwide system for distributing drugs across the nation to the individuals who want it.

Regardless of unavoidable uncertainty about how future occasions will unfold, occasions of the previous 12 months have made among the long-term well being penalties very clear. Individuals who have sustained disabling accidents would require lifetime care, together with kids who’ve misplaced limbs and would require new prosthetic gadgets as they develop up. That’s why, amongst different issues, Direct Reduction is placing cash, in addition to materials support, into rehabilitation companies, which is a precedence for the Ukrainian authorities and well being leaders.

As this tragic second in historical past unfolds in Ukraine, Direct Reduction will proceed to serve the individuals whose lives have been upended, with deepest thanks to every individual and group that’s a part of this effort.

Thomas Tighe, Direct Reduction President & CEO

The Russian invasion of Ukraine in February 2022 induced widespread and long-lasting disruptions to the nation’s well being care system whereas drastically growing the necessity for well being companies throughout all geographies and demographic teams. As of the tip of January 2023, over 3.6 million individuals remained internally displaced, and one other 8 million stay outdoors Ukraine as refugees. In areas of Ukraine the place Internally Displaced Individuals (IDP)s are concentrated, the variety of individuals looking for healthcare has strained native sources, notably on the main care stage.

Persistent assaults on well being, energy and water infrastructure have lowered service capability throughout the well being system. The best impacts occurred in areas near the entrance traces within the japanese and southern areas. The intensified assaults for the reason that starting of October 2022 have destroyed or broken greater than half of Ukraine’s energy infrastructure, leaving tens of millions of individuals with no regular provide of energy and restricted entry to water or warmth. To battle chilly climate, mills and gasoline tanks are in excessive demand. Medical amenities are not any exception. Energy stays a problem for the upkeep of the prevailing companies – the medical tools requires an uninterrupted energy provide to function and to make sure it stays calibrated and practical.

Likewise, lowered entry to transportation – given injury, value, and issues of safety – continues to have an effect on each side of Ukraine’s well being system, from affected person visits to provide chains. Transportation limitations have lowered bodily entry to care for a lot of sufferers and led to persistent stock-outs of wanted medicines all through the pharmacy and medical community. Shortages of medicines exist on the main well being care stage, notably for persistent illnesses, together with insulin, thyroid gland remedy, hormonal remedy, and drugs for coronary heart illnesses and persistent obstructive pulmonary illness, in addition to a scarcity of vaccines for tetanus, diphtheria, and different frequent vaccinations. Entry to care stays higher in bigger cities and cities, however outpatient clinics in smaller settlements and villages are left with nearly no tools and provides. The state of affairs is worse in frontline areas and just lately de-occupied areas, the place there are shortages of main well being care suppliers and nearly no practical pharmacies.

Regardless of the impression of assaults on well being infrastructure and different companies, well being care inside Ukraine stays manifestly resilient to shocks. A latest survey by the World Well being Group (WHO) discovered that 95% of Ukrainians had been nonetheless receiving main care companies, 90% reported getting access to persistent illness care, and 93% had been in a position to entry a household physician both at a clinic or via an increasing community of telemedicine companies. The resilience of the well being system is a testomony without delay to the dedication of Ukrainian well being professionals and to the energy of worldwide assist and collaboration.

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PART TWO

THE APPROACH

“At any time when we’re contemplating an impending donation in essentially the most tough of circumstances and the query is raised internally “Who would possibly have the ability to deal with such a formidable job?” – the reply is all the time clear. For that motive, we really feel proud and humbled to be working so intently with Direct Reduction.”

– AMALIA ADLER-WAXMAN, SVP, International Head, ESG and Head of Company Affairs of Worldwide Markets, Teva Prescribed drugs

Direct Reduction is prioritizing the next strategic areas in its response to the humanitarian disaster in Ukraine:

Enhance entry to well being companies, together with main well being care, prevention and remedy of non-communicable illnesses, emergency medical companies, and specialised care
Guarantee supply of medicines and medical provides to Ukraine
Develop and strengthen rehabilitation companies for individuals wounded by conflict
Enhance entry to psychological well being and psychosocial assist companies
Enhance entry to medical provides and companies for Ukrainian refugees

76 tons of medical support are loaded right into a 777 constitution aircraft at FedEx’s distribution heart in Memphis, Tennessee, on March 26, 2022, sure for Ukraine. (Lara Cooper/Direct Reduction)

In its Ukraine response, Direct Reduction continues providing two sorts of assist: drugs and provides to deal with disruptions within the medical provide chain, and monetary help to extend entry to well being companies, enhance the provision of medicines, and enhance the well being and well-being of the inhabitants.

Direct Reduction has constructed inside Ukraine an in depth and continually increasing community of medical supplier companions that embrace the Ministry of Well being, the World Well being Group, regional well being departments, public hospitals and clinics, choose personal hospitals offering companies with out cost, and native humanitarian foundations and associations.

The Kharkiv Renovation Fund delivering Direct Reduction-provided medicines to healthcare suppliers on December 6, 2022. (Courtesy picture)

Since February 2022, Direct Reduction has donated 8.3 million items (e.g., bottles, vials, pre-filled syringes) of prescription medicines. Direct Reduction additionally offered tens of millions of items of non-pharmaceutical merchandise corresponding to pen needles, oxygen concentrators, mills, ambulances, medical consumables, and different well being care know-how.

Letter from The Ukrainian Ministry of Well being

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Direct Reduction is engaged in a number of totally different traces of exercise to bolster main well being care in Ukraine. In areas the place rural geography and the impression of conflict have curtailed entry, assist for cell well being care items shall be increasing capability for early prognosis, remedy, and prevention of illness. The place well being care amenities have seen lowered means to offer companies as a result of lack of energy, the set up of mills and gasoline tanks ensures steady electrical energy. On the similar time, entry to medicines is being ensured via a vetted community of non-governmental companions able to offering common distribution to main well being amenities and neighborhood pharmacies.

In lots of circumstances, main well being care will be a superb place to offer rehabilitation companies for these injured by conflict. Direct Reduction is assessing the likelihood that an expanded panorama of rehabilitation companies will be developed via main care networks. Likewise, main care companies are linked in Ukraine to the availability of emergency care. Direct Reduction is continuous to assist emergency companies via provision of funding, ambulances, medicines, and provides.

Challenge Highlight

Diabetes Look after Ukraine

Main, Emergency, and Specialised Care Grants

Dobrobut Hospital – $2 million
Society of Vital Care Drugs – $1.5 million
Worldwide Confederation of Midwives – $583,000
Crown Brokers – $500,000

Razom for Ukraine – $250,000 for mills and $180,000 for specialised companies
UA Brokers with out Borders – $300,000
Ukrainian Diabetes Federation – $150,000
Dobrze Urodzeni (Properly Born) – $140,000

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PART FOUR

Supplying Medical Materials

“We’re grateful to have the ability to use our world community to supply logistics assist for organizations like Direct Reduction who’ve lengthy been dedicated to sourcing and delivering vital provides in occasions of disaster. This case impacts many, together with our personal Ukrainian group members, and we stay dedicated to serving to throughout this devastating time.”

– KAREN REDDINGTON, Regional President of Europe, FedEx Specific

When the conflict started, Direct Reduction had present relationships with Ukrainian well being suppliers and the Ukrainian Ministry of Well being, however it rapidly established a much more strong pipeline working intently with European pharmaceutical firms, warehouses, and logistics firms. Direct Reduction has elevated its agility and adaptability whereas deepening its relationships and capability in Europe.

Supporting the Humanitarian Medical Provide Chain

A discipline hospital was outfitted with 50 beds that had been handed over to the army. (Pictures courtesy of Charity Fund TAPS)

In a rustic with a government-led healthcare system, Ukraine’s Ministry of Well being has performed a central function within the medical provide chain, each pre-war and through the conflict. As humanitarian donations of medical provides poured into Ukraine from world wide, the capability of the MoH to deal with the movement was strained. Direct Reduction stepped in to shore up Ukraine’s medical provide chain, making certain that humanitarian medical provides reached the those that wanted them most.

IV fluids from Direct Reduction arrive in central Ukraine to assist native hospitals in 2022. (Photograph courtesy of Charity Fund Fashionable Village and City)

For the primary few months of the conflict, the MoH estimated operations prices associated to the receipt, dealing with, and distribution of humanitarian support at as much as $750,000 per thirty days. At the moment, with the amount and frequency of donations considerably decreased, the MoH has estimated the added value of warehousing, dealing with, and distributing humanitarian medical provides at $200,000 per thirty days.

Direct Reduction has authorized a grant of $2 million to the MoH to cowl these humanitarian logistics prices for 10 months via the tip of 2023.

A surgical X-ray clear electro -hydraulic desk was bought utilizing Direct Reduction-provided funds. This desk is the one one within the space, permitting state-of-the-art arterial implantations to be carried out, saving lives and limbs. In the course of the first week, 100 operations had been carried out. (Courtesy of Charity Fund TAPS)

Direct Reduction additionally offered seven organizations with operational grants to offset the bills for the receipt and distribution of donated merchandise:

Charity Fund Fashionable Village and City – $610,000
HromadaHub – $220,000
Fondation Humanitaire Internationale AICM Ukraine – $250,000
Charity Fund “TAPS” – $220,000

Charitable Fund Humanitarian Hub Zhytomyr – $210,000
Kharkiv Renovation Fund – $150,000
Yevgen Pyvovarov’s Charity Fund – $90,000

Deploying from Europe

Whereas Direct Reduction’s Santa Barbara, California,warehouse stays its world distribution hub, the outbreak of conflict drove Direct Reduction to ascertain a really robust medical provide chain inside Europe. Greater than 40% of pallets of product delivered to Ukraine over the previous 12 months have been fulfilled inside Europe. Direct Reduction has greater than doubled the variety of healthcare firms donating drugs to the group from inside Europe.

Odesa Metropolis Hospital receives a cargo of emergency medical provides on Oct. 11, 2022. (Photograph courtesy of Odesa Metropolis Hospital)

First responders in Ukraine deploy with a Direct Reduction emergency medic pack. (Courtesy picture)

Direct Reduction achieved this vital improve partly by establishing distinctive pharmaceutical warehousing capability within the Netherlands – totally licensed, professionally staffed, with house for 1000’s of pallets, and expertise in advanced humanitarian product imports, exports, and customs clearance. Direct Reduction has additionally organized massive drugs donations drop-shipped instantly from donor producer amenities inside Ukraine and elsewhere in Europe to its Ukrainian companion organizations.

Chilly-Chain Necessities

A lot of crucial pharmaceutical merchandise wanted in Ukraine – corresponding to insulins, most cancers therapies, antibiotics, and immunotherapies – require cold-chain logistics (sustaining temperatures between 2° C and eight° C from manufacturing facility to affected person). Direct Reduction has developed a really strong capability for world cold-chain drugs supply, utilizing trendy software program to validate delivery lanes and correctly pack the shipments, in addition to extensively monitoring temperatures in real-time through the supply course of.

Youngsters with diabetes who’ve been displaced since Russia’s invasion of Ukraine collect at an occasion organized by the Ukrainian Diabetes Federation Kharkiv area department. (Courtesy picture)

Direct Reduction has been in a position to ship over 2.1 million items (vials/cartridges/prefilled syringes) of assorted sorts of insulin to its many companion organizations in Ukraine that deal with diabetic sufferers, in addition to over 320,000 extra items of cold-chain medicines to deal with most cancers, infections, immune circumstances, blood problems, and different severe circumstances. Included in these figures had been shipments to the WHO of donated insulin. Direct Reduction additionally offered 40-foot refrigeration containers to assist Ukraine tackle cold-chain storage capability points at key amenities such because the Ukrainian Nationwide Most cancers Institute in Kyiv.

Generic Business Supplies Important Important Medicines

With vital coordination and assist from the Affiliation of Accessible Medicines (AAM), Medicines for Europe, and the Worldwide Generic and Biomedical Affiliation (IGBA), Direct Reduction labored intently with its generic pharmaceutical firm donors to offer over 130 million outlined each day doses of generic medicines to the impacted inhabitants of Ukraine.

The businesses offering these prescription medicines, which fulfilled them to Direct Reduction from each Europe and the US, embrace Accord Healthcare, Ajanta Pharma, Alvogen, Apotex, Baxter, Edenbridge, Hikma, ICU Medical, Meitheal Prescribed drugs, Perrigo, Teva, and Viatris. Their merchandise have been very important to the success of Direct Reduction’s humanitarian response in Ukraine and offered over 2.5 million items (bottles or vials) with a wholesale worth exceeding $170 million. The medicines tackle therapeutic areas together with infections, diabetes, heart problems, respiratory sickness, psychological well being circumstances, ulcers, ache, most cancers, and different severe circumstances.

Amalia Adler-Waxman, SVP and world head of ESG at Teva, mentioned, “At any time when we’re contemplating an impending donation in essentially the most tough of circumstances and the query is raised internally, ‘Who would possibly have the ability to deal with such a formidable job?’ The reply is all the time clear. For that motive, we really feel proud and humbled to be working so intently with Direct Reduction and stay up for many extra years of collaboration and assist.”

Assist from Pharmaceutical and Medical Provide Corporations

Sixty-nine world healthcare firms have to this point donated drugs and medical provides to Direct Reduction for its humanitarian response in Ukraine, with a wholesale worth of over $763 million USD. The businesses that offered the donations embrace:

Abbott

AbbVie

Accord Healthcare

Ajanta Pharma USA

Alvogen

AmerisourceBergen

Amgen

Apotex

AstraZeneca

Baxter Europe

Baxter Worldwide

Bayer AG

Bayer USA

BD Europe

Belmora

Biogen

Boehringer Ingelheim

Cal OES

Carlsbad Expertise

Covidien

CVS

DeVilbiss Healthcare GmBH

Dragerwerk AG

Drive Medical GmBH

Edenbridge Prescribed drugs

Eli Lilly & Firm

Encube Ethicals

Ethicon

Genentech

Grifols US

Grifols Worldwide

GSK

GSMS Included

Henry Schein

Hikma Prescribed drugs

ICU Well being

ICU Medical

Inogen

Integra LifeSciences

Janssen Prescribed drugs

Jazz Prescribed drugs

J&J Shopper

Kate Farms

Kirk Humanitarian

LifeScan

Liquid IV

McKesson Medical Surgical

Medline Industries

Medtronic

Merck & Co.

Merck KGaA

Meitheal Prescribed drugs

MSD

Novo Nordisk A/S

Organon

Perrigo Prescribed drugs

Pfizer

Purdue Pharma

Sanofi

Takeda Prescribed drugs USA

Teva Prescribed drugs Europe

Teva Prescribed drugs USA

Unilever

Unite to Gentle

Vitaris Europe

Vitaris USA

ViiV Healthcare

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Based on the United Nations Excessive Commissioner for Human Rights (UNHCR), Ukrainian civilians have suffered practically 12,000 accidents for the reason that begin of the conflict, and Ukrainian troopers many extra. Many of those people require vital medical interventions to restore trauma and bodily rehabilitate. Supporting rehabilitation and restoration from conflict accidents, each bodily and psychological, has been a central tenet of Direct Reduction’s monetary assist technique in Ukraine for the reason that conflict’s begin.

At Saint Nicholas Pediatric Hospital in Lviv, Ukraine, Mr. Artem (34 years outdated) performs with Kira (8 months) within the space of Traumatology. Kira was wounded and has shrapnel in her physique from when the automotive through which she and her mom the place touring in was attacked. Her mom was additionally wounded and misplaced a finger whereas escaping and caring for Kira and one other youngster. (Courtesy picture)

To strengthen rehabilitation companies in Ukraine, Direct Reduction is prioritizing the next areas:

Strengthening in-patient rehabilitation departments in hospitals recognized by the Ukrainian Ministry of Well being (MOH) to allow them to obtain civilian and army casualties by offering tools, coaching, and supportive supervision by professional groups
Focusing on rehabilitation facilities with some present capability whereas ensuring to not neglect areas with excessive wants and no present capability. The precedence checklist shall be decided collectively with the MOH
Supporting the event of extremely specialised companies (wounds, burns, prosthetics-orthotics) to additional develop capacities on the Unbroken heart in Lviv whereas additionally offering tools for smaller facilities nearer to the entrance traces
Assessing the feasibility of offering assistive gadgets and community- and home-level follow-up by skilled professionals via present main healthcare companies (together with by coaching main well being care suppliers on particular rehabilitation wants and interventions)

Associate Highlight

UNBROKEN

Because the conflict rages on in Ukraine’s east, it creates a gradual movement of wounded individuals needing advanced surgical procedures, long-term rehabilitation and prosthetics. Many of those sufferers arrive by evacuation trains and ambulances on the Unbroken Nationwide Rehabilitation Heart in Lviv.

Direct Reduction has granted $1 million to Unbroken to acquire rehabilitation tools, develop remedy protocols, and prepare rehabilitation personnel. The rehabilitation packages give attention to amputation restoration, occupational remedy, speech remedy, and psychosocial assist.

A affected person present process rehabilitation after a shrapnel wound from a rocket explosion in japanese Ukraine. The affected person is receiving remedy on the Nationwide Rehabilitation Heart Unbroken in Lviv (Photograph courtesy of Unbroken)

Unbroken is a part of the First Medical Union of Lviv, an umbrella affiliation of multi-specialty clinics that has offered care to 80,000 internally displaced individuals for the reason that starting of the conflict.

Direct Reduction has additionally offered $250,000 to UNITED24 for renovating the Psychological Well being and Rehabilitation Heart Veterans “Lisova Poliana” within the Kyiv area of Ukraine. The middle makes a speciality of treating problems associated to fight stress, helping survivors of captivity and torture, and offering bodily rehabilitation companies.

The establishment wanted to scale up operations urgently because of the quickly growing variety of individuals impacted by the conflict. The funds will develop affected person companies and enhance the ability. The 220-bed heart, which supplies inpatient companies for bodily rehabilitation, will endure reconstruction and overhaul to fulfill demand.

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The World Well being Group estimates that greater than 20% of people who instantly expertise conflict develop or have elevated results from psychological well being problems, together with melancholy and nervousness, PTSD (Put up Traumatic Stress Dysfunction), schizophrenia, and plenty of different points. Primarily based on these estimates, WHO locations the variety of Ukrainians needing psychological well being look after a number of circumstances at practically 10 million individuals.

A gaggle of Ukrainian psychologists at Gabčíkovo, a refugee heart in Slovakia. (Photograph Courtesy of the League for Psychological Well being)

Psychological well being is an integral a part of Direct Reduction’s Ukraine response, chopping throughout many classes of labor: drugs donations, main care, rehabilitation support, look after refugees and extra.

Associate Highlight

Grants for Psychological Well being

Razom for Ukraine – $550,000

The League for Psychological Well being – $3 million

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Greater than 18.5 million Ukrainians have fled their nation for the reason that conflict started, and greater than 8 million of them stay outdoors Ukraine as refugees, in accordance with the Centre for Analysis & Evaluation of Migration. An estimated 90% of the refugees from Ukraine are ladies and youngsters. Most have fled to Poland, however vital numbers have sought security in Hungary, the Republic of Moldova, Romania, Slovakia, and different international locations within the area.

A crowd of individuals in Ukraine line up for trains departing the nation. (Oscar B. Castillo for Direct Reduction)

Instantly following the invasion, Direct Reduction provided assist to Ministries of Well being of the neighboring international locations and has since established robust partnerships with nonprofit well being organizations in Poland and Slovakia, working to extend entry to well being look after Ukrainian refugees overseas.

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Direct Reduction acknowledges that the beneficiant supporters who made monetary contributions over the past 12 months to assist individuals in Ukraine did so with the categorical intent that their contributions profit individuals in Ukraine and people who fled to neighboring international locations as a direct results of the conflict.

In accepting funds for the response to the state of affairs in Ukraine, Direct Reduction understands that each those that contributed and the Ukrainian individuals for whose profit the contributions had been made should know, intimately, how Direct Reduction is utilizing these funds.

contributions to the response

In response to the conflict in Ukraine, Direct Reduction acquired 151,669 Ukraine-designated monetary contributions totaling $101,129,967.

Donations had been acquired from individuals in 83 international locations (together with Russia and Belarus) and from individuals in all 50 U.S. states, Washington DC, 5 U.S. territories, and three U.S. abroad army addresses.

*Knowledge from February 24, 2022, to January 31, 2023

To this point, Direct Reduction has spent and dedicated a complete of $39.4 million (39%) on the response. Of that, $38.6 million has been disbursed, and $748,000 has been dedicated.

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Complete Grants Awarded: $24.9 MILLION

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SUPPORTED GROUPS DISTRIBUTING AID TO 400+ HOSPITALS & CLINICS

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Ukraine One-12 months Report

INTRODUCTION