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The full-scale invasion of Ukraine by Russia in 2022 caused immediate and extensive damage to healthcare facilities, particularly those close to the frontline. A new Irish charity, driven by the business community, undertook to identify and replace facilities in key areas, using philanthropic funds. Consultation with local health authorities identified areas where facilities were destroyed, damaged or inaccessible and staff were available to continue to provide services. Purpose designed, equipped and built transportable medical modules in 20' containers were installed. No costs were incurred by local authorities, to whom ownership and operational responsibility were transferred. Data was collected on viability, initial patient contact rates and operation into 2025. 19 modules were installed (eight trauma, five maternity, four primary care, two laboratory), by September2023 and most in frontline communities, at a total cost of €1.7 m. One module was unused and three had to be relocated because of nearby fighting. All active units reported patient contacts (weekly average range 4.2-80.5). Of the 19, 13 remained active in 2025, three have had to close in November 2025 due to nearby fighting and three are unknown/inactive. Local access to healthcare is central to the life of communities. This project developed and delivered medical modules to frontline communities in Ukraine swiftly and at reasonable cost. Many of those units remain active in 2025. The ability of a 'pop-up' charity to deliver 'plug-in', bespoke assistance may have wider application.

Wartime conditions have exacerbated the importance of infection prevention and control (IPC) practices and their impact on patient prognosis. While microflora contamination occurs at the time of injury, multiple subsequent invasive procedures potentially place patients at a higher risk of acquiring nosocomial flora. This study aimed to evaluate whether the region of trauma, the length of the evacuation chain, or the previous healthcare facility impact the risk of acquiring ESKAPE pathogens upon admission to a rear hospital, and to assess the consequences of these pathogens on wound microflora and patient prognosis. A retrospective cohort study was conducted at the Feofaniya Clinical Hospital of the State Administration of Affairs, which serves as a rear hospital in Ukraine's medical evacuation chain. Combatants treated in the Surgical Intensive Care Unit (ICU) were selected for analysis. Medical records were reviewed to obtain geographical details of the trauma region, the approximate route and duration of evacuation, injury type, and microbiological results from wound swabs collected upon ICU admission. Binary logistic regression analysis was performed to identify factors associated with the primary outcome. A total of 264 male combatants admitted between February 2022 and December 2024 were included (mean age: 38.1 years). The median time from injury to admission at the rear hospital was 7 days. The most frequent regions of trauma were Donetsk (57.1%) and Kharkiv (12.2%), with patients primarily evacuated via hospitals in the Dnipro region and the Kharkiv Northern region military medical center. Blast injuries predominated (70.3%), followed by gunshot wounds (22.4%). Initial microbiological screening revealed ESKAPE pathogens in 63.8% of blast injury cases and 62.7% of gunshot wounds. While the prevalence of ESKAPE-positive swabs slightly decreased from 66.0% in 2022 to 58.2% in 2023, it rose to 59.3% in 2024, remaining the dominant finding. Logistic regression analysis indicated that the geographic region of trauma, evacuation route, and duration of evacuation did not significantly affect the risk of ESKAPE pathogen presence upon admission (\(p > 0.05\)). However, the presence of ESKAPE pathogens at admission was a significant independent predictor of mortality (aOR 22.39; 95% CI 2.97-168.55; \(p = 0.003\)). Our study demonstrated that neither the specific geographical region of injury nor the medical evacuation route significantly influenced the microbiological profile of combat-related wounds upon admission to a rear hospital. ESKAPE pathogens are highly prevalent in the initial wound swabs of combatants and serve as a critical independent predictor of increased in-hospital mortality. Not applicable.

Access to assistive products remains highly uneven across health systems. Policy discussions in rehabilitation frequently emphasize workforce development, service delivery models, and clinical standards. Less attention has been given to the institutional mechanisms through which assistive products are procured and supplied. Ukraine's prosthetics sector provides a contemporary illustration of how procurement systems influence rehabilitation service delivery. Following the escalation of armed conflict in 2022, Ukraine experienced a sharp increase in demand for prosthetic services. National programmes expanded rapidly to support individuals requiring rehabilitation and assistive technologies. In this context, procurement arrangements - including decentralized purchasing across multiple providers and reliance on imported prosthetic components, have highlighted structural challenges affecting supply chain coordination, pricing transparency, and system scalability. This paper argues that procurement architecture represents an under-recognized determinant of rehabilitation system performance. Drawing on insights from Ukraine's prosthetics sector, the paper explores how fragmented procurement arrangements can reduce cost efficiency in access to assistive technologies even when financing and service delivery capacity expand. It further outlines procurement reform principles that may strengthen rehabilitation systems, including pooled purchasing mechanisms, framework agreements, demand forecasting integration, and digital procurement platforms.

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The ongoing war in Ukraine has severely disrupted the health system, with repeated attacks on energy and health infrastructure, as well as damage to transport routes, posing a major threat to maintaining the vaccine cold chain. In this context, the authorities, along with WHO, took action to strengthen the preparedness of subnational vaccine stores to effectively respond to emergencies and minimize the risk of temperature excursions during vaccine storage and transportation. Ukraine's vaccine cold chain operates through 25 newly established subnational vaccine stores. These facilities play a critical role in storing and distributing vaccines to lower levels of the health system. Following recent modernization, most stores use WHO-prequalified cold chain equipment, remote temperature monitoring, power backup systems, and specialized vehicles. However, the ongoing conflict exposes them to frequent disruptions in power, logistics, and communications. To address this need, we co-created on-site functional simulation exercises. The 7-h programme combined a locally led risk analysis with three progressively complex simulated emergencies, testing responses to equipment failure, prolonged power outages, and transport incidents. Between July and November 2025, simulation exercises were conducted in 18 oblasts, revealing recurring gaps in alert systems, backup storage and transport capacity, procedures implementation, and staff training. After the exercises, each store developed a tailored action plan to address these. Participant feedback indicated improved technical readiness, clearer roles and responsibilities. Co-created, on-site simulation exercises proved effective and cost-efficient for enhancing cold chain preparedness, offering a replicable model for other public health functions in conflict settings.

Ukraine's HIV epidemic remains concentrated among key populations, with sex workers (SWs) facing overlapping vulnerabilities, including a history of injection drug use. Although overall HIV prevalence has declined, prevention coverage remains below national and global targets. Accurate mapping of sex work hotspots is essential for effective outreach, yet existing data are fragmented and incomplete, especially in privatized and digitally mediated environments. This study aimed to systematically identify and characterize sex work venues across eight Ukrainian cities and assess their coverage by HIV prevention services. In 2021, we conducted a two-stage, multi-informant mapping study across eight Ukrainian cities, interviewing 1,212 secondary and 2,277 primary key informants, including SWs. Hotspots were characterized by type, perceived safety, access modality, operating schedule, and presence of SW subgroups. We used descriptive statistics, exploratory factor analysis, and multivariable mixed-effects regression to identify factors associated with HIV prevention service coverage. Of 2,581 identified hotspots, 2,118 (82.1%) were validated as active. Apartments (43.2%), virtual platforms (11.7%), and street-based sites (11.1%) were the most common. Only 13.7% of hotspots were registered in the national HIV service registry, while 34.1% received prevention service delivery and 18.9% were reached by mobile vans. Coverage was highest at street-based and office-type venues and consistently lowest in private, virtual, and pimp-mediated settings. Service coverage was positively associated with 24/7 or daytime operation, higher perceived safety, open access, and the presence of SWs who inject drugs. This study provides comprehensive mapping of sex work hotspots in Ukraine, revealing persistent gaps in HIV prevention for less visible and harder-to-reach SWs. Community-led mapping achieved high validation rates (86.8%) and identified substantial unmet needs in digital and concealed hotspots. Routine hotspot mapping, combined with engagement with SW communities, is essential for data-driven, equitable, and adaptive HIV responses in rapidly changing contexts.

The war in Ukraine has disrupted access to maternal and infant nutrition services, intensified commercial milk formula marketing risks, and increased demand for accessible, evidence-based breastfeeding support. To respond, FHI 360 and UNICEF Ukraine deployed Harmony of Parenthood, a closed-domain, ethically governed Artificial Intelligence (AI)-enabled breastfeeding and Infant and Young Child Feeding in Emergencies (IYCF-E) support system, integrated with facility-based counseling and a national mentorship programme for lactation counselors. The aim of this study was to evaluate the feasibility, safety, acceptability, and operational contribution of an AI-enabled hybrid counseling model to continuity and quality of Infant and Young Child Feeding in Emergencies services during protracted conflict, including its integration with facility-based counseling and mentorship systems and its potential influence on caregiver feeding practices and counseling quality. A convergent mixed-methods approach triangulated: (1) chatbot analytics (user characteristics, interaction volume, response quality); (2) facility counseling data from four conflict-affected oblasts; (3) structured competency assessments following >600 mentorship visits; and (4) qualitative feedback from caregivers and health workers. Governance, safety, and Code-compliance safeguards were assessed against the World Health Organization (WHO) AI ethics guidance, the Operational Guidance on Infant and Young Child Feeding in Emergencies (OG-IFE), and Ukraine's breastfeeding policies. Between November 2024 and October 2025, 2,066 caregivers generated more than 38,000 chatbot interactions. Ninety-eight percent of answers met accuracy and safety criteria; one hallucination event was detected and corrected through real-time review. Caregivers used the system predominantly during periods of insecurity or when services were inaccessible, valuing its 24-h availability, emotional reassurance, and escalation to human counselors. In parallel, facility data showed improved quality of counseling, strengthened referral pathways, and increases in early initiation and exclusive breastfeeding among women receiving repeated support. Mentorship visits demonstrated competency gains among lactation counselors, enhanced adherence to the Code, and more consistent use of MoH-aligned counseling tools. An AI-enabled, human-supervised hybrid model is feasible, acceptable, and safe for sustaining breastfeeding and IYCF-E support during active conflict. When anchored in authoritative guidance and embedded within national systems, AI tools can complement skilled counselors, strengthen continuity of care, and uphold Code-compliant, evidence-based support for mothers and infants. To our knowledge, this is the first documented evaluation of an AI-enabled IYCF-E intervention implemented during an active conflict.

Psychological support providers embedded within military and law enforcement organizations during armed conflict are exposed to both direct and secondary trauma, placing them at elevated risk for posttraumatic stress disorder (PTSD). In Ukraine, the staff title "psychologist" designates psychological support providers employed by security organizations, encompassing providers with varying levels of formal training. The "security sector" comprises three uniformed branches - the Armed Forces, the National Guard, and the National Police - with distinct operational missions and combat exposure. Little is known about how the PTSD burden and its correlates differ across these branches when examined concurrently. This study examined PTSD symptom severity and probable DSM-5 PTSD among psychologists in each branch during the ongoing war. A cross-sectional survey conducted in 2024 also measured adverse childhood experiences (ACEs), lifetime trauma exposure, depressive symptoms, and anxiety symptoms. Ordinary least squares and logistic regression models were estimated for pooled and branch-specific samples. Psychologists in the Armed Forces showed higher PTSD symptom severity and a greater prevalence of probable PTSD than those in the National Guard or National Police. Across branches, cumulative lifetime trauma exposure and depressive symptoms were the most consistent correlates of PTSD outcomes, whereas anxiety showed more variable associations. Childhood adversity was weakly associated with PTSD after adjustment for adult trauma exposure and current emotional symptoms. Branch differences in PTSD burden persisted beyond measured individual-level risk. Findings underscore the need for branch-specific, broad-spectrum strategies to support provider well-being during prolonged conflict.

The full-scale Russian invasion in February 2022 severely impacted the organizational structure of Ukraine's healthcare system. The devastation wrought by the Russian aggression requires the Ministry of Health to find ways to address the most pressing healthcare issues and limit impacts on the health of the population. We summarize a series of papers that assessed the challenges to the health and trauma system in Ukraine since the Russian invasion. We performed a framework synthesis of 10 manuscripts using data from a qualitative study of Ukraine's health and trauma systems. We synthesized the findings using the Doctrine, Organization, Training and Education, Materiel, Leadership, Personnel, Facilities, Policy (DOTMLPF-PI) framework developed by the DoD to assess system efficiency and effectiveness and includes NATO's domain of Interoperability. The assessment of Ukraine's military medical system under large-scale combat operations (LSCO) revealed key systemic limitations across the DOTMLPFP-PI domains-particularly training category (27), materiel (19), doctrine (18), policy (17), and interoperability (17). The overall assessment reveals a health system under severe strain, operating within outdated frameworks that are misaligned with modern warfare realities. This work generated a comprehensive set of recommendations that, if implemented, would enhance the effectiveness of Ukraine's military medical system in both the current conflict and into the future. The recommendations are also broadly applicable to other state-actors and their military-health systems, particularly in the context of the evolving realities of modern LSCO.

This article examines Ukraine's Global Fund "Transition Plan" as a governance technology that reorganised time, responsibility, and uncertainty in HIV prevention, rather than as a policy instrument that simply succeeded or failed. Introduced in 2016 as a condition of continued donor support, the Plan promised a "gradual" shift from zero state financing of prevention to 80% by 2020. While the assessments concluded that Ukraine met-and even exceeded-its budgetary commitments, substantially less funding reached frontline services. We show how this gap was produced through performance-based spending, procurement rules, and audit procedures tied to pre-set coverage and service-volume targets that proved difficult to realise under punitive drug policy, repeated cycles of forced client mobility and disappearance, and broader precarity. Drawing on multi-sited qualitative fieldwork and policy analysis, we trace how donors, state bodies, and NGOs reproduced vertical governance through metrics, tenders, and accountability regimes. We situate these dynamics within a "double becoming" of Western and (post-)Soviet modernities, in which future-oriented targets produce (un)certainty while displacing attention from present constraints. The Plan thus appears simultaneously feasible, as an auditable system, and fantastic, as delivery depends on stabilising criminalised, mobile lives-producing an interpretive impasse between budgetary overfulfilment and service underdelivery. This, we argue, constitutes the Transition Plan as a broader condition, as a metaphor for post-Soviet transformation towards the "West".

Armed conflicts severely disrupt cancer care delivery, destroying infrastructure and limiting access to essential diagnostics and treatments. Evidence on service challenges, adaptations, and policy implications remains fragmented. This scoping review of four databases (Scopus, PubMed, ScienceDirect, and CINAHL) was conducted for original peer-reviewed studies published between January 2020 and August 2025. The search focused on the effect of wars on cancer service delivery in conflict zones, and its impact on cancer care. Wars in conflict-affected countries like Palestine, Sudan, Syria, Iraq, Ukraine, and Afghanistan caused widespread destruction of cancer infrastructure, unsafe hospitals, and interruptions in chemotherapy, radiotherapy, and surgery. Countries faced shortages of specialized centers, technicians/radiologists, and medical records, alongside high costs and supply chain disruptions. Despite these challenges, healthcare systems demonstrated resilience through adaptations including Ukraine's MedEvac program for EU treatment evacuation, cross-border referrals (Iraq→Lebanon, Afghanistan→Pakistan), telemedicine, mobile diagnostic units, and community-based care models. Policy responses emphasized international aid coordination, conflict-sensitive health planning, and supply chain restoration. Conflicts cause infrastructure destruction, workforce depletion/migration, treatment barriers/delays, drug supply disruptions, and psychosocial/economic impacts, which in turn create urgent policy/governance challenges. Although humanitarian aid may provide temporary relief, sustainable solutions require peace and global commitment, grounded in equity and the fundamental right to health.

IntroductionThe HEART-UA (Healthcare Extracorporeal Assessment and Resource Tracking in Ukraine) survey represents the first nationwide evaluation of extracorporeal life support (ECLS) and renal replacement therapy (RRT) availability in Ukraine. The study aimed to systematically characterize national ECLS and RRT capacity, assess temporal changes before and during the conflict, and identify major operational limitations affecting access to extracorporeal organ support.MethodsA structured cross-sectional survey was conducted among Ukrainian hospitals providing ECLS and/or RRT. Data collection included institutional characteristics, ECMO device availability, case volumes in 2021 and 2023, staffing models, barriers to ECLS provision, and the availability of CRRT and intermittent hemodialysis. Responses were clustered at the institutional level, and duplicates were merged. Categorical variables were compared between the pre-war and wartime periods using Fisher's exact or chi-squared tests where appropriate.ResultsTwenty-two institutional responses were analyzed, including 15 ECLS centers, 16 CRRT centers, and 19 IHD-capable institutions. Geographical distribution showed regional clustering of ECLS resources. No statistically significant expansion in ECMO device availability or procedural volumes was observed between 2021 and 2023. The predominant barriers to ECLS provision included shortages of consumables (60%), insufficient trained personnel (53%), and inadequate numbers of ECMO devices (47%). CRRT availability was higher, but most centers reported major limitations due to shortages of consumable circuits, machine availability, and infrastructural instability. Humanitarian aid related to extracorporeal support was received by only 27% of institutions and was irregular, fragmented, and insufficient to meet national needs.ConclusionsThe HEART-UA survey demonstrates that Ukraine's capacity to provide extracorporeal organ support has remained critically constrained during the war. Device availability, trained personnel, and consumable supply chains are still major limiting factors. Although many centers continue to provide lifesaving ECLS, CRRT, and IHD despite extreme operational challenges, the overall system is highly dependent on inconsistent humanitarian aid.

The One Health approach integrates human, animal, plant, and environmental health through multisectoral collaboration and is increasingly recognized as essential for addressing zoonotic diseases, antimicrobial resistance (AMR), food security, and ecosystem degradation. Ukraine has formally adopted One Health principles through national strategies and international partnerships; however, the ongoing full-scale military conflict has profoundly disrupted health, veterinary, and environmental systems, challenging effective implementation. This study aimed to evaluate the current status, achievements, and constraints of the One Health approach in Ukraine, with particular emphasis on the effects of armed conflict on governance, surveillance capacity, and intersectoral coordination, and to outline strategic priorities for strengthening One Health resilience. A mixed-methods approach was used, combining bibliometric analysis of Scopus-indexed literature on zoonoses, AMR, food security, and environmental safety with targeted case studies and a review of policy documents. National legal frameworks, international guidelines, and reports from global organizations were systematically analyzed to assess institutional capacity and operational readiness. Ukraine has established a solid policy foundation for One Health, notably through the national Strategy for Biosafety and Biosecurity, which is grounded in the One Health principle and aligned with quadripartite frameworks. Active initiatives address priority zoonoses (rabies, leptospirosis, tuberculosis), AMR surveillance, and food safety. Nevertheless, implementation remains fragmented. Armed conflict has caused extensive damage to laboratories, displaced the workforce, created surveillance blind spots, and disrupted multisectoral communication. AMR trends have intensified due to healthcare strain, while environmental and plant health components remain under-integrated despite their relevance to food security and long-term resilience. The Ukrainian experience demonstrates that policy commitment alone is insufficient in the context of conflict. Effective One Health operationalization requires institutionalized governance mechanisms, interoperable surveillance systems, and sustained investment in human resources and laboratory infrastructure. Environmental and plant health integration remains a critical gap. Reinforcing the One Health framework is essential for Ukraine's recovery and long-term health security. Sustained international technical and financial support, coupled with national institutionalization of One Health principles, is crucial to rebuilding integrated surveillance, mitigating biological risks, and enhancing resilience in conflict-affected settings.

The full-scale invasion of Ukraine in 2022 created unprecedented pressures on the national immunization supply chain (ISC). Despite large-scale energy disruptions, population displacement, and insecurity, vaccine availability and storage conditions were largely maintained. This study aimed to examine how Ukraine's ISC has adapted to war-related disruptions and to identify key enablers, barriers, and priorities for strengthening its resilience. A mixed-methods approach combined 15 semi-structured interviews with stakeholders from national, oblast, and facility levels, a review of literature, regulatory documents, and programme data. Data were analyzed using thematic analysis and interpreted using the Blanchet et al. health system resilience framework. Analysis found that the digitalization of the vaccine stock management system and the wide availability of training strengthened the knowledge capacity of the ISC. Large-scale investments by international partners in WHO-prequalified cold chain equipment during the COVID-19, complemented by the deployment of backup power solutions, significantly improved the system's ability to manage uncertainty related to electricity outages. The centralization of ISC function enhanced governance and coordination, contributing to legitimacy capacity. Strong collaboration across government institutions and with international partners also helped sustain ISC in the face of the war disruptions, demonstrating the importance of interdependence capacity. However, several barriers persist, including gaps in population data for forecasting vaccine needs and coverage monitoring, unequal distribution of new cold chain equipment, and continued reliance on donor support. Despite repeated attacks, Ukraine's ISC has continued to function. The findings highlight key enablers of resilience and remaining bottlenecks and provide actionable recommendations. Ukraine's experience offers transferable lessons for strengthening ISC resilience in other conflict settings.

Ukraine faces intersecting epidemics of HIV and drug-resistant TB (DR-TB), with high risk of progression from TB infection to active disease. The Support TB Control Efforts in Ukraine project supported the National TB Program's efforts to operationalise World Health Organization recommendations on TB infection testing and TB preventive treatment (TPT) across 17 regions of Ukraine. In September 2021, QuantiFERON-TB Gold Plus (QFT-Plus) testing was introduced through a public-private laboratory model. Eligible populations included TB contacts and other high-risk groups. Data on referrals, test outcomes, and TPT initiation were collected electronically and analysed descriptively. Out of 11,495 individuals referred for testing, 9,788 (85.2%) completed QFT-Plus testing, with adult TB contacts showing the highest positivity rate at 28.1%. Among 1,717 eligible for TPT, 1,512 (88.1%) started TPT, and this was 93.3% for drug-susceptible TB (DS-TB) contacts and 82.8% for DR-TB contacts. DS-TB contacts were offered shorter rifapentine-based regimens, while DR-TB contacts received levofloxacin. Implementation challenges were addressed through training and mentorship. Ukraine's implementation of QFT-Plus testing and shorter TPT regimens marks progress in broadening TB prevention efforts, particularly for DR-TB contacts. These initial results highlight that such approaches are feasible even in challenging, high-burden environments, offering insights for future expansion.

The full-scale invasion of Ukraine has increased demand for rehabilitation services, exacerbating preexisting deficiencies in the rehabilitation system. This policy brief examines Ukrainian legislation, scientific and grey literature, and findings from stakeholder consultations to reveal persistent marginalization of persons with disabilities (PwD) and limited inclusion in education, employment, and public life. The rehabilitation system and its governance remain fragmented and overly institutional, resulting in poor continuity of care, weak interdisciplinary collaboration, and limited community integration. Resource provision is strained by the war and rising demand for assistive devices. Yet, the influx of humanitarian and development actors presents an opportunity to rebuild and modernize systems and narratives. We propose (i) establishing an integrated governance and coordination mechanism for rehabilitation services (ii) launching scalable patient pathway models linking hospitals, community-based rehabilitation, and accompanying service providers, and (iii) developing a case management system for smooth assistive device provision. Improving Ukraine's rehabilitation ecosystem can advance destigmatization, social reintegration, and a rights-based disability framework, offering lessons for other conflict-affected contexts.

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Natural ecosystems face significant pressure from climate change, biodiversity loss, and increasing socio-economic and political stressors-all of which are exacerbated by military conflict. This paper focuses on Ukraine and examines the root causes of disturbances in the country's forest socio-ecological systems (SES), as well as the impacts of the ongoing war, to identify recovery pathways. Using a multi-method approach, we assess factors affecting Ukraine's forest SES and identify three key recovery pathways: (1) an economic focus through forest use for low-carbon recovery, including timber for reconstruction and small-scale energy production; (2) a "close-to-nature and close-to-people" approach, leveraging digital tools and innovations for climate-resilient recovery; and (3) anticipatory governance and socio-ecological innovation. Relying on a single pathway risks long-term vulnerability. We highlight that integrating recovery pathways creates synergies. Coordinated actions within Ukraine and from international actors are essential to enable a recovery aligned with "build back better" principles. Our findings offer valuable insights for Ukraine and other conflict-affected regions.

Before Russia's full-scale invasion in February 2022, Ukraine maintained a well-functioning oncology system, supported by universal health coverage and expanding access to advanced diagnostics and clinical trials. The war caused profound disruptions across all aspects of cancer care-diagnostics, treatment, research and palliative support-yet the system demonstrated exceptional resilience. While hospitals in combat zones were forced to pivot to trauma care, oncology facilities in safer regions were rapidly reorganised and adapted. By late summer 2022, core cancer care in government-controlled territories largely recovered to near pre-war levels through coordinated leadership, emergency regulations and international support, though this recovery remains fragile and uneven, with some patients still facing barriers related to displacement, insecurity and disrupted pathways. Partnerships with the WHO, European Union and oncology societies helped with drug supply, telemedicine, workforce training and patient evacuation abroad. Despite early shortages, drug and radiotherapy capacity has rebounded, aided by modernisation efforts and advocacy networks. Clinical trials, initially halted, are being gradually restored under decentralised and cross-border collaboration models. Grassroots and non-profit organisations have been essential for patient navigation and advocacy, also addressing challenges of treatment delays, drug access, psychological support and palliative care. Looking ahead, Ukraine's National Cancer Control Strategy 2030 prioritises workforce development, early cancer detection and quality improvement to strengthen system resilience. Ukraine's experience demonstrates that even amid prolonged conflict, coordinated governance, adaptive regulation and international collaboration can sustain complex cancer care and offers a practical framework for rebuilding oncology and other non-communicable disease services in conflict-affected settings.