KYIV – Ongoing efforts to overhaul the country’s defective and corrupt health-care system took a serious blow on February 5 when a Kyiv administrative circuit court issued an injunction that barred its chief implementer – Dr. Ulana Suprun – from performing her duties as acting health minister of Ukraine.
From the outset of her appointment on July 27, 2016, the Ukrainian American physician has stepped on the toes of deeply entrenched corruption interests. Their actions of theft and graft have created a system that has failed to meet the most basic needs of patients in a country where the privileged seek medical care abroad.
A remnant of the USSR’s failed promises, every Ukrainian citizen is constitutionally entitled to free medical care, but that never was a reality before or after independence. For example, patients grew accustomed to paying for syringes and X-ray film, vaccines for children and cancer treatment.
Dr. Suprun’s approach to ensure that “money follows the patient,” modeled after Great Britain’s health-care system, among other quality-care improvements, came to a temporary end when Justice Serhiy Karakashyan ruled in favor of the plaintiff, populist lawmaker Ihor Mosiychuk of the Radical Party, who has repeatedly challenged the legality of Dr. Suprun’s position as acting health minister.
Judge Karakashyan ruled that she has dual Ukrainian and U.S. citizenship in contravention of the law. He also said that the term had expired for her to continue in the role of acting health minister. Instead, he said, she could fulfill the duties of first deputy minister of health.
National Deputy Mosiychuk and his parliamentary faction leader, Oleh Lyashko, have criticized Dr. Suprun’s policies.
Dr. Suprun issued a statement on February 6 upon returning to Kyiv, following an official trip to the U.S. that she cut short after learning of the court’s injunction.
She voiced concern over $23 million worth of drugs that await delivery to regional hospitals and clinics based on 33 public procurement programs. “After all, their distribution requires the signature of the acting health minister,” she wrote on Facebook. “Who will sign contracts with the international organizations who will purchase drugs, vaccines, and medical products with money from the government’s 2019 budget?”
Justice Minister Pavlo Petrenko challenged the court’s decision, and the same court is scheduled to hear his case on behalf of the government on February 11, Dr. Suprun tweeted.
“Absurd and feckless decisions of Ukrainian courts will not prohibit Ulana [Suprun] from performing the duties of health minister,” Mr. Petrenko wrote on Facebook on February 6.
Leaders of the country’s three branches of government followed with separate statements of support.
President Petro Poroshenko, while speaking at the American Chamber of Commerce’s (AmCham) yearly meeting of members, said that “I want to emphasize that Mrs. Suprun has [the] full support of the president of Ukraine,” according to the presidential administration website.
He didn’t comment on the judge’s decision, saying that it was inappropriate for him to do so as president.
Next, he commented on her citizenship: “I want to emphasize and remind that the issue of citizenship belongs to the exclusive competence of the President of Ukraine… I emphasize that Pani [Ms.] Ulana is a citizen of Ukraine, according to the decree on granting her Ukrainian citizenship signed by President of Ukraine Petro Poroshenko.”
AmCham President Andy Hunder, a Ukrainian Briton, in turn, said that Ukraine’s business community supports the physician. Moreover, he told the president that Dr. Suprun should be finally appointed health minister – a move that would shield her from further lawsuits that have disrupted her tenure so far. His statement elicited a round of applause.
“We should not stay aside. It is now very important for the government and business to support a person who managed to implement one of the most progressive reforms and reduce the level of corruption in this field,” he said.
The Cabinet of Ministers, led by Prime Minister Volodymyr Groysman, said in a February 5 statement that it was “concerned about the unprecedented pressure… exerted in various ways to halt efforts taken” by Dr. Suprun’s health-care team “to reform the sector.”
Efforts to eradicate corruption were named in the Cabinet’s statement as the “main reason why this campaign is waged against” her and “her team.”
Verkhovna Rada Chair Andriy Parubiy noted on Twitter that Dr. Suprun “took on a complicated job… she stood in the way of the medical field’s main evil – corruption!”
Born in the Detroit area to a patriotically minded Ukrainian family, Dr. Suprun has saved more than $220 million just by purchasing crucial HIV/AIDS, tuberculosis and other medicine through an international consortium that includes the United Nations Development Program (UNDP).
It’s similar to the amount that the “health-care mafia lost,” said Dmytro Sherembey, who chairs the non-profit group All-Ukrainian Network of People Living with HIV. Dr. Suprun “is an obstacle for them because she turned off all the financial taps,” he added, as cited by Euromaidan Press.
Her publicly avowed enemies include Viktor Medvedchuk, a close friend of Russian President Vladimir Putin; and Olha Bohomolets, a presidential candidate who heads parliament’s Committee on Health Care and a former member of the president’s faction in the legislature. Yulia Tymoshennko, a current lawmaker and populist presidential candidate, also has opposed health-care reforms.
Ms. Tymoshenko and Dr. Bohomolets have both hyperbolically misused the word “genocide” to describe Dr. Suprun’s changes to health-care policies.
Dr. Suprun’s ministry has endured numerous government audits that never found anything amiss. She has won two previous lawsuits brought on by the current plaintiff, Mr. Mosiychuk. Two more pending against Prime Minister Groysman were filed by the lawmaker to challenge Dr. Suprun’s appointment. And, Dr. Suprun regularly gets smeared on social media and national television channels that are controlled by the nation’s richest oligarchs, who have contingents of loyal national deputies in the national legislature.
Still, the trained radiologist has earned praises from the country’s Western donors and medical institutions – including the World Health Organization, World Bank and UNDP – for what she has accomplished since 2016.
Aside from removing kickback schemes in medicinal procurement, Dr. Suprun has ensured that more than 70 percent of drugs get purchased directly from manufacturers. Four years ago, 95 percent of medicines were bought from local distributors that made their purchase prohibitively expensive for the majority of the population.
She has increased wages for medical staff, initiated an “accessible medicine” program whereby certain drugs are free or discounted for the most common of illnesses, started an electronic health-care system, and let patients choose family doctors regardless of their address to encourage competition and reduce dependency based on residence, according to corruption watchdog Transparency International (TI) Ukraine.
By upholding the plaintiff’s complaint, Judge Karakashyan created “a dangerous precedent” that “tries not to restore someone’s violated right, but rather to artificially influence the activities of the Ministry of Health, which is a violation of the rule of law principle,” said Maksym Kostetskyi, legal adviser to TI Ukraine.
The U.S. Embassy reacted by saying that it is monitoring the situation, whereas the Swiss and British Embassies expressed “concern.”
“Still awaiting further details on this case, but concerned about the potential impact on Ukraine’s vital healthcare reforms,” tweeted British Ambassador Judith Gough.
Their respective governments have provide donor money to reform Ukraine’s health sector through various developmental assistance programs.