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Times of Crisis,
Times of Opportunity

The post–Cold War world is approaching a turning point. The rise of far-right politicians, shifts in geopolitical power, the erosion of international law, the entrenchment of post-truth, and the largest war in Europe in eighty years — all these challenges are testing the resilience of established democracies. And unfortunately, not all are passing the test. We are witnessing a crisis of institutions, a crisis of mechanisms, and a crisis of leadership.

Ukraine, standing at the center — or rather, the frontline — of these tectonic shifts, offers a crucial insight: in moments like these, the most effective investment is in civil society. When the state fails, protesters during the Revolution of Dignity defend democracy. Volunteers in times of war support the army. Activists drive reforms at every level. An informed and engaged society serves as both a safeguard and a driver of government accountability.

That is why the “Health Solutions” Charitable Foundation places people at the heart of everything we do. We believe that Ukrainians, as a dignity-based society, deserve better. Not a post-Soviet model of survival marked by reactive solutions, generalized approaches, shifting responsibility, stagnant state institutions, and a “minimum required” mindset. Sadly, these approaches persist in Ukraine. Even more concerning, our experience shows that not everyone sees a reason to change them.

“Health Solutions” strives instead to bring health to the center of state policy and public discourse — not as the passive “absence of disease,” but as active well-being. As a cultural value. As a shared responsibility between individuals, communities, and the state.

Every strategic decision in this direction can yield a powerful, emergent effect.

For example, the “Health Solutions” Charitable Foundation is working on the issue of restoring healthcare to Ukrainian territories temporarily occupied by Russia. The healthcare system is often among the first sectors to fall under repressive control by occupying forces, as it serves as a means of exerting pressure on local populations. We, however, believe that introducing a renewed, value-based healthcare system after de-occupation can not only improve people’s lives but also serve as a vital force for reintegration.

The path to de-occupation is being courageously paved by Ukrainian soldiers — and their health is one of our top priorities. At the onset of the full-scale invasion, military medicine had to scale rapidly. But its development remains uneven, hampered by outdated governance systems. That’s why our foundation is committed to bridging these systemic gaps, analyzing the best international practices, and bringing to light uncomfortable yet vital issues — such as addiction among service members and veterans. We cannot abandon our heroes just because certain conversations make us uneasy.

Indeed, awareness is a fundamental prerequisite for making informed and healthy choices. That is why the “Health Solutions” Charitable Foundation has conducted its Health Index research for the sixth year in a row. This annual study explores how Ukrainians perceive their health, navigate the healthcare system, and engage with institutions. While this year’s results show mostly positive trends, the lingering Soviet legacy remains visible — particularly in the low prioritization of disease prevention and mental health.

Perhaps the clearest legacy of the Soviet past is the lack of agency among Ukrainian doctors. Or more precisely, the systemic suppression of that agency. In the Soviet era — and to a large extent, still today — a doctor is not viewed as an independent professional, but rather as mere extensions of the institutions in which they work — almost like functions of the building itself. We want to change that. We want doctors to be empowered to make their own decisions, take personal responsibility, remain mobile professionals, and be treated with dignity.

Unfortunately, the current system is so deeply entrenched and conformist that there is still no strong demand for such reform. That is why the “Health Solutions” Charitable Foundation engages in a complex, two-pronged advocacy effort — both with policymakers and with medical professionals themselves.

Ultimately, even the best strategies and policies are just words unless there are people ready to implement and defend them. That is why “Health Solutions” works closely with local communities. Communities, which, under decentralization, are in the best position to drive change on the ground, understanding their own needs and challenges. We’ve seen that grassroots initiatives in Ukraine hold immense transformative potential. But people must be supported in moving beyond outdated conceptions of health.

On the other end, we cooperate with national-level actors and emerging institutions capable of implementing systemic reforms — such as the National Health Service of Ukraine, the Ministry of Defense’s Department of Health, and the State Logistics Operator. Our goal is to help build an integrated health system in Ukraine, one where every decision is grounded in the interests and needs of the people.

They say times of crisis are also times of opportunity. If that’s true, then Ukraine may be one of the most promising countries in the world. We already have a strong, active society that is hungry for change, driven by an existential need to evolve. What the system still lacks are shared, thoughtful, and optimal solutions. We are committed to uncovering and implementing them.