Medtechs Track Changing Needs In Support Of Ukraine Healthcare

Ukraine’s medical supply needs have evolved since Russia launched its military invasion of the country on 24 February. EU healthcare decision makers and the medical technology industry have stood firm in their support of the besieged country, said MedTech Europe’s Jesús Rueda.

Away from the front line, the mounting civilian death toll, and the worsening humanitarian crisis in the under-siege areas of Ukraine, the healthcare industry in the free world is doing all it can to help Ukraine’s healthcare system meet the needs of patients and the casualties of war. 

The European medtech industry, national European governments and EU decision makers have been at the forefront of the response to local healthcare needs, which have evolved and intensified in the 15 weeks since Russia began its war in Ukraine. (Also see "Health Care Industry Reacts To War In Ukraine" - In Vivo, 4 Apr, 2022.)

Adjustments have also had to be made in the global medtech supply chain as a result of disruption to normal trade. MedTech Europe’s Jesús Rueda said that while the war initially led to certain shortages of raw materials sourced in Ukraine, by and large the wider industry had managed to secure alternative sources for most of them.

Medtech Supply Issues

But there are ongoing concerns in two particular areas, Rueda, who is director general strategies, special projects and international affairs, told In Vivo at the European association’s offices in Brussels on 12 May, the week after the MedTech Forum. (Also see "Bernasconi: Europe Needs A Better Strategic Rudder For Medtech Innovation Policy" - In Vivo, 9 May, 2022.)

The first relates to the supply of microchips, which was already subject to severe difficulties as a function of production and delivery issues in the wake of COVID-19. It now threatens to become affected even more acutely by the disruption to Ukraine’s production of neon gas.

Ukraine has been one of the major suppliers of the gas, which is used in the production of microchips. Ukraine’s production facilities have been destroyed, according to reports locally. “We fear this might exacerbate the already ongoing microchip shortage. It’s a real concern,” Rueda said.

The second worry surrounds the potential loss of a source of highly talented IT developers in the medtech sector. Ukraine IT experts have much experience in coding, computer control systems and the embedded software that is needed to run various kinds of medical equipment.

The war has disrupted that; while some local staff have relocated outside Ukraine, a not insignificant number has signed up for the Ukraine national defense forces and gone to the front.

Medtech companies will be affected in different ways and to varying extents. But in general all companies that make complex IT systems for technologies such as medical robotic systems and the big analyzers that need to be integrated into hospital IT systems will have to adjust.

“Where there is hardware with embedded software, there’s potentially an impact when contractors in Ukraine are involved, or if companies have offices in the country.”

Evolving Needs On The Ground

The types of medical supplies being requested by Ukraine have changed. Early in the conflict, the industry was sending, more or less as expected, routine supplies for hospitals but saw a spike in demand for trauma kits, battlefield medication systems and wound control treatments.

The medtech industry is now also being asked to supply equipment for use in trains that have been converted into mobile hospitals for the purposes of evacuating the very sick out of Ukraine. Essentially, this means providing mobile ICU equipment for refugees and Ukrainians fleeing westwards into Europe.

Among the first patients to be evacuated was a group of pediatric cancer patients, who were moved to Warsaw, Paris and Berlin, and also to the Netherlands and Italy. MedTech Europe member companies received requests to support the action to continue delivering care to these children.

EU member states have also requested from industry trauma kits and systems for use in children so that they can be treated as soon as the patients arrive in the west. EU member states are hosting a large number of refugees.

There have also been more requests for geriatric treatments, Rueda observed. Many evacuees from Ukraine are older patients needing geriatric medicine. This often includes ICU medicine, given that that many of the patients being evacuated are very sick.

The industry has also helped set up screening programs for COVID-19, and has been working with the European Commission’s Health Emergency preparedness and Response Authority (HERA) in coordinating efforts and treating incoming patients. (Also see "Medtech’s Place In Health Care R&I Boosted Under Horizon Europe" - In Vivo, 27 Jul, 2021.)

This EU intelligence gathering agency, launched in 2021, has an overall aim of providing information to prevent, detect and respond to health emergencies and potential health crises.   

As to ongoing elective care in Ukraine, the European medtech industry is distributing products for full hospital work across the country where it can. In some areas of the country, hospitals are no longer operational, except for providing battlefield medicine. Patients requiring dialysis, say, are being evacuated to safer areas.

Many hospitals have been destroyed and some have been repurposed. The areas of Ukraine that are considered safe and still have functional hospitals have seen a big increase in patient numbers.

Rueda said the full effects of the Ukraine conflict on medtech and healthcare are yet to be seen. Amid the uncertainty, MedTech Europe's member companies continue to support Ukraine's evolving healthcare needs. “We have been engaged in the humanitarian relief efforts since the start, and are in contact with Ukraine Embassy every week to get updated lists of Ukraine supply needs,” Rueda stressed.

He added that the EU has reacted very well in supporting Ukraine with medtech needs to date. The early logistic and transport hitches have been resolved and warehouses have been set up, streamlining the delivery process. The commission has also asked MedTech Europe to be a liaison on the rebuilding of the Ukraine health system once the conflict is over.

Some medtech companies have contributed financially to the effort, and others have contributed with in-kind donations that have been well received. All the time, mechanisms are being put in place or improved to guarantee supplies and medical support to Ukraine.

Healthcare Supplies To Russia

Meanwhile, medtech companies states are aware of the moral imperative to keep up supplies to Russia for local patient care. In practice, most companies are continuing to supply to Russia, but are not trying to expand and are not investing there.

Medtech has not been part of the EU sanctions regimes – covering Russia, Belarus and Russian-controlled Ukraine  ̶  which have been extended to five rounds with a sixth on the way. Kazakhstan and fellow Eurasian Economic Union (EAEU) member states (Armenia and Kyrgyzstan) are not affected by the EU’s sanctions. However, supplying them would entail the use of longer delivery routes and the associated higher logistics costs.

Internally, Russia continues to implement new regulatory policy and is looking at mechanisms for early recognition of foreign medtech approvals, to speed up the regulatory process which has seen bottlenecks of late.