Since the onset of the Russian invasion in February 2022, Ukraine’s healthcare system has endured unprecedented strain. Yet, paradoxically, this period of crisis has catalysed reform in Ukraine’s clinical research environment – prompting changes advantageous for sponsors and contract research organisations (CROs).
Long regulatory approval times remained a major bottleneck within Ukraine’s clinical trials sector even before the war. A 2020 report by GlobalData noted that Ukraine had significantly fewer trial starts than other Eastern European peers, in part due to slower ethics and regulatory approvals.
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“Before the war, our clinical trials regulations were aligned with European regulations, but our regulatory approval times were longer,” says Dr. Ivan Vyshnyvetsky, managing director of FutureMeds and the President at Ukrainian Association for Clinical Research.
“This was not attractive, and no sponsors wanted to start new studies in Ukraine.”
In the early months of the Russian invasion, thousands of clinical trial participants were internally displaced. However, Ukrainian investigators prioritised continuity of data and care through rapid coordination with sponsors and CROs as well as digital recordkeeping, protocol harmonisation, and telemedicine.
As the war escalated, Ukraine’s Ministry of Health took decisive to strengthen the country’s value proposition for clinical research. Emergency decrees and streamlined approval procedures were introduced, reducing the time it takes for clinical trials to get off the ground.
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By GlobalData“Our Ministry of Health decided to support changes to the legislation by decreasing the time of this regulatory review,” says Dr Vyshnyvetsky.
“So, in Ukraine, we are now able to get faster approvals [of clinical trials] than in many other countries.”
The reality on the ground in Ukraine
While faster regulatory approval has strengthened Ukraine’s clinical research appeal on paper, the reality on the ground has been far more complex. War has taken a devastating toll on healthcare infrastructure and the World Health Organization (WHO) estimates that by early 2024, over 1,400 healthcare facilities that were previously active in global clinical trials. had been damaged or destroyed in the conflict.
As a consequence, clinical trial sponsors faced immediate disruption and trial teams were forced to relocate westward. At the same time, the collapse of Ukraine’s civil aviation services left one of the most critical components of trials – biological sample transport –effectively paralysed. Despite these challenges, Dr. Vyshnyvetsky said Ukrainian research professionals responded with ingenuity.
Dr Vyshnyvetsky says: “During the war, our teams and patients relocated internally from the conflict zones to more western cities. We didn’t have civil aviation and all bio samples are sent mostly by land to and from Poland’s central labs. But biological samples are time sensitive. So, we had to invent a new supply chain to send bio samples in 48-72 hours to be in the central bank. Now, it is business as usual.”
Now in its third year of full-scale war, pharmaceutical sponsors and CROs in Ukraine are learning to navigate operational unpredictability, balancing patient access, investigator quality, and regulatory compliance against external threats. Trial registries such as ClinicalTrials.gov and the EU Clinical Trials Information System (CTIS) confirm that hundreds of trials in Ukraine remain active, with sponsors ranging from niche biotech companies to global pharmaceutical giants.
One of the turning points in reviving sponsor confidence has been the precedent set by other conflict-zone countries, like Israel. Explaining that for decades, sponsors worked in Israel despite the risks of military operations, Dr Vyshnyvetsky says, “they are accepting this as a new normal. This was an important factor for one of the huge sponsors that hesitated to restart activities in Ukraine. But now, they are quite successful.” By reframing the war as a condition to operate within – rather than a barrier to entry – Ukraine has been able to regain its position in global trial planning.
Why Ukraine still matters in global research strategy
As the global pharmaceutical industry becomes increasingly cost-sensitive and time-conscious, the choice of trial site is critical. Sponsors today seek regions that offer a combination of regulatory efficiency, skilled investigators, fast recruitment, and data integrity. Ukraine, despite being a country at war, continues to check these boxes, often outperforming more stable Western European nations in key metrics.
One of Ukraine’s strongest assets is its “huge access to diverse patient population and in different indications.” With universal health coverage limited by public system constraints, “it is easier and cheaper to recruit patients” in clinical trials that offer access to innovative therapies not yet available in the national formulary, particularly for rare diseases, oncology, and advanced-stage chronic conditions. Despite Ukraine’s Ministry of Health introducing new legislation during the war to allow for compassionate use programmes, Dr Vyshnyvetsky explains that compassionate use access is not automatic and depends heavily on the willingness of pharmaceutical companies to supply their experimental medicines outside of formal trials. Therefore, in reality, clinical trials remain the “only way to have access to unregistered treatments” in Ukraine.
The Ukrainian government has also made critical strides in domestic health policy, particularly the Affordable Medicines Program (AMP). For the Ukrainian public, this initiative has improved health outcomes and reduced out-of-pocket expenditures. But its ripple effect on the clinical research sector has been more complex and for investigators and sponsors, the AMP has actually improved trial efficiency.
“The affordable medicines programme has really impacted our clinical research sector. On one hand, patients became less willing to participate in clinical trials because they received their care. But on the other hand, it was also a benefit for investigators because we started seeing patients that are already eligible for participation in many studies,” Dr Vyshnyvetsky says.
“Prior to this, if a patient came to the site and was under-treated, we would need to initiate standard care treatment first, wait for some period of time to evaluate if this was effective and if not, then the patient would be eligible to participate in the study and could be enrolled in the clinical trial. So, the affordable medicines programme decreased the workload of preparing patients because they already came to us treated. So, it was positive for our health care.”
A call to the global research community
While Ukraine’s clinical trial sector has demonstrated exceptional resilience, the migration of qualified professionals has created serious challenges for trial continuity and institutional stability.
Dr Vyshnyvetsky says: “We have this important problem about the lack of qualified staff because many qualified professionals have moved abroad. Many clinical research professionals continue to move away from the eastern and southern parts to Kyiv and western parts of Ukraine.”
As the war stretches into its third year, international support is waning. Funding schemes and collaborative outreach from pharmaceutical sponsors have slowed. However, Dr Vyshnyvetsky states that “the clinical research sector in Ukraine is alive and still delivers results that are reliable, of good quality and issues related to logistics are resolved”.
Ukraine still provides a uniquely valuable environment for clinical trials: rapid patient recruitment, high retention rates, cost efficiency, and adherence to international GCP standards. Therefore, global sponsors and CROs have a strategic role to play – not only in supporting trials during wartime but in ensuring Ukraine remains embedded in the global innovation ecosystem.
“Despite the war, we see recovery within this industry and we see more and more studies coming to Ukraine. This means that sponsors are trusting us and accepting potential risks related to the war,” says Vyshnyvetsky.
The Ukrainian government now explicitly recognises clinical trials as a strategic sector. Policymakers view clinical research not only as a driver of scientific advancement but as a critical economic engine, bringing in foreign investment, cutting-edge therapies, training, and technology transfer.
Vyshnyvetsky says: “Our government understands that clinical trials are a great additional economic boost because there is a significant inflow of money, new technologies and expertise, which is very important to rebuild our economy. So, I believe that we will not only regain what we had before the war – we will build on that and we will be even stronger.”
With the right mix of international reinvestment, domestic reform, and continued scientific leadership, Ukraine has the potential to emerge from the war with a research ecosystem more integrated, agile, and globally competitive than ever before.
