Ukraine’s Ministry of Health announced last Wednesday that eight people had died of measles thus far in 2019. The announcement marks a sharp rise in deaths due to the disease compared to 2018, when a total of 18 people died of measles during the entire year. Among this year’s victims are two children and six adults.
Measles is a highly contagious disease that is spread through the air by coughing, sneezing or coming into contact with saliva or nasal secretions of infected individuals. Initial symptoms, including fever, cough, runny nose, and inflamed eyes, usually start 10-12 days after infection, and are then followed by an infamous spotty red rash that spreads from the face to the entire body three to five days later. Death, while occurring in just 0.2 percent of infected cases, can occur in up to 10 percent of cases with malnutrition.
Measles today is a disease that is easily preventable thanks to the widespread availability of safe and effective vaccines that can be administered in early childhood. Even those who do not receive the vaccine are protected by “herd immunity” when approximately 95 percent of the surrounding population is vaccinated. This makes the outbreak in Ukraine all the more politically significant.
Ukraine has by far the highest rate of both measles infections and deaths in all of Europe. In 2018 over 53,000 people were infected with measles in Ukraine. Serbia, the country with the second highest rate of measles infections in 2018, had just over 5,000 cases. Meanwhile, Russia, a former Soviet state as well, with a population of approximately 100 million more people than Ukraine, experienced just over 2,000 cases of measles in 2018.
The outbreak is not limited to any single region: it has spread throughout the country, leading to the closing of schools, day care centers and playgrounds for quarantine. In the capital of Kiev, over 100 schools have been closed due to measles and an accompanying flu outbreak.
According to the Lancet medical journal, Ukraine’s “precipitous” fall in measles “vaccination level began after 2008, when 95% of eligible children in Ukraine received their second (and final) recommended dose of the MMR vaccine. By 2016, the rate was 31%, among the lowest in the world. Although now rising again, the latest 85% measles vaccination rate recorded by WHO remains below that needed for herd immunity.”
Ukraine also has relatively low rates of vaccinations for other diseases, such as polio and hepatitis. In 2018, only 67 percent of one-year-olds in Ukraine received the polio vaccine and 51 percent received the hepatitis vaccine.
According to World Health Organization vaccine specialist Katrine Habersaat, in addition to the promulgation of medical misinformation throughout Eastern Europe, “other factors include complacency about the threat of the disease, the convenience of vaccination services, and confidence in health workers who carry out vaccination campaigns.”
Mistrust of the medical establishment is particularly high in Ukraine since, due to extremely low salaries of around $200 a month, doctors and other medical workers are often forced to rely on bribes from patients to make ends meet. A recent poll by the Ukrainian government found that 68 percent of Ukrainians had experienced bribery and corruption in healthcare.
While medical care is theoretically free in Ukraine, nearly half of all healthcare payments are made out-of-pocket, further limiting the access of care to those who can afford it.
The country also faces a shortage of skilled workers such as medical doctors, who, faced with poverty wages, are fleeing the country in droves to earn better wages in countries like Germany, Poland and the Czech Republic. Between 2016 and 2017 alone, 66,000 doctors left the country.
Despite the fact that the rapid drop in vaccinations began in 2008, Lancet, in accordance with imperialist propaganda, blames the reports of measles outbreak on “Russian trolls” allegedly using social media. Lancet’s claim is ludicrous. The journal does not even bother to explain how or why these trolls would have carried out such a scheme.
This kind of propaganda seeks to divert attention from the fact that the current outbreak is the result of a massive social crisis, which is ultimately the product of the dissolution of the Soviet Union in 1991 and the restoration of capitalism, and that has been significantly exacerbated in the wake of the imperialist-orchestrated, far-right coup in Kiev in 2014.
Following the dissolution of the USSR, Ukraine, like all former Soviet republics, has experienced an enormous spread of diseases that had hitherto been practically wiped out, including tuberculosis and polio. Russia and Ukraine have also become the countries with the largest HIV epidemic outside of Africa, an epidemic that is bound up not only with a lack of sex education, but above all with extremely widespread heroin abuse, a stark expression of the social despair facing millions of workers. Ukraine also has one of the lowest life expectancy figures in Europe.
While the exact causes for the drop in measles vaccinations since 2008 remain to be investigated, it is clear that they are bound up with the devastating economic and social crisis that has ravaged the country. The financial crisis of 2009 has hit Ukraine particularly hard. As a result of a skyrocketing trade deficit, inflation and widespread layoffs between 2008 and 2009, Ukraine’s GDP fell by over 14 percent. Subsequently, health expenditures per capita fell by 22 percent between 2008 and 2009.
The western-backed coup in 2014 and the civil war in eastern Ukraine further exacerbated the crisis of Ukraine’s health sector and disrupted the country’s supply chain for vaccinations. In 2014, following the secession of parts of eastern Ukraine and the annexation of Crimea by Russia, Ukraine began imposing sanctions on a wide variety of Russian goods, including medical supplies, thus forcing the country to find new sources of vaccines for import and causing shortages. The country’s current American-born health minister, Ulana Suprun, has admitted that several years ago the country imported ineffective vaccines that worsened the current crisis.
In 2014, as a result of the right-wing coup in Kiev, Ukraine’s GDP fell by 6.6 percent and then by another 9.8 percent in 2015. Ukraine’s health expenditures per capita fell in 2014 by over 35 percent and another 31 percent in 2015.
According to the World Bank, Ukraine continues to rank much lower than other European countries in per capita health care expenditures. While the country’s healthcare sector continues to falter and disease outbreaks that are rare in neighboring countries continue unabated, the Poroshenko regime plans to spend just $3.4 billion on healthcare in 2019, while spending $7.45 billion on the Ukrainian military.