At­tacks On Suprun Seen As Re­venge For Her Suc­cess In Fight­ing Cor­rup­tion

Kyiv Post - - Front Page - BY I GOR KOSSOV [email protected]

The na­tion’s med­i­cal re­forms could screech to a halt and pos­si­bly go into re­verse if Act­ing Health Min­is­ter Ulana Suprun is re­moved from her post, ac­cord­ing to the Cabi­net of Min­is­ters and mul­ti­ple civil so­ci­ety or­ga­ni­za­tions.

Kyiv Dis­trict Ad­min­is­tra­tive Court on Feb. 5 banned Suprun from ex­er­cis­ing her pow­ers, fol­low­ing a law­suit by Ihor Mosiy­chuk, a law­maker from the Rad­i­cal Party of Oleh Lyashko.

The law­suit ac­cused Suprun of in­com­pe­tence, of un­law­fully oc­cu­py­ing her post for longer than one month, and of hold­ing dual Ukrainian and U.S. cit­i­zen­ships — Ukraine does not rec­og­nize dual cit-

izen­ship. A hear­ing is set for Feb. 15.

The re­sult was a back­lash from Suprun’s sup­port­ers, who told the Kyiv Post that Suprun was the only health min­is­ter to achieve real re­forms since Ukraine be­came in­de­pen­dent in 1991. While many of these re­forms were con­tro­ver­sial, sup­port­ers worry that with­out Suprun, the health care sys­tem will slide back into cor­rup­tion and waste.

"For many decades, no one chal­lenged the health care sys­tem, that's why Ukraini­ans have huge prob­lems with the qual­ity of medicine," Prime Min­is­ter Volodymyr Groys­man said at a cabi­net ses­sion on Feb. 6. "This court rul­ing is an at­tempt to turn us back.”

Pres­i­dent Petro Poroshenko also said that Suprun has “the full sup­port of the pres­i­dent of Ukraine.”

Claims of sab­o­tage

Mosiy­chuk re­leased a state­ment on Face­book ac­cus­ing Suprun of “caus­ing ir­repara­ble harm” to Ukraine’s “badly dam­aged” health care sys­tem. He claimed that first aid is un­avail­able to peo­ple who need it, and that ba­sic medicine is “im­pos­si­ble to find.”

“We’re fight­ing for the life and health of Ukraine,” Mosiy­chuk wrote. Suprun posted a re­but­tal on Feb. 4, point­ing to Mosiy­chuk’s own legal trou­bles — the law­maker once pled guilty to tak­ing bribes.

This is not Suprun’s first runin with Lyashko’s party. In April 2018, the Na­tional Anti-Cor­rup­tion Bureau of Ukraine said that one of Lyashko’s aides had tried to bribe Suprun — he of­fered her a new apart­ment in ex­change for med­i­cal al­lo­ca­tions to a hos­pi­tal in Vysh­n­eve. Suprun promptly turned the aide in to the po­lice. Shortly af­ter, Lyashko de­manded that the Rada dis­miss Suprun due to her al­leged dual cit­i­zen­ship.

Also in April 2018, the Rada’s health com­mit­tee ap­proved a draft de­cree to dis­miss Suprun due to “dis­rup­tions,” caused by her at­tempts to re­form Ukraine’s drug pro­cure­ment sys­tem.

At the time, Olga Bo­go­mo­lets, the health com­mit­tee head, law­maker from the Poroshenko bloc and a ma­jor op­po­nent of Suprun’s pro­posed re­forms, called on the govern­ment to de­cide whether Suprun’s “pro­fes­sional in­ep­ti­tude” was be­hind Ukraine’s pro­cure­ment trou­bles.

Prob­lems sur­face

Ac­cord­ing to the Min­istry of Health's state­ment on Feb. 6, the court in­junc­tion is al­ready block­ing a ship­ment of vi­tal medicine worth a to­tal of Hr 633 mil­lion, or about $23 mil­lion. Be­fore this ship­ment can go to re­gional hos­pi­tals, it re­quires a min­is­ter’s or act­ing min­is­ter’s sig­na­ture.

“Cur­rently, Ukr­vak­tsina and Ukrmed­postach are in the ware­houses of state en­ter­prises pre­par­ing to dis­patch vi­tal prod­ucts in the re­gions through 33 pub­lic pro­cure­ment pro­grams,” the min­istry wrote, in a state­ment.

“Among them are vac­cines against measles, mumps and rubella (al­most 390,000 doses) and po­lio (954,000 doses),” the min­istry wrote. “With the on­go­ing measles out­break, any de­lay in de­liv­er­ing these vac­cines to the re­gions is un­ac­cept­able.”

Suprun ex­pressed alarm at these de­vel­op­ments. “Thou­sands of peo­ple might be left with­out treat­ments,” she wrote in her Face­book state­ment.

Frag­ile re­forms

Non­govern­men­tal or­ga­ni­za­tions, in­clud­ing Pa­tients of Ukraine, Trans­parency In­ter­na­tional and the HIV char­ity 100% Life, say Suprun made pow­er­ful en­e­mies by try­ing to re­form Ukraine’s med­i­cal pro­cure­ment sys­tem, which pre­vi­ously fun­neled rev­enue to a hand­ful of com­pa­nies and cor­rupt of­fi­cials.

The health min­istry used to pro­cure all drugs for Ukraine's state hos­pi­tals. The job of pro­cure­ment of­ten went to a hand­ful of com­pa­nies that could buy drugs abroad and in­flate their price through a chain of sub­sidiaries. The new sys­tem caps the fi­nal price and del­e­gates much of the pro­cure­ment to in­ter­na­tional or­ga­ni­za­tions, in­clud­ing branches of the United Na­tions. Re­form back­ers claimed that this made drugs and med­i­cal sup­plies 40 per­cent cheaper.

“The min­istry (un­der Suprun) helped fight against a feu­dal sys­tem,” Maksym Rovin­skyi, the di­rec­tor of com­mu­ni­ca­tions at 100% Life, which sup­ports Ukraini­ans liv­ing with HIV, told Kyiv Post. “Be­fore her, there were peo­ple who could sit on these money streams and skim off a big per­cent­age of govern­ment funds meant for med­i­cal pro­cure­ments.”

Suprun also over­saw the cre­ation of a sys­tem to re­im­burse pa­tients for the pur­chase of drugs for treat­ing car­dio­vas­cu­lar dis­ease, asthma and Type 2 di­a­betes. How­ever, the re­im­burse­ment only cov­ers the cost of the cheap­est gener­ics. Pa­tients who want brand name drugs must pay the dif­fer­ence out of their own pock­ets. Also un­der Suprun’s watch, the health min­istry adopted a World Health Or­ga­ni­za­tion stan­dard by which hos­pi­tals are obliged to buy medicines with al­lo­cated funds.

NGOs that spoke to the Kyiv Post are wor­ried that all these re­forms might be on the chop­ping block with­out Suprun in con­trol.

“Right now, all our strength must be thrown into keep­ing Ulana in place,” said Inna Iva­nenko, the ex­ec­u­tive di­rec­tor of Pa­tients of Ukraine. “We’re all ready to go out into the streets to picket and sup­port her in any way we can.”

Rep­re­sen­ta­tives of sev­eral for­eign pow­ers echoed these con­cerns. Bri­tish Am­bas­sador Ju­dith Gough tweeted that the court case may en­dan­ger Ukraine’s “vi­tal” health care re­forms.

Legal ques­tions

Con­sti­tu­tional ques­tions hang over Suprun’s pend­ing court case — where her power comes from and how it can be stripped away.

Legal ex­pert An­driy Guck told the Kyiv Post that Suprun can con­tinue work­ing as act­ing min­is­ter de­spite the in­junc­tion. He said the court ban on Suprun’s pow­ers would be ef­fec­tive if she was in­stalled by a min­is­ter of health. But Suprun was in­stalled by the Cabi­net of Min­is­ters.

“In such a legal con­flict, in my opin­ion, it is im­pos­si­ble for Suprun to be crim­i­nally li­able for not com­ply­ing with the court or­der,” Guck told Kyiv Post. “She has a bind­ing or­der (from the govern­ment) that is still valid.”

An­drii Borovik, the ex­ec­u­tive di­rec­tor of Trans­parency In­ter­na­tional Ukraine, told the Kyiv Post that Suprun en­joys broad sup­port from the pres­i­dent and the Cabi­net of Min­is­ters, which might sim­ply try to re-ap­point her. How­ever, he ac­knowl­edged that there may not be enough votes in par­lia­ment to con­firm her as a full-fledged min­is­ter.

“It would be very un­de­sir­able if she was re­moved,” he said.

Since Suprun was brought in as a re­place­ment in the ab­sence of a health min­is­ter, it’s un­clear un­der Ukrainian law whether the cabi­net can en­dow a deputy min­is­ter with the full power of a min­is­ter. Ac­cord­ing to an ar­ti­cle by Guck, the law isn’t clear on what hap­pens when par­lia­ment re­fuses to con­firm an “act­ing min­is­ter” whose func­tions are then in­ter­rupted, like Suprun’s.

Ac­cord­ing to Guck, there are two pos­si­ble ways out for Suprun. One is to ap­peal against the court rul­ing and con­tinue try­ing to do her job with­out full min­is­te­rial pow­ers. The other is to pro­vide a for­mal ra­tio­nale as to why the court rul­ing can­not be legally im­ple­mented.

Kyiv Post staff writ­ers Anas­ta­sia She­p­el­eva and Ar­tur Korni­ienko con­trib­uted to this re­port.

Act­ing Health Min­is­ter Ulana Suprun re­ceives a flu shot in Kyiv in Novem­ber 2017 while pro­mot­ing med­i­cal re­forms. Suprun is widely praised as a prin­ci­pled re­former, but her suc­cess has drawn fire from crit­ics, in­clud­ing some who prof­ited from cor­rupt state spend­ing in the sec­tor be­fore her ar­rival. (UNIAN)

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