In response to the brutal fighting, continuing attacks on Ukraine’s civilians, destruction of the country’s electricity infrastructure, and infliction of widespread psychological trauma, Direct Relief has conducted its largest and most sustained humanitarian aid response in its 75-year history.

The $1 billion milestone reached this month includes more than 292 million daily defined doses of prescription medicine for all kinds of conditions, including diabetes, infections, seizures, cancer, hypertension, psychological conditions, transplants and more, reaching millions of Ukrainians.

As Direct Relief operates without government funding, the $1 billion in donations comes entirely from private sources. (The U.S. government has provided $3.9 billion in humanitarian assistance since the war’s start.)

In the city of Kremenchuk along the Dnieper River, the children’s hospital had received no new supplies from early February through April, when a large shipment of Direct Relief donations arrived, delivered by the Association Internationale de Coopération Médicale (AICM), Direct Relief’s core partner in the eastern Poltava region. The hospital was treating around 250 children, many of them suffering war wounds, when the supplies arrived.

The donations from Direct Relief “should sustain us for the next six months,” Deputy Director Iryna Roman told Direct Relief.

“It is hard to overestimate the impact of Direct Relief’s emergency response to the war in Ukraine,” said Nataliia Bohachenko, head of Ukrainian Soul, an Odesa-based NGO that is a partner of Direct Relief. “Continuous support, diversified grant programs and repeating shipments helped to fill gaps in the supply of Ukrainian hospitals and other healthcare facilities caused by war, thus helping and saving the lives of many Ukrainians who needed the help.”

For people with diabetes, Direct Relief has delivered 2.2 million bottles and vials of insulin, 3.7 million needles and syringes, and 4.1 million test strips. Direct Relief has been the largest humanitarian supplier of insulin to Ukraine since the war began.

The aid also has included large quantities of medical supplies ranging from battlefield tourniquets to diabetes test strips to prenatal vitamins.

The $1 billion total figure represents the wholesale value of the products delivered between Feb. 2022 and August 2023. Direct Relief has based the valuation on the wholesale costs of prescription medications in Europe, where prices for certain products are as much as 70% lower than comparable products sold in the United States

In addition to the $1 billion in donated medicine and supplies, Direct Relief has committed $35 million in grants in financial support to local healthcare organizations providing care in Ukraine and others in countries, including Poland and Slovakia, that have opened their doors to Ukrainian refugees.

That funding has covered medication costs for more than 266,000 Ukrainian refugees in Poland, provided mental health care for close to 25,000 Ukrainian refugees in Slovakia, and funded rehabilitation programs focused on working with amputees, occupational therapy, speech therapy, and psychosocial support. Direct Relief is also providing funding to support Ukraine’s national system for distributing medicine around the country to the people who need it.

“Direct Relief has reached this milestone through the generous support of people in 84 countries around the world, as well as from dozens of the world’s leading pharmaceutical makers,” said Thomas Tighe, Direct Relief’s President and CEO. “It reflects the breadth of support for the people of Ukraine and our ongoing commitment to help them through this terrible national ordeal.”

Support from Companies and Organizations

Seventy-nine pharmaceutical and medical supply companies and organizations donated their products to Direct Relief’s Ukraine response. Of the 292 million daily defined doses of medicine donated to Ukraine, about 163 million have been of generic drugs. The companies that provided donations include:

3M
Abbott
AbbVie
Accord Healthcare
Ajanta Pharma USA
Alvogen
AmerisourceBergen
Amgen
Apotex
AstraZeneca
Baxter Europe
Baxter International
Bayer AG
Bayer USA
BD
BD Europe
Belmora
Biogen
Boehringer Ingelheim
Cal OES
Carlsbad Technology
Coherus Biosciences
Covidien
CVS
DeVilbiss Healthcare GmBH
Dragerwerk AG
Drive Medical GmBH
Edenbridge Pharmaceuticals
Eli Lilly & Company
Encube Ethicals
Ethicon
Genentech
Gilead
Grifols US
Greenstone
Grifols Worldwide
GSK
GSMS Incorporated
Haleon
Henry Schein
Hikma Pharmaceuticals
ICU Health
ICU Medical
Inogen
Integra LifeSciences
Janssen Pharmaceuticals
Jazz Pharmaceuticals
J&J Consumer
Kate Farms
Kenvue
Kirk Humanitarian
LifeScan
Liquid IV
McKesson Medical-Surgical
Medline Industries
Medtronic
Merck & Co.
Merck KGaA
Meitheal Pharmaceuticals
MSD
Novo Nordisk A/S
Organon
Perrigo Pharmaceuticals
Pfizer
Purdue Pharma
Sanofi
Society of Critical Care Medicine
Takeda Pharmaceuticals USA
Mepha Schweiz
Teva Pharmaceuticals Europe
Teva Pharmaceuticals USA
Trifecta
Unilever
Unite to Light
Viatris Europe
Viatris USA
ViiV Healthcare
Westminster Pharmaceuticals
Zydus Pharmaceuticals

Support for Rehabilitation

Events of the past 18 months have made some of the long-term health consequences of the war very clear. People who have sustained disabling injuries will require lifetime care, including children who have lost limbs and will require new prosthetic devices as they grow up. Supporting rehabilitation and recovery from war injuries, both physical and psychological, has been a core focus of Direct Relief. The organization has allocated $15 million to specifically support rehabilitation and injury recovery efforts in Ukraine, including support for the Unbroken National Rehabilitation Center in Lviv.

Helping Ukrainians Manage Psychological Trauma

A significant portion of the Ukrainian population has suffered from psychological trauma. Trauma-focused psychologists are providing care at the scene of Russian attacks, to help victims begin to process what they have experienced. Direct Relief has provided funding to organizations, including a $550,000 grant to Razom for Ukraine, a Ukrainian-American nonprofit that, with this funding, is providing mental health services to war-impacted individuals in Lviv and Ivano-Frankivsk, Ukraine.

A $320,000 grant has enabled HromadaHub, a Ukrainian nonprofit, to train Ukrainian psychologists to provide emergency psychological support. During five-day sessions, it has so far trained more than 300 participants on how to interact with people at the site of attacks, as well as those who have suffered trauma accumulated over longer periods.

“By organizing the training, we are not giving the fish but the fishing rod to the psychologists so they can start helping their communities,” Hromada Hub’s head Lily Bortych told Direct Relief. The goal is to build up the resilience and sustainability of the country’s psychological support system. “Ukraine doesn’t have to rely only on foreign specialists but can build up an army of trained emergency psychologists speaking the same language, living in the same area, and sharing the same problems with the people they help,” Bortych said.

“Miracles happen when you work with the right people,” Hromada Hub’s emergency psychology coordinator Melinda Endrefy told Direct Relief.

“There is a proverb in Ukrainian: ‘In grief and your hour of trouble, you will recognize a loyal person,’” said Marina Makarenko, head of Charitable Fund Modern Village and Town. “From the first day of the war, we have felt the support of a friend – Direct Relief. Thanks to this powerful financial support of our charitable projects and initiatives, ambulances, medicines, oxygen concentrators, and emergency medical aid backpacks, our NGO was able to withstand the first week of the war and continue to help thousands of Ukrainians.”

Medical Support for Ukraine

The post Direct Relief Delivers $1 Billion in Donated Medicine and Medical Supplies to Ukraine appeared first on Direct Relief.

On Feb. 6, 2023, a devastating 7.8-magnitude earthquake and the aftershocks that followed reverberated through multiple provinces of Turkey and Syria, and the combined impact of the earthquakes killed more than 50,000 people and injured more than 100,000. Hundreds of thousands were displaced by dangerous and uninhabitable buildings and forced into temporary shelters.

Immediately after the earthquake, Direct Relief dispatched medical aid to assist with the first phase of the emergency, search and rescue efforts. The organization provided field medic packs for triage care, as well as emergency funds for search and rescue operations, and mobilized requests for medical aid from Turkey’s Ministry of Health and local organizations in both Turkey and Syria, providing health services to impacted communities.

As the region moves through the recovery phase, many people remain internally displaced from their homes, including healthcare staff remaining in the region. Hot and dry weather has created challenging conditions for those living in temporary encampments without access to air conditioning, and basic needs for clean water and power remain.

Access to mental health support, rehabilitation services for people injured by the earthquakes, and maternal and reproductive health needs remain high. Direct Relief is focusing on these areas for long-term recovery by directing funding and financial support for the continued strengthening of the health system.

In the six months since the earthquake, the organization has provided more than $4.6 million in financial assistance to groups providing essential health services in Turkey and Syria. Direct Relief has also provided 550 tons of medical aid, valued wholesale at $90.2 million, to support the work of health workers in the wake of the earthquakes.

Financial Summary

The information included in this report, by necessity, includes unaudited figures because the organization’s formal audit coincides with its fiscal year, which is from July 1 to June 30. Audited figures for this period will be included when that audit and report are completed. Numbers are as of August 3, 2023.

Who Donated to the Response?

In response to the crisis, Direct Relief received contributions from 54,730 donors totaling $15,800,583 from individuals, foundations, businesses, and organizations located in 111 countries (including the U.S.). Donations from all 50 U.S. states and 4 territories were received.

Of the total amount of Turkey-Syria earthquake-designated contributions —

• $9,307,057 was contributed by 54,474 individuals
• $5,513,573 was contributed by 135 businesses
• $866,500 was contributed by 39 foundations
• $113,453 was contributed by 82 organizations

How Were the Funds Used?

Of the total Turkey-Syria earthquake response-designated cash contributions received to date, Direct Relief has expended or committed $8,679,553 to improve the health and lives of people affected by the disaster.

This includes:

• $1,858,058 on transportation (paid and pending)
• $4,680,000 on financial assistance to organizations supporting emergency response
• $1,154,234 on procurement of oxygen concentrators, field medic packs, and other supplies
• $987,251 on emergency personnel costs and other organizational response management expenses

Consistent with Direct Relief’s Donation Policy, 100 percent of funds received for specific emergency events are devoted entirely to those events, and none of the funds donated for Turkey-Syria earthquake response have been used for fundraising.

(As explained here, all Direct Relief's fundraising expenses are paid by the Direct Relief Foundation, which uses earnings on previously received bequests to the organization for this purpose and other non-programmatic costs.)

Medical Material Assistance

Direct Relief’s earthquake response support can be divided into three categories: medical material assistance, direct financial assistance and information assistance.

Direct Relief’s main objective in any large-scale disaster response is to safely and securely deliver emergency medical resources – requested, approved by the responsible government authority, and appropriate for the circumstances – where they are most needed, as fast and efficiently as possible.

As aftershocks continued, Direct Relief began working with local, regional and country-level organizations, including Turkey's Ministry of Health, to determine needs and requests for aid.

In Syria, Direct Relief leaned into strong, existing relationships with organizations that have long worked in the country to channel a high volume of aid.

At the start of the emergency, Direct Relief’s first emergency shipment consisted of more than 100 field medic backpacks for search and rescue personnel dealing with injuries, infections, and other acute medical needs. Working with organizations such as the Society of Critical Care Medicine and the Renal Disaster Task Force, Direct Relief supported intensivists working to treat and stabilize those with traumatic injuries.

As needs became clearer, Direct Relief began to channel large volumes of aid via three separate charter flights to the region as part of the response. In April, an 80-ton charter, with transportation provided by FedEx, included specifically requested antibiotics, respiratory medications, anti-seizure therapies, vitamins for children and adults, personal protective equipment, hygiene items, and more. FedEx also provided funding for emergency medical backpacks sent.

As of Aug. 6, 2023, Direct Relief’s Turkey-Syria response efforts have resulted in the delivery or pending delivery of 550 tons of emergency medical goods, with a wholesale value of more than $90.2 million.

Over the past six months, Direct Relief’s relationships with local groups, its strong partnership with corporate donors, and its ability to securely deliver large quantities of medical goods – including temperature-sensitive products that require the use of cold-chain supplies and technologies – have resulted in the organization becoming a significant channel for the delivery of medical goods to benefit people in Turkey and Syria recovering from the quake.

Read More: ‘Death Just Beneath You’: Doctor Describes Turkey Earthquake, Ongoing Challenges

In Turkey

Healthcare facilities and organizations in Turkey that have received medical goods include:

• Turkey's Ministry of Health
• AKUT Search and Rescue
• Ahbap Dernegi
• Adana Metropolitan Municipality
• Istanbul Metropolitan Municipality

In Syria

Healthcare facilities and organizations in Syria that have received medical goods include:

• Syrian American Medical Society
• Syrian Relief and Development
• Independent Doctor's Association

Direct Financial assistance

Thanks to the outpouring of financial support from donors, Direct Relief continues providing cash assistance to help facilities and organizations effectively respond to the ongoing needs of patients impacted by the earthquakes.

To date, Direct Relief has identified, vetted, and awarded emergency financial support totaling $4,694,240 in cash support for groups responding to medical needs related to the earthquake. The organization has supported groups in Turkey with $1,530,000 in funding and groups in Syria with $3,164,240.

Read More: Turkish Midwives Step Up for Mothers and Newborns, Post Earthquake

Financial Support for Response in Turkey

Financial Support for Response in Syria

Information Assistance

In addition to providing medical material and financial aid, Direct Relief has been a critical information supplier to key organizations involved in the response. Working with technology companies, academic institutions, and health providers, Direct Relief has used human mobility data, geospatial analysis, and other data collection and analytics instruments to help understand key issues.

Within Turkey, Direct Relief has focused mainly on understanding the scale of human displacement. Using data from Meta on change in population density and movement between places, linked to surveys on the needs of internally displaced persons, Direct Relief has shared nearly two dozen reports and analytical data feeds focused on population displacement with agencies ranging from AFAD to the World Food Program.

Corporate Support

Direct Relief was able to supply a large array of medical material support without the expenditure of donor funds due to the in-kind donations from healthcare manufacturers and distributors, many of which Direct Relief works with on an ongoing basis.

Healthcare company donors responded expansively to requests for their participation. Included among them are 3M, Abbott, AbbVie, Accord Healthcare, Amgen, AmerisourceBergen, Apotex, AstraZeneca, Baxter, Bayer, BD, BioMarin, BMS, Boehringer Ingelheim, Edenbridge, Eli Lilly & Co., Embecta, Genmab, Gilead, Grifols, GSK, Haleon, Henry Schein, Hikma, Integra Lifesciences, Janssen, Jazz Pharma, J&J, Kenvue, Liquid IV, McKesson, Medline, Merck & Co., Pfizer, Sandoz, Takeda, Teva (Turkey), Ultragenyx, Unilever, Vertex, Viatris, and Westminster.

Looking Forward

With the amount of infrastructure damage and displacement of people still significant six months later, true recovery from the earthquake's damage will likely be decades-long. As this phase continues, Direct Relief remains committed to general support of the health system, as well as focus areas in Turkey and Syria.

In Turkey and Syria, Direct Relief is focused on increasing and supporting maternal and reproductive health care services, mobile health services, and sustaining primary care access.

Direct Relief has supported HASUDER's women's health and reproductive service unit, which provides health services and screenings, counseling, personal care and family planning items for people displaced by the earthquake.

Supporting access to psychosocial services for those affected by the earthquake, including health workers, also remains a priority. One example of support includes the Turkish Psychiatric Association, which deploys volunteer psychiatrists to earthquake-impacted areas to provide psychosocial services for survivors and first responders.

The organization also holds regional-certified disaster mental health training for medical professionals in the field to support a sustainable, integrated approach to care. To ensure the Syrian refugee communities also have access to these services, the Turkish Psychiatrists Association employs trained Arabic translators from refugee settlements in the earthquake zones.

As the response continues, Direct Relief remains able to provide support detailed in this report as a result of its existing strong relationships with non-governmental organizations that were already receiving Direct Relief medical product shipments, ongoing work with clinical experts in the field to guide distribution and procurement decisions, existing partnerships and contracts in place to quickly request and receive high-quality medications from pharmaceutical manufacturers and distributors, and a strong track record of shipping large volumes of product, including those requiring cold chain packaging and storage, to difficult-to-access places to reach the most vulnerable patients.

Direct Relief will continue to provide assistance to the region as recovery continues.

The post Six Months After Devastating Earthquake in Turkey and Syria, Recovery Continues appeared first on Direct Relief.

PART ONE

THE SITUATION

“Direct Relief was created out of the ashes of WWII by Europeans who fled. It’s stunning and sad that humanitarian assistance is needed again in the same neighborhood, but it’s consistent with our organization’s roots, initial focus, and longstanding mission.”

– THOMAS TIGHE, Direct Relief President & CEO

The Russian invasion of Ukraine in February 2022 caused widespread and long-lasting disruptions to the country’s health care system while drastically increasing the need for health services across all geographies and demographic groups. As of the end of January 2023, over 3.6 million people remained internally displaced, and another 8 million remain outside Ukraine as refugees. In areas of Ukraine where Internally Displaced Persons (IDP)s are concentrated, the number of people seeking healthcare has strained local resources, particularly at the primary care level.

Persistent attacks on health, power and water infrastructure have reduced service capacity across the health system. The greatest impacts occurred in areas close to the front lines in the eastern and southern regions. The intensified attacks since the beginning of October 2022 have destroyed or damaged more than half of Ukraine’s power infrastructure, leaving millions of people without a steady supply of power and limited access to water or heat. To battle cold weather, generators and fuel tanks are in high demand. Medical facilities are no exception. Power remains a challenge for the maintenance of the existing services – the medical equipment requires an uninterrupted power supply to operate and to ensure it remains calibrated and functional.

Likewise, reduced access to transportation – given damage, cost, and safety issues – continues to affect every aspect of Ukraine’s health system, from patient visits to supply chains. Transportation limitations have reduced physical access to care for many patients and led to persistent stock-outs of needed medications throughout the pharmacy and clinical network. Shortages of medicines exist at the primary health care level, particularly for chronic diseases, including insulin, thyroid gland medication, hormonal therapy, and medicine for heart diseases and chronic obstructive pulmonary disease, as well as a lack of vaccines for tetanus, diphtheria, and other common vaccinations. Access to care remains better in larger towns and cities, but outpatient clinics in smaller settlements and villages are left with almost no equipment and supplies. The situation is worse in frontline areas and recently de-occupied areas, where there are shortages of primary health care providers and almost no functional pharmacies.

Despite the impact of attacks on health infrastructure and other services, health care within Ukraine remains manifestly resilient to shocks. A recent survey by the World Health Organization (WHO) found that 95% of Ukrainians were still receiving primary care services, 90% reported having access to chronic disease care, and 93% were able to access a family doctor either at a clinic or through an expanding network of telemedicine services. The resilience of the health system is a testament at once to the commitment of Ukrainian health professionals and to the strength of international support and collaboration.

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PART TWO

THE APPROACH

“Whenever we are considering an impending donation in the most difficult of conditions and the question is raised internally “Who might be able to handle such a formidable task?” – the answer is always clear. For that reason, we feel proud and humbled to be working so closely with Direct Relief.”

– AMALIA ADLER-WAXMAN, SVP, Global Head, ESG and Head of Corporate Affairs of International Markets, Teva Pharmaceuticals

Direct Relief is prioritizing the following strategic areas in its response to the humanitarian crisis in Ukraine:

• Increase access to health services, including primary health care, prevention and treatment of non-communicable diseases, emergency medical services, and specialized care
• Ensure delivery of medicines and medical supplies to Ukraine
• Develop and strengthen rehabilitation services for people wounded by war
• Increase access to mental health and psychosocial support services
• Increase access to medical supplies and services for Ukrainian refugees

In its Ukraine response, Direct Relief continues offering two types of support: medicine and supplies to address disruptions in the medical supply chain, and financial assistance to increase access to health services, improve the supply of medications, and improve the health and well-being of the population.

Direct Relief has built within Ukraine an extensive and constantly expanding network of medical provider partners that include the Ministry of Health, the World Health Organization, regional health departments, public hospitals and clinics, select private hospitals providing services without charge, and local humanitarian foundations and associations.

Since February 2022, Direct Relief has donated 8.3 million units (e.g., bottles, vials, pre-filled syringes) of prescription medications. Direct Relief also provided millions of units of non-pharmaceutical products such as pen needles, oxygen concentrators, generators, ambulances, medical consumables, and other health care technology.

Letter from The Ukrainian Ministry of Health

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PART THREE

BROADENING Access to health services

“This was nothing about business. We didn’t think to help or not; it was so natural. It was a natural consequence of so many people needing help.”

– ZBIGNIEW MOLENDA, Founder and VP of Pelion S.A., Poland’s largest healthcare sector business

Direct Relief is engaged in several different lines of activity to bolster primary health care in Ukraine. In areas where rural geography and the impact of war have curtailed access, support for mobile health care units will be expanding capacity for early diagnosis, treatment, and prevention of disease. Where health care facilities have seen reduced ability to provide services due to loss of power, the installation of generators and fuel tanks ensures continuous electricity. At the same time, access to medicines is being ensured through a vetted network of non-governmental partners capable of providing regular distribution to primary health facilities and community pharmacies.

In many cases, primary health care can be an excellent place to provide rehabilitation services for those injured by war. Direct Relief is assessing the possibility that an expanded landscape of rehabilitation services can be developed through primary care networks. Likewise, primary care services are linked in Ukraine to the provision of emergency care. Direct Relief is continuing to support emergency services through provision of funding, ambulances, medicines, and supplies.

Issue Spotlight

Diabetes Care for Ukraine

Cancer Care for Ukraine

Primary, Emergency, and Specialized Care Grants

Support for Dobrobut Medical Network

Emergency Vehicles for Ukraine

Sustainable Power for Ukraine

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PART FOUR

Supplying Medical Material

“We are grateful to be able to use our global network to offer logistics support for organizations like Direct Relief who have long been committed to sourcing and delivering critical supplies in times of crisis. This situation impacts many, including our own Ukrainian team members, and we remain committed to helping during this devastating time.”

– KAREN REDDINGTON, Regional President of Europe, FedEx Express

When the war began, Direct Relief had existing relationships with Ukrainian health providers and the Ukrainian Ministry of Health, but it quickly established a far more robust pipeline working closely with European pharmaceutical companies, warehouses, and logistics companies. Direct Relief has increased its agility and flexibility while deepening its relationships and capacity in Europe.

Supporting the Humanitarian Medical Supply Chain

In a country with a government-led healthcare system, Ukraine’s Ministry of Health has played a central role in the medical supply chain, both pre-war and during the war. As humanitarian donations of medical supplies poured into Ukraine from around the world, the capacity of the MoH to handle the flow was strained. Direct Relief stepped in to shore up Ukraine’s medical supply chain, ensuring that humanitarian medical supplies reached the people that needed them most.

For the first few months of the war, the MoH estimated operations costs related to the receipt, handling, and distribution of humanitarian aid at up to $750,000 per month. Currently, with the volume and frequency of donations significantly decreased, the MoH has estimated the added cost of warehousing, handling, and distributing humanitarian medical supplies at $200,000 per month.

Direct Relief has approved a grant of $2 million to the MoH to cover these humanitarian logistics costs for 10 months through the end of 2023.

Direct Relief also provided seven organizations with operational grants to offset the expenses for the receipt and distribution of donated products:

Deploying from Europe

While Direct Relief’s Santa Barbara, California,warehouse remains its global distribution hub, the outbreak of war drove Direct Relief to establish a very strong medical supply chain within Europe. More than 40% of pallets of product delivered to Ukraine over the past year have been fulfilled within Europe. Direct Relief has more than doubled the number of healthcare companies donating medicine to the organization from within Europe.

Direct Relief achieved this significant increase in part by establishing exceptional pharmaceutical warehousing capacity in the Netherlands – fully licensed, professionally staffed, with space for thousands of pallets, and experience in complex humanitarian product imports, exports, and customs clearance. Direct Relief has also arranged large medicine donations drop-shipped directly from donor manufacturer facilities within Ukraine and elsewhere in Europe to its Ukrainian partner organizations.

Cold-Chain Requirements

Many of the most important pharmaceutical products needed in Ukraine – such as insulins, cancer therapies, antibiotics, and immunotherapies – require cold-chain logistics (maintaining temperatures between 2° C and 8° C from factory to patient). Direct Relief has developed a very robust capacity for global cold-chain medicine delivery, using modern software to validate shipping lanes and properly pack the shipments, as well as extensively monitoring temperatures in real-time during the delivery process.

Direct Relief has been able to deliver over 2.1 million units (vials/cartridges/prefilled syringes) of various types of insulin to its many partner organizations in Ukraine that treat diabetic patients, as well as over 320,000 additional units of cold-chain medicines to treat cancer, infections, immune conditions, blood disorders, and other serious conditions. Included in these figures were shipments to the WHO of donated insulin. Direct Relief also provided 40-foot refrigeration containers to help Ukraine address cold-chain storage capacity issues at key facilities such as the Ukrainian National Cancer Institute in Kyiv.

Generic Industry Provides Vital Essential Medicines

With important coordination and support from the Association of Accessible Medicines (AAM), Medicines for Europe, and the International Generic and Biomedical Association (IGBA), Direct Relief worked closely with its generic pharmaceutical company donors to provide over 130 million defined daily doses of generic medicines to the impacted population of Ukraine.

The companies providing these prescription medicines, which fulfilled them to Direct Relief from both Europe and the United States, include Accord Healthcare, Ajanta Pharma, Alvogen, Apotex, Baxter, Edenbridge, Hikma, ICU Medical, Meitheal Pharmaceuticals, Perrigo, Teva, and Viatris. Their products have been vital to the success of Direct Relief’s humanitarian response in Ukraine and provided over 2.5 million units (bottles or vials) with a wholesale value exceeding $170 million. The medicines address therapeutic areas including infections, diabetes, cardiovascular disease, respiratory illness, mental health conditions, ulcers, pain, cancer, and other serious conditions.

Amalia Adler-Waxman, SVP and global head of ESG at Teva, said, “Whenever we are considering an impending donation in the most difficult of conditions and the question is raised internally, ‘Who might be able to handle such a formidable task?’ The answer is always clear. For that reason, we feel proud and humbled to be working so closely with Direct Relief and look forward to many more years of collaboration and support.”

Support from Pharmaceutical and Medical Supply Companies

Sixty-nine global healthcare companies have thus far donated medicine and medical supplies to Direct Relief for its humanitarian response in Ukraine, with a wholesale value of over $763 million USD. The companies that provided the donations include:

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PART FIVE

BOLSTERING REHABILITATIVE SERVICeS

“We are very grateful to Direct Relief for the support of unbroken Ukrainians. With this funding, we will get even more opportunities for the treatment and rehabilitation of our people.”

– OLEG SAMCHUK, General Director of the First Lviv Medical Union

According to the United Nations High Commissioner for Human Rights (UNHCR), Ukrainian civilians have suffered nearly 12,000 injuries since the start of the war, and Ukrainian soldiers many more. Many of these individuals require significant medical interventions to repair trauma and physically rehabilitate. Supporting rehabilitation and recovery from war injuries, both physical and psychological, has been a central tenet of Direct Relief’s financial support strategy in Ukraine since the war’s start.

To strengthen rehabilitation services in Ukraine, Direct Relief is prioritizing the following areas:

• Strengthening in-patient rehabilitation departments in hospitals identified by the Ukrainian Ministry of Health (MOH) to enable them to receive civilian and military casualties by providing equipment, training, and supportive supervision by expert teams
• Targeting rehabilitation centers with some existing capacity while making sure not to neglect regions with high needs and no existing capacity. The priority list will be determined jointly with the MOH
• Supporting the development of highly specialized services (wounds, burns, prosthetics-orthotics) to further develop capacities at the Unbroken center in Lviv while also providing equipment for smaller centers closer to the front lines
• Assessing the feasibility of providing assistive devices and community- and home-level follow-up by trained professionals through existing primary healthcare services (including by training primary health care providers on specific rehabilitation needs and interventions)

Partner Spotlight

UNBROKEN

As the war rages on in Ukraine’s east, it creates a steady flow of wounded people needing complex surgeries, long-term rehabilitation and prosthetics. Many of these patients arrive by evacuation trains and ambulances at the Unbroken National Rehabilitation Center in Lviv.

Direct Relief has granted $1 million to Unbroken to procure rehabilitation equipment, develop treatment protocols, and train rehabilitation personnel. The rehabilitation programs focus on amputation recovery, occupational therapy, speech therapy, and psychosocial support.

Unbroken is part of the First Medical Union of Lviv, an umbrella association of multi-specialty clinics that has provided care to 80,000 internally displaced persons since the beginning of the war.

Direct Relief has also provided $250,000 to UNITED24 for renovating the Mental Health and Rehabilitation Center Veterans “Lisova Poliana” in the Kyiv region of Ukraine. The center specializes in treating disorders related to combat stress, assisting survivors of captivity and torture, and providing physical rehabilitation services.

The institution needed to scale up operations urgently due to the rapidly increasing number of people impacted by the war. The funds will expand patient services and improve the facility. The 220-bed center, which provides inpatient services for physical rehabilitation, will undergo reconstruction and overhaul to meet demand.

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PART SIX

INCREASING ACCESS TO MENTAL HEALTH SERVICeS

“The unprecedented support by Direct Relief is truly appreciated. In our experience, this is an exceptional case where support was provided when it was most needed and on a scale that can make a difference.”

– ANDREJ VRSANSKY, CEO of League for Mental Health Slovakia

The World Health Organization estimates that more than 20% of individuals who directly experience war develop or have increased effects from mental health disorders, including depression and anxiety, PTSD (Post Traumatic Stress Disorder), schizophrenia, and many other issues. Based on these estimates, WHO places the number of Ukrainians needing mental health care for one or more conditions at nearly 10 million people.

Mental health is an integral part of Direct Relief’s Ukraine response, cutting across many categories of work: medicine donations, primary care, rehabilitation aid, care for refugees and more.

Partner Spotlight

Razom for Ukraine

Razom initiated its Together with You program in July 2022, providing psychological help to war-impacted individuals, including children. Direct Relief has provided $550,000 in funding to Razom for Ukraine for this program.

Razom provides care at two centers in Lviv and Ivano-Frankivsk, where 10 experienced psychologists work with different age groups and specialize in different types of psychological trauma. In addition to individual therapy sessions, the specialists conduct group sessions at centers for displaced persons, hospitals, rehab facilities, geriatric institutions, and orphanages.

A recent assessment done by RAZOM shows that 80% of the newly admitted individuals to the program have never received psychological support in their life. Therefore, to scale the mental health efforts, RAZOM seeks to open eight additional counseling centers and begin offering online counseling, focusing on the people in de-occupied regions and those returning to their homes.

HromadaHub

HromadaHub is a nonprofit providing humanitarian medical supplies to medical facilities throughout Ukraine and providing emergency psychology treatment. The organization was founded by two Ukrainian women in February 2022 as a humanitarian hub to help quickly and decisively get humanitarian and medical aid to people in Ukraine affected by war.

Direct Relief has donated $540,000 to Hromada Hub, including $220,000 as operational support (receiving, warehousing, and distributing donated material) and $320,000 for emergency psychosocial support. This includes training up to 300 psychologists and social workers in emergency psychology and then deploying teams to affected communities for up to 70 visits. Emergency psychology provides rapid intervention by crisis intervention specialists to help people cope with traumatic situations, trying to minimize the subsequent impact.

Grants for Mental Health

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PART SEVEN

SUPPORT FOR REFUGEES

“This is an absolutely incredible partnership…to care for so many Ukrainian refugees. Truly life saving work, and we are grateful to help support it in our small way.”

– CHRISTINE EDWARDS, Senior Foundation Manager of Bungie Foundation

More than 18.5 million Ukrainians have fled their country since the war began, and more than 8 million of them remain outside Ukraine as refugees, according to the Centre for Research & Analysis of Migration. An estimated 90% of the refugees from Ukraine are women and children. Most have fled to Poland, but significant numbers have sought safety in Hungary, the Republic of Moldova, Romania, Slovakia, and other countries in the region.

Immediately following the invasion, Direct Relief offered support to Ministries of Health of the neighboring countries and has since established strong partnerships with nonprofit health organizations in Poland and Slovakia, working to increase access to health care for Ukrainian refugees abroad.

Slovakia

Unlike Poland, Germany, and the Czech Republic, which have opted to fold refugees into their public health insurance systems, the Slovakian government currently only provides emergency medical services to the roughly 100,000 Ukrainian refugees who fled there. That means Ukrainians living with depression, anxiety, PTSD, or any other mental health conditions are not able to receive care from the national health system until their condition reaches a critical state.

The League for Mental Health, a national NGO that has worked on reforming the mental healthcare system in Slovakia for decades, decided to step in. As the war in Ukraine began, their team established a Ukrainian-language telephone helpline but then saw that more help was needed.

“Where do we find new capacities?” League director, Andrej Vršanský, remembered asking himself.  “The answer was obvious: through people who were coming to our country from Ukraine. This would help them, would help the country through creating additional capacities and of course would help the new Ukrainian communities.” 

Since June 2022, Direct Relief has provided $3 million to fully fund a mental healthcare program launched country-wide by the League for Mental Health to provide mental health support to Ukrainian refugees living in Slovakia. The League currently has 112 Ukrainian refugees on staff as mental health specialists to provide counseling, support groups, and other free psychosocial services to fellow Ukrainians scattered throughout the country’s eight regions and the capital of Bratislava. Since the beginning of the program, the organization has served nearly 25,000 individuals.

Moving forward, the program will attempt to reach some of the Slovakian communities hosting Ukrainians that are directly affected with the process of integration of refugees. The trained psychologists and social workers have also developed a plan to replicate the program in Ukraine – once the situation on the ground stabilizes.

Poland

Since the start of the war, over 9.5 million Ukrainians have crossed the border between Ukraine and Poland, and over 1.5 million have registered for temporary protection status within Poland. To help meet their needs for medications and other health goods, Direct Relief teamed up with the Polish healthcare company Pelion and its fintech subsidiary, Epruf, to provide $15 million in funding to create and sustain the Health4Ukraine program.

Through Health4Ukraine, over 266,000 Ukrainian refugees have received digital cash payment cards that cover 100% of prescription medication co-payments and 85% of non-prescription drug costs at pharmacies located in every region of Poland. These cards have been used in 57% of all nationwide pharmacies.

As compared to a demographically similar group of Polish citizens, Ukrainian users of the Health4Ukraine program tended to purchase drugs for non-communicable diseases like cardiovascular diseases at significantly higher rates, as well as drugs for treating respiratory illness, musculo-skeletal disorders and viral infections.

The partnership with Pelion has been a lifeline for hundreds of thousands, while reducing the burden of healthcare costs on the Polish government and leveraging the core expertise, resources, and systems of the private sector to move quickly and accurately to meet the specific and evolving health needs of Ukrainian refugees.

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PART EIGHT

GLOBAL DONOR SUPPORT

“All of us at Global Citizen are so proud to stand alongside Direct Relief in this work amid the ongoing crisis.”

– ALEXANDRA STABLER, Director of Global Partnerships, Global Citizen

Direct Relief recognizes that the generous supporters who made financial contributions over the last year to help people in Ukraine did so with the express intent that their contributions benefit people in Ukraine and those who fled to neighboring countries as a direct result of the war.

In accepting funds for the response to the situation in Ukraine, Direct Relief understands that both those who contributed and the Ukrainian people for whose benefit the contributions were made deserve to know, in detail, how Direct Relief is using these funds.

contributions to the response

In response to the war in Ukraine, Direct Relief received 151,669 Ukraine-designated financial contributions totaling $101,129,967.

Donations were received from people in 83 countries (including Russia and Belarus) and from people in all 50 U.S. states, Washington DC, five U.S. territories, and three U.S. overseas military addresses.

*Data from February 24, 2022, to January 31, 2023

To date, Direct Relief has spent and committed a total of $39.4 million (39%) on the response. Of that, $38.6 million has been disbursed, and $748,000 has been committed.

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PART NINE

FINANCIAL ASSISTANCE

“Our laboratory [now] has a powerful generator, so we no longer have to stop work during power outages and are able to conduct sample analyses at any time.”

– YULIA KOVALEVA, Senior Laboratory Assistant, St. Panteleimon Clinical Hospital in Sumy, Ukraine

Total Grants Committed: $30.8 MILLION

Supporting the flow of medical material into Ukraine

• Ukraine’s Ministry of Health – $2 million – Granted funds to the Ukrainian government to facilitate and sustain medical logistics operations in-country through December 2023.
• Charity Fund Modern Village and Town – $610,000 – Funding went to support the operational costs of this Ukrainian nonprofit, which has worked with Direct Relief since 2015 and provides humanitarian medical supplies to medical facilities to Ukraine’s Cherkasy region.
• Polish National Agency for Strategic Reserves (RARS) – $350,000 – The Polish Government appointed RARS to act as humanitarian hub for medical aid intended for Ukraine. RARS has worked with Direct Relief to support forwarding of shipments into Ukraine and to store medical aid safely.
• HromadaHub – $220,000 – Funding went to support the operational costs of this Ukrainian nonprofit, which was founded by three Ukrainian women at the start of the war and is providing emergency psychology treatment as well as humanitarian medical products to medical facilities in Luhansk, Donetsk, Zaporizhia, Kharkiv, Odesa, and Chernivtsi oblasts.
• Fondation Humanitaire Internationale AICM Ukraine – $250,000 -This group of 31 medical experts, engineers, and project managers has been conducting health projects in Ukraine since 2004. During the current conflict, they have been delivering medical aid to support 150 medical facilities concentrated in the northeast of Ukraine. This funding went to support their operational costs.
• Charity Fund “TAPS” – $220,000 – Founded in 2018, this Ukrainian non-profit’s mission is to support the families of fallen soldiers, which they do in part by distributing medicines and medical supplies to those in need. Funding went to support their operational costs, as well as the purchase of an electrohydraulic operating table which was requested by a nearby hospital
• Charitable Fund Humanitarian Hub Zhytomyr – $210,000 – Funding went to support the operational costs, including payment of the formerly all-volunteer staff, of this Ukrainian nonprofit providing humanitarian medical supplies to over 40 medical facilities in Sumy, Chernivtsi, Luhansk, Dnipro, and Kharkiv oblasts since the beginning of the conflict.
• Kharkiv Renovation Fund – $150,000 – Funding went to support the operational costs of this Ukrainian nonprofit providing humanitarian medical supplies to medical facilities throughout Ukraine.
• Yevgen Pyvovarov’s Charity Fund – $90,000 – Funding went to support the operational costs of this Kharkiv-based Ukrainian nonprofit that begain in 2020 as an initiative of providing humanitarian medical supplies to medical facilities throughout Ukraine

Developing and strengthening of rehabilitation services

• Dobrobut Hospital – $2 million- Funding supported the biggest network of private medical facilities in Ukraine, which has been providing free medical services during the war.
• Society of Critical Care Medicine – $1.5 million – Largest critical care nonprofit organization globally – a global community of clinicians who provide care to critically ill or injured patients in over 100 countries. Members in Ukraine and the surrounding countries have identified critical medical aid needed for people affected by the ongoing war. The funding was used to procure medication and supplies needed most urgently by intensivists in these countries, using well-established supply chains.
• First Lviv Medical Union (Unbroken) – $1 million – Medical center in Lviv, Ukraine, providing comprehensive rehabilitation services.
• United24 – $250,000 – Increased access to primary health care, emergency medical services, and specialized care.
• Crown Agents – $500,000 – British organization that has been working with the Ukrainian government on public procurement reform for over 25 years. Grant funding was for purchasing generators on behalf of the Ministry of Health.
• UA Brokers without Borders – $300,000– International nonprofit run by Ukrainians living abroad that focuses on urgent, grassroots humanitarian projects for Ukraine. Grant funding was for the purchase of 15 generators for hospitals in need of backup power.
• Razom for Ukraine – $250,000 for generators, $180,000 for specialized services (medical missions) – A Ukrainian-American nonprofit established in 2014 to support the people of Ukraine
• Ukrainian Diabetes Federation – $150,000 – Organization for advocacy and awareness of diabetes in Ukraine. This in-country organization distributes medical equipment and monitors where people who need insulin are located and where they are fleeing. The funding was used for operational costs – distributing material aid and gathering and sharing vital information.
• Dobrze Urodzeni (Well Born) – $140,000– Polish organization of midwives, doulas, psychologists, and lactation consultants that focuses on independent midwifery practice and out-of-hospital perinatal care. Grant funds were given to develop and assemble birth kits and distribute them in Ukraine.
• Motanka – Mobile Medical Services – $120,000 – Franco-Ukrainian nonprofit organization dedicated to supporting war victims in Ukraine. These funds committed by Direct Relief will allow Motanka to procure medical and personal care products, surgical equipment, and medicines for doctors and surgeons on the frontline of the war.
• Project Joint Guardian – $90,000 – A Californian nonprofit sending firefighting equipment and international teams of firefighters to Ukraine to train and work alongside Ukrainian firefighters.
• Pirogov First Volunteer Mobile Hospital – $80,000 – A Ukrainian non-governmental organization of civilian healthcare professionals treating and evacuating injured Ukrainians on the frontlines of the war. This funding will facilitate the procurement of an armored all-terrain vehicle to provide a mobile, heated and sheltered stabilization point for performing surgeries in the field.

Improving access to mental health and psychosocial support services

• Razom for Ukraine – $550,000 – A Ukrainian-American nonprofit established in 2014 that, with this funding, is providing mental health services to war-impacted individuals in Lviv and Ivano-Frankivsk, Ukraine.
• HromadaHub – $320,000 – A Ukrainian nonprofit providing humanitarian medical supplies to medical facilities throughout Ukraine and, with this funding, is providing emergency psychology treatment.
• Health Tech Without Borders – $100,000 – A global non-profit, Health Tech Without Borders (HTWB) serves as an innovative hub that connects qualified and vetted volunteer clinicians to survivors of humanitarian disasters, war, or assault. Since the beginning of the war on Ukraine in 2022, HTWB has provided critical tools, resources, and technology to overwhelmed and under-resourced healthcare workers. The funding was used to enhance the team’s capacity to engage, recruit, and train new volunteers.

Improving access to health care for refugees

• Doz Fundacja Dbam O Zdrowie (Pelion) – $15 million (Poland)– A Polish healthcare company that, with this funding from Direct Relief, is providing digital cash payment cards to Ukrainian refugees to help cover their healthcare cost
• League for Mental Health Slovakia – $3,700,000 – Supported mental health services and employed Ukrainian mental health specialists working with the Ukrainian refugee community in Slovakia. Part of the funding was also used to provide local transportation for Ukrainian citizens residing at a temporary housing in Slovakia.
• Fire Medical – $600,000 (Slovakia)– Operational funding provided to an ambulatory services nonprofit that acts as an out-patient clinic and operates hospital transportation services free of charge for refugees.
• International Confederation of Midwives – $583,000 – Funding provided for midwifery services for refugees over a period of 12 months, supporting the Midwife Associations in the following seven countries: Estonia, Finland, Czech Republic, Hungary, Latvia, Poland, and Romania.
• HealthInova North Macedonia – $200,000 – Provided pharmacy and medical services vouchers to cover the most immediate needs for Ukrainian patients in Macedonia.
• URTICA Foundation Poland – $120,000 – Supported children in oncological and hematological wards around Poland. Since the war broke out in Ukraine, and millions of Ukrainians were forcefully displaced, the Foundation started providing psychosocial support services for pediatric oncology patients from Ukraine as well. The funding was used to expand the provision of services throughout Poland.
• Polish Diabetes Association – $100,000 (Poland) – Patient association in Poland committed to diabetes education and advocacy. The funding was used to provide pharmacy and food vouchers to cover the most immediate needs to Ukrainian diabetes patients in Poland.

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PART TEN

MEDICAL MATERIAL AID

“Through your generous donations we have been able to support the needs of Ukrainians during this challenging time for our country. You truly make a difference for us.”

– VIKTOR LIASHKO, Minister of Health, Ukraine

SUPPORTED GROUPS DISTRIBUTING AID TO 400+ HOSPITALS & CLINICS

Ministries of Health

Ministry of Health, Poland

Ministry of Health, Republic of Moldova

Ministry of Health, Ukraine

Organizations

Amosova Hospital

Charitable Fund Humanitarian Hub “Zhytomyr”

Charity Fund Modern Village and Town

Charity Fund “TAPS”

Chernivtsi City Charitable Fund “Myloserdia”

Chernivtsi Regional Charity Foundation “Viktoriia”

City Center for Humanitarian Aid, Information and Economic Support

HromadaHub

Fondation Humanitaire Internationale AICM Ukraine

Kharkiv City Council

Kharkiv Renovation Fund

Kyiv City Center of Nephrology & Dialysis

Mission Kharkiv

MN Dobrobut

National Cancer Institute in Kyiv

Polski Czerwony Krzyż Polish Red Cross

Razom for Ukraine

Reach Out Worldwide

Ukraine Association for Pediatric Endocrinologists

Ukraine Diabetes Federation

Ukrainian Association of Nephrologists

U.S. & Mexico Firefighters United

Yevgen Pyvovarov’s Charity Fund

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The post Ukraine One-Year Report appeared first on Direct Relief.

Under a collaboration agreement, Ukraine’s Ministry of Health is working with Direct Relief to secure medicine donations from pharmaceutical manufacturers, enabling the use of Direct Relief’s existing contractual and working relationships, smoothing the processes of securing the drugs and then ensuring their timely delivery. Direct Relief has secured and delivered critical medical aid (with over 10% of the pallets requiring cold-chain handling and logistics) specifically requested or approved by the Ministry of Health since the war began. Direct Relief began its collaboration with Ukraine’s Ministry of Health in the year before the invasion working together to provide monoclonal antibody therapies to help address the large Covid-19 outbreaks in the country.

Novo Nordisk Manufactures Insulin Specifically for Ukraine Donation

Among the large prescription medicine donors is Novo Nordisk A/S, which has provided many different types of human and analog insulin for Direct Relief’s humanitarian response in Ukraine, including a large donation of insulin that was manufactured to donate specifically for Direct Relief’s humanitarian efforts. In total, the Denmark-based company has helped meet the needs of tens of thousands of patients with diabetes.

“While we are still deeply concerned with the ongoing aggression against Ukraine, we are grateful that we have been able to team up with Direct Relief, other humanitarian actors and the Ministry of Health to safeguard the supply of our lifesaving medicines to the people who depend on them in Ukraine. I would like to extend my gratitude to the staff of Direct Relief, who work tirelessly in times of crises to serve unmet needs for health care around the world,” said Lars Fruergaard Jørgensen, President and CEO of Novo Nordisk.

Pfizer Donates Critical Anti-infective and Other Medicines to Direct Relief for Ukraine

Pfizer has been among the largest donors to Direct Relief’s response in Ukraine, providing lifesaving therapies to address severe bacterial and fungal infections, as well as medicines to treat patients with Covid-19 infections, which was very important given the recent Covid-19 waves that impacted Ukraine over the past six months. In addition, Pfizer provided various chronic disease medicines and therapies to address uncontrolled bleeding (critical for trauma and wound victims) and chemical warfare antidotes. Pfizer made these donations to Direct Relief’s Ukraine response from the United States and its European affiliates.

Caroline Roan, Pfizer Senior Vice President of Global Health and Social Impact, said: “Ensuring critical medicines continue to reach patients impacted by this tragic and challenging war is paramount to Pfizer. We are committed to contributing to ongoing humanitarian efforts that support the safety, health and wellbeing of people affected by these terrible events. We are very proud to be one of Direct Relief’s largest donors in this program – as part of our broader humanitarian commitments in support of the people of Ukraine, and complementing our efforts to improve access to healthcare worldwide.”

Baxter Donates 10 Truckloads of IV Fluids, Dialysis-Related Products, and More for Ukraine

Baxter International Inc. made one of the largest donations by volume, delivering to Direct Relief more than ten truckloads of critical medical products needed for Ukrainian patients with trauma and wounds, as well as vulnerable patients with renal conditions that required dialysis.

Given the critical need within Ukraine, Baxter provided the products from its facility in nearby Poland, allowing more time to get these essential medicines where they are needed.

“We are deeply grateful to the Direct Relief team for their incredible actions in Ukraine and surrounding countries and are proud to have supported their efforts with donations of more than 100 different types of Baxter products. Our longstanding partnership has been a critical factor in our response efforts as we collaborate on community health needs in the region,” said ​Cristiano Franzi, ​Senior Vice President, and President, EMEA, Baxter International Inc.

The list of pharmaceutical and medical technology manufacturers that made large product donations through Direct Relief (and examples of the types of products provided) to benefit the Ukrainian people include:

• 3M: various wound care dressings and products, N-95 masks, and stethoscopes
• Abbott: diabetes meters and test strips, OTC medications, and infant baby formula
• AbbVie: anesthesia and medicines to treat ocular conditions, thyroid conditions, and cancer
• Accord Healthcare: essential and chronic disease medicines
• Ajanta Pharma: type 2 diabetes medicines
• Alvogen: essential and chronic disease medicines
• Amgen: specialized cancer medications, steroids, and antibiotics
• AmerisourceBergen: bandages and wound care products
• Apotex: essential and chronic disease medicines
• AstraZeneca: respiratory inhalers, cancer therapies, and chronic disease medicine
• Baxter International Inc.: nephrology, anesthesia, surgical products, and IV fluids
• Bayer: antibiotics for hospitalized patients with serious respiratory or skin infections
• Boehringer Ingelheim: type 2 diabetes and cardiovascular medications, and bronchial inhalers
• ConvaTec: wound dressings
• Eli Lilly: various types of insulin, and therapies to treat cancer, mental health conditions and Covid-19
• Grifols: human albumin for hospitalized patients with severe conditions
• GSK: essential chronic disease medicines to treat infections, epilepsy, and mental health conditions
• Hikma: essential, nephrology, chronic disease, and oncology medicines
• ICU Medical: IV catheters and IV solutions
• Johnson & Johnson: medicines for mental health conditions, cardiovascular disease, and diabetes
• LifeScan: diabetes meters and test strips
• McKesson: consumable medical products
• Meitheal Pharma: cancer therapies and muscle relaxants used as an adjunct to general anesthesia
• Medtronic: sutures, skin stapler, catheters, and surgical mesh
• Merck KGaA, Germany: medicines for type 2 diabetes, hypertension, and thyroid conditions
• MSD / Merck & Co.: antibiotics, oral Covid-19 therapies, type 2 diabetes medicines
• Novo Nordisk A/S: various types of insulin, including a sizeable manufacture-to-donate batch for Ukraine
• Organon: cardiovascular disease medicines
• Pfizer: medicines for infections, uncontrolled bleeding, and chronic disease, Covid-19 antiviral medication, chemical warfare antidotes
• Sanofi – through Foundation S: hypodermic needles for medicine injections
• Takeda: medicines for nephrology, hemophilia, gastrointestinal conditions, inflammation, and human albumin
• Teva: medicines for infections, edema, pain, respiratory conditions, and other chronic diseases
• Viatris: medicines for infections, cancer, cardiovascular disease, and other chronic diseases

The post Direct Relief Works with Ukrainian Ministry of Health and Global Drug Makers to Deliver 890 Tons of Medical Aid to Ukraine appeared first on Direct Relief.

That includes a FedEx humanitarian relief flight with 76 tons of medicines and supplies from Direct Relief that arrived last week in Poland and was distributed throughout four Ukrainian cities.*

Aboard the FedEx Boeing 777 was a 50-bed emergency field hospital donated by the State of California and substantial quantities of trauma and wound care medications, drugs for chronic diseases, oxygen concentrators, and Covid-19 antiviral tablets, among other emergency medicines and supplies.

Supplies on the flight were donated by companies including 3M, AmerisourceBergen, Baxter, Boehringer Ingelheim Cares Foundation, Inc., Hikma Pharmaceuticals, McKesson, Merck & Co., Inc., Pfizer Inc., TEVA, Unilever, and Viatris, among others.

More than two tons of insulin also arrived in Ukraine last week and over the weekend. The diabetes meds were shipped from Direct Relief’s distribution center in Europe in special cold-chain containers with monitoring equipment inside.

All items were provided at the request of, and approved by, Ukraine’s Ministry of Health and other on-the-ground healthcare providers.

In Other News

Fortnite raised $144 Million for Ukraine Relief – The Verge

“The funds are being put towards several aid groups, including Direct Relief, the United Nations High Commissioner for Refugees, the United Nations Children’s Fund, and the World Food Programme.”

World-renowned Photographers Sell Stunning Prints – Washington Post

“Vital Impacts, a women-owned nonprofit based in Montana, has organized a print sale by National Geographic photographers to raise money for Direct Relief, an organization that works to provide humanitarian aid to those suffering from the numerous conflicts happening around the world.”

* Specific aid distribution locations within Ukraine are being withheld for security reasons

The post Humanitarian Aid Flows to Ukraine Accelerating appeared first on Direct Relief.

Aid aboard the FedEx Boeing 777 cargo aircraft included an emergency field hospital donated by the State of California and substantial quantities of emergency medicines and supplies, including trauma and wound care medications, chronic disease medications, oxygen concentrators, and Covid-19 antiviral tablets. Direct Relief team members were on site for the offload and final-mile distribution to Ukraine.

“Our hearts are with each person pushed into crisis by the war in Ukraine, and Direct Relief will continue responding to the urgent requests for medical support,” said Thomas Tighe, Direct Relief President and CEO. “Direct Relief is deeply grateful to FedEx for stepping up, yet again, to provide logistics and delivery of medical support so critically needed by families and people whose lives have been upended and face tremendous hardship and uncertainty.”

All items were provided at the request of, and approved by, Ukraine’s Ministry of Health.

Supplies on the flight were donated by companies including 3M, AmerisourceBergen, Baxter, Boehringer Ingelheim Cares Foundation, Inc., Hikma Pharmaceuticals, McKesson, Merck & Co., Inc., Pfizer Inc., TEVA, Unilever, and Viatris, among others. 

Direct Relief and FedEx have been collaborating to deliver critical aid for more than 28 years. Together, the organizations are able to assist communities in need around the world by leveraging logistical expertise to transport critical aid where and when it is needed most.

“The humanitarian crisis in Eastern Europe is devastating as millions of Ukrainians flee the conflict in their country, seeking refuge in communities across Poland and other neighboring countries,” said Karen Reddington, regional president of Europe, FedEx Express. “We are grateful to be able to use our global network to offer logistics support for organizations like Direct Relief who have long been committed to sourcing and delivering critical supplies in times of crisis. This situation impacts many, including our own Ukrainian team members, and we remain committed to helping during this devastating time.”

Since February 24, Direct Relief has provided more than 125 tons of medical aid in response to the crisis, from field medic packs — which contain items to address trauma, including tourniquets and wound dressings — to diabetes and cancer medications.

FedEx has committed more than $1.5 million (U.S.) in humanitarian aid to support those impacted by the conflict in Ukraine, including $1 million that has been allocated for in-kind shipping with the company’s longstanding nonprofit partners.

The post 76 Tons of Donated Medicines, Supplies for Ukraine Arrive in Poland Via FedEx Charter appeared first on Direct Relief.

Shakiness, insomnia, nausea, vomiting, and anxiety are all common, said Menendez, who is the chief medical officer at Family Health Services. Without medical attention, death is “always a risk” when a patient with substance use disorder enters incarceration, he said.

In addition, the health center provides treatment to patients who have recently left jail, offering them a combination of medication and mental health services to treat substance use disorders. “Because of our presence in the community, most of the people in jail are our patients anyway,” Menendez explained.

Treating substance use disorders is part and parcel of Family Health Services’ work. In 2020, Direct Relief awarded the health center a $50,000 AmerisourceBergen Innovation Award in Community Health, designed to address the opioid crisis in underserved communities. Within the first six months of funding, Family Health Services reached more than 10,000 patients through their substance use disorder program.

But not long ago, they became aware of an additional need. “The sheriff started telling us too that the county jail is one of the biggest detox units in the area,” recalled Dr. Anna Hatic, who oversees the medication-assisted treatment program at Family Health Services. “If we could find ways to offer better treatment and options…[we could] really help people to live their best lives.”

Working closely with the Darke County Sheriff’s Department and local providers of medication-assisted treatment and medication for opioid use disorder, Family Health Services has begun offering precisely that.

When people are booked into a local jail, they’re screened for drug and alcohol use. Medical staff evaluate whether medication-assisted treatment is an appropriate option; if so, it’s offered to each person who qualifies.

If a prospective patient is amenable, they’ll receive telehealth care from a Family Health Services doctor, and any accompanying medications will be given by a jail nurse who’s been trained in the protocols.

Because patients are in a controlled setting, Hatic explained that a doctor might be more likely to choose vivitrol, a time-release, injectable form of naltrexone that’s one of three medications approved by the FDA for opioid use disorder. “In a jail-type setting, if they’re detoxified,” it’s a good option, she explained. “The health provider controls it a little more.”

Hatic said that a jail setting may be the first time a substance use disorder is identified. “If somebody’s actively using opiates without a prescription, they tend to try not to seek medical care,” she said. “I think they don’t want to be identified.”

Asked what’s unique about treating patients in a jail setting, Menendez said it’s quite similar to offering medication-assisted treatment through telehealth more generally, which the health center began doing in earnest once Covid-19 hit.

Treating a patient for substance use disorder is similar to treating other mental health issues such as depression and anxiety, Menendez said. “Although they probably have depression and anxiety along with their substance use,” he added.

About 60 patients have been screened thus far, and Family Health Services doctors have already noticed some challenges.

“You can understand that a lot of people are distrustful of the system, and they’re not really sure if it’s for their well-being that they’re being asked these questions,” Hatic explained. Complicating matters is the fact that a nurse isn’t always available to screen patients, which means that a correctional officer will conduct a screening instead.

In addition, she said, the variable length of a patient’s stay can present complications. If a doctor has an intervention planned, but the patient posts bail, “they lose the opportunity with very little notice.”

That’s part of why, for Hatic and Menendez, it’s important that treating patients in a jail setting is the beginning of a relationship rather than a one-time event.

On release, patients are given the opportunity to watch an informational video about naloxone, a lifesaving drug that can instantly reverse an opioid overdose, and to receive their own doses of naloxone to carry with them.

In addition, patients have the opportunity to continue receiving care from Family Health Services.

Menendez explained that an advantage of the program is that “we can begin some interactions while they’re still incarcerated,” and continue treatment once a patient is released.

“It is important for us to make contact and for patients to know…‘Once you come back to the community, we have resources here to continue to help you,” Hatic said.

The post For Incarcerated Patients Battling Addiction, A New Program Offers Treatment appeared first on Direct Relief.

In the year since, Direct Relief has emerged as one of the largest charitable providers of personal protective gear (PPE) and critical care medications globally, having delivered more than 82 million units of PPE, 173 million defined daily doses of vital medicines, and 36 thousand pieces of diagnostic and intensive care equipment to thousands of local organizations across 100 countries, including the U.S.

The organization has also supported health care providers with more than $50 million in direct financial assistance to sustain care and expand services that include mobile and pop-up testing sites, telehealth expansion, and greater cold chain capacity.

For an overview of Direct Relief’s activities in response to the Covid-19 pandemic, please continue reading.

Financial Summary

Covid-19 Pandemic Donations

Jan. 27, 2020 – Jan. 27, 2021

Direct Relief does not accept government funding. Its work is made possible entirely through the support of companies, organizations, foundations, and individuals.

The organization recognizes that supporters who made generous contributions of funding, services, and in-kind goods amid the pandemic did so with the specific intent that their contributions fight Covid-19 and its devastating consequences. In accepting funds as part of its Covid-19 response, Direct Relief understands that these supporters deserve to know precisely how those funds have been and will be disbursed.

Direct Relief received more than 151,000 financial contributions designated for Covid-19, totaling $125.8 million.

Some of these Covid-19-designated donations also had additional restrictions from donors requiring the funds be used for a particular region or country. All designated funds have been respected, administered, and disbursed accordingly.

How Were Funds Used

Direct Relief initiated its Covid-19 response activities using general operating funds. As Direct Relief began receiving funds donated for Covid-19, it expanded its activities and spending accordingly. The situation remains dynamic, with designated funds continuing to be accepted. Direct Relief takes great care to deploy incoming funds responsibly, efficiently, and as rapidly as possible, consistent with donors’ intent.

The following offers a snapshot of the total Covid-19 donations received over the past year:

To date, Direct Relief has spent or committed a total of $83.5 million in cash (66% of the $125.8 million received) in its pandemic response — which continues at high-pace.

Of that amount, $40.8 million has been spent or committed as direct grants to organizations on the frontlines of the pandemic, $35.6 million has been spent on purchasing essential medical items not available through donation, and $7.1 million was spent to distribute all material and financial assistance provided in response to Covid-19, as described below.

Covid-19 Response

By the numbers

Jan. 27, 2020 – Jan. 27, 2021

Grant Making

Medical Aid

Protective Gear

Medical Material Support

Direct Relief has been responding to the pandemic since its earliest days, beginning with requests for help from overstretched hospitals in Wuhan, China. From there, Direct Relief’s response quickly expanded to the United States and the rest of the world.

Since Jan. 2020, the organization has provided support to more than 3,000 partner organizations fighting Covid-19 worldwide.

As of Jan. 27, 2021, that support has included more than 29,000 medical aid shipments totaling 4.9 million pounds and valued at $1.3 billion. Medical aid has reached organizations in 55 U.S. states and territories and 100 countries.

Material support has taken several distinct forms:

• Supplies to protect frontline health workers: Direct Relief provided masks, gloves, gowns, powered air-purifying respirators, face shields, and other PPE to health care organizations globally.
• Medical resources for intensive care: As the pandemic strained hospital resources, the organization provided ventilators, oxygen concentrators, and ICU medications to help overstretched hospitals treat patients with critical cases of Covid-19.
• Ongoing support for chronic health: To minimize interruptions to essential health services, including primary and specialty care, maternal and child health services, mental health treatment, and substance use disorder interventions, Direct Relief provided a wide range of support — chronic health medications, the overdose-reversing medication naloxone, midwife kits, and more.

Direct Relief arranged for and managed the logistics, transport, and delivery of all products to health facilities – free-of-charge.

Direct Financial Assistance

Throughout the Covid-19 pandemic, designated contributions have allowed Direct Relief to bolster the health care system with financial assistance and support the efforts of locally run organizations with strong ties to their communities.

Thanks to corporate and individual donors’ generosity, Direct Relief has granted more than $53 million in cash worldwide since Jan. 27, 2020.

Grant recipients include health centers, clinics, and locally run organizations providing vital care, testing, and other health care services during the pandemic. These grants helped sustain strained health facilities, keep patients out of hospitals, maintain continuity of care, and fund Covid-19 testing and vaccinations.

For a list of health care facilities and organizations worldwide that have received direct funding from Direct Relief in response to the Covid-19 pandemic, click here.

Covid-19 Response

By Region

United States

• Grants Disbursed: $48.6 million
• Material Aid Provided: $284.3 million
  • Shipments: 28.8 thousand
  • PPE: 21.3 million units
  • Medications: 48.6 million Defined Daily Doses
  • ICU Kits: 178
  • Ventilators & oxygen concentrators: 1,046

Americas

• Grants Disbursed: $405 thousand
• Material Aid Provided: $341 million
  • Shipments: 260
  • PPE: 8.2 million units
  • Medications: 61.1 million Defined Daily Doses
  • ICU Kits: 84
  • Ventilators & oxygen concentrators: 1,497 units

Asia

• Grants Disbursed: $1.3 million
• Material Aid Provided: $169.6 million
  • Shipments: 234
  • PPE: 4.1 million units
  • Medications: 15.6 million defined daily doses
  • ICU Kits: 58
  • Ventilators & oxygen concentrators: 420 units

Africa

• Grants Disbursed: $1.26 million
• Material Aid Provided: $489 million
  • Shipments: 234
  • PPE: 42.4 million units
  • Medications: 27.9 million defined daily doses
  • ICU kits: 73
  • Ventilators & oxygen concentrators: 326

Europe

• Grants Disbursed: $503 thousand
• Material Aid Provided: $33.1 million
  • Shipments: 50
  • PPE: 1.4 million units
  • Medications: 1.5 million defined daily doses
  • ICU kits: 4
  • Ventilators & oxygen concentrators: 524

Applied Research and Analytics

Even before the pandemic, Direct Relief had facilitated emergency managers’ use of population movement and other data for decision-making purposes, including in Texas, California, and Michigan.

When Covid-19 hit, it was immediately apparent that this kind of data would be an essential tool for analyzing social distancing effectiveness.

In March of 2020, Direct Relief, with researchers at the Harvard School of Public Health, established the Covid-19 Mobility Data Network. The network, comprised of a group of about 70 infectious disease epidemiologists and other researchers, began creating simple, usable data projects to help public health officials and policymakers understand the impacts of social distancing measures in a given area.

Officials have used the group’s research and information tools in the UK, Spain, Italy, India, Australia, Botswana, Chile, and other countries. The data used for these analyses is hosted on the UN’s Humanitarian Data Exchange, allowing governments worldwide to receive support or analyze the data themselves.

While the Covid-19 Mobility Data Network was convened because of an emergency, Direct Relief and the researchers wanted to ensure that similar data would be readily available in a clear and actionable form and on an ongoing basis for future crises, including wildfires and hurricanes.

CrisisReady, working with the World Bank, is in the initial stages of creating a global emergency response network, which will launch in March-April of 2021.

In addition, Direct Relief is funding two researchers whose essential work combines population movement data and health crisis analysis: Pamela Martinez at the University of Illinois and Amy Wesolowski at Johns Hopkins University.

Among the resources developed by Direct Relief to inform and track its pandemic response are the following:

• The Covid-19 International Vulnerability Index examines population movement data and information about case counts, hospital beds, and other vulnerability indicators to generate actionable information and analysis.
• The United States forecast map draws on anonymized data to predict the spread of Covid-19.
• The United States pandemic response tracker shows Direct Relief’s distribution of medical aid across the country.
• The international pandemic response tracker shows the organization’s global distribution.

Looking forward

The remaining funds designated for the pandemic will enable Direct Relief to continue its worldwide response, focusing on:

1. Supporting vaccination efforts

• Expanding cold-chain storage and transport at hospitals and health centers and providing coolers for mobile vaccination campaigns.
• Providing needles and syringes to administer vaccines.
• Supplying PPE to health workers giving vaccinations.
• Funding education, awareness, and outreach campaigns at health centers and hospitals, particularly in poor communities and communities of color.
• Employing digital tools and artificial intelligence to determine low vaccine uptake areas and provide that information to policymakers and public health officials.
• Funding health centers that experience reimbursement gaps after administering vaccines.
• Increasing Direct Relief’s internal capabilities to receive, store, and distribute the vaccine.
• Supporting the opening of large-scale vaccination sites with funding and supplies.
• Providing back-up power sources to health care sites at risk of power loss, which can destroy vaccines.

2. Addressing Covid-19 gaps in hardest-hit areas

• Funding health initiatives in primarily minority communities hit disproportionately hard by the pandemic.
• Providing grants to health care providers in the United States and around the world struggling to care for patients affected by Covid-19.
• Continuing to provide critical care medications, oxygen concentrators, and ventilators to hospitals worldwide caring for Covid-19 patients.
• Supplying PPE to providers unable to access these lifesaving supplies reliably.
• Establishing and funding Covid-19 treatment and isolation wards ensures that low-resource areas have the resources to care for Covid-19 patients safely.
• Providing health care support for Covid-19 patients to recover at home, freeing hospital beds for more critical cases.

3. Continuing support for people with other health care needs:

• While global health resources are diverted towards preventing and treating Covid-19, fundamental health care needs continue.
• Babies continue to be born. The number of people with chronic conditions like diabetes and cancer is only growing. And children with diabetes, hemophilia, and rare diseases still need lifesaving therapies.
• As the pandemic continues, Direct Relief will continue to provide the essential medical aid required for their care.

Thank You

Direct Relief’s extensive ability to provide a wide range of medical aid, from PPE to medications intended for critical cases of Covid-19, would not have been possible without in-kind and financial donations from dozens of pharmaceutical and medical supply companies, with air transport and logistical services provided by FedEx.

Many of these organizations work closely with Direct Relief on an ongoing basis to fund and supply humanitarian projects and programs. However, the outpouring of support from corporate partners, both new and ongoing, has been unprecedented during the Covid-19 pandemic. Direct Relief is deeply grateful for their generosity and commitment.

Included among them are:

The post Covid-19 Relief: One-Year Report on Use of Funds and Response Activity appeared first on Direct Relief.

But with pregnant women, providers can be hesitant to administer opiate-based drugs.

According to a study out of Vanderbilt University, pregnant women are 20% more likely to be denied medication assisted therapy than non-pregnant women.

“In the beginning, I was so scared as a new provider to write my first prescription for medication assisted therapy to pregnant women,” said Dr. Linda Thomas-Hemak of the Wright Center for Community Health in Scranton, Pennsylvania.

The health center serves low-income individuals who are underinsured or lack insurance altogether, many of whom struggle with opioid misuse.

“Pennsylvania was hit particularly hard by the opiate epidemic that really has plagued, terrified and challenged America,” said Hemak, who is a board certified addiction medication specialist.

On this episode of the podcast, we speak with Dr. Hemak about whether medication assisted therapy is safe for new and expectant mothers and how the Wright Center is helping women overcome opioid dependency during pregnancy.

Direct Relief granted $50,000 to The Wright Center for its extraordinary work to address the opioid crisis. The grant from Direct Relief is part of a larger initiative, funded by the AmerisourceBergen Foundation, to advance innovative approaches that address prevention, education, and treatment of opioid addiction in rural communities across the U.S. 

In addition to grant funding, Direct Relief is providing naloxone and related supplies. Since 2017, Direct Relief has distributed more than 1 million doses of Pfizer-donated naloxone and BD-donated needles and syringes to health centers, free and charitable clinics, and other treatment organizations.

Transcript:

When it comes to getting treatment for an opioid use disorder, pregnant women have an uphill battle.

Most patients undergoing opioid treatment are prescribed safer opioids that reduce dependency while limiting the risk of overdose and withdrawal.

This kind of treatment is called medication assisted therapy, or MAT.

But with pregnant women, providers can be hesitant to administer opioids.

According to a study out of Vanderbilt University, pregnant women are 20% less likely than non-pregnant women to be accepted for medication assisted therapy.

“In the beginning, I was so scared as a new provider to write my first prescription for medication assisted therapy to pregnant women,” said Dr. Linda Thomas-Hemak.

Hemak is a board-certified addiction medication specialist and CEO of the Wright Center in Scranton, Pennsylvania.

“Pennsylvania was hit particularly hard by the opiate epidemic that really has plagued, terrified and challenged America,” said Hemak who has been practicing in the state for several years.

In 2016, the health center launched a comprehensive opioid treatment program to address the growing crisis in their community. They quickly realized a number of patients were pregnant—and had specific needs, from prenatal care to job support. And so, a new program was born.

“The Healthy MOMS program is based on assisting mothers who are expecting babies or have recently had a child, up until the age of two,” explained Maria Kolcharno — the Wright Center’s director of addiction services and founder of the Healthy MOMS program.

“We have 144 moms, through the end of August, that we have served in the Healthy MOMS program and actively, we have enrolled 72.”

The program provides new and expectant moms with behavioral health services, housing assistance, educational support; providers have even been delivering groceries to moms’ homes during the pandemic.

But the crux of the program is medication assisted therapy.

Moms in the program are prescribed an opioid called buprenorphine—unlike heroin or oxycodone, the drug has a ceiling effect. If someone takes too much, it won’t suppress their breathing and cause an overdose.

Nonetheless, it’s chemically similar to heroin, which may raise eyebrows. But while some substances, like alcohol have been shown to harm a developing fetus, buprenorphine isn’t one of them.

“Clearly there are medications, like alcohol, that are teratogenic. And there’s medications like benzodiazepines that have strong evidence that they are probably teratogenic. When you look at the opioids that are used and even heroin, there is no teratogenic impacts of opiates on the developing fetus,” Dr. Hemak explained.

So, opioids like buprenorphine can be safe for pregnant women. What’s not safe is withdrawal.

If someone is abusing heroin, overdose is likely. In order to revive them, a reversal drug called Naloxone is used, which immediately sends the person into withdrawal.

But when a woman is pregnant and goes into withdrawal, it can cause distress to her baby, lead to premature birth, and even cause a miscarriage.

Which is also why these women can’t just stop taking opioids.

“Stopping cold a longstanding use of an opiate because you’re pregnant is a very bad idea and it is much safer for the baby and the moms to be transitioned from active opiate use to buprenorphine when pregnant,” explained Hemak.

Because buprenorphine has a ceiling effect and is released over a longer period of time, women are less likely to overdose on the drug.

Regardless, there’s still a risk their baby goes through withdrawal once they’re born. For newborns, withdrawal is called neonatal abstinence syndrome or NAS.

Babies may experience seizures, tremors, and trouble breastfeeding. Symptoms usually subside within a few weeks after birth.

Fortunately, the syndrome has been shown to be less severe in babies born from moms taking buprenorphine versus those using heroin or oxycodone.

That’s according to Kolcharno who has been comparing outcomes between her patients and those dependent on opioids, but not using medication assisted therapy.

“Babies born in the Healthy MOMS program, we’re finding, that are released from the hospital, have a better Apgar and Finnegan score, which is the measurement tool for NAS and correlates all the withdrawal symptoms to identify where this baby’s at,” said Kolcharno.

But NAS is not the only concern women have post-partum.

During and after delivery, doctors often prescribe women pain killers. For those with an opioid dependency, these drugs can trigger a relapse.

Dr. Thomas-Hemak says preventing this kind of scenario requires communication.

The Wright Center works with their local hospital to ensure OBGYNs are aware of patient’s substance use history.

“We want the doctor to know that this may be somebody that you’re really sensitive to when you’re offering postpartum pain management,” said Hemak.

That way, doctors know to tailor patients’ post-partum medication regimens. Instead of prescribing an opiate-based pain killer they can offer alternatives, like Ibuprofen or Advil.

Maintaining an open line of communication between addiction services and hospital providers also helps to reduce stigma.

Women with substance use disorders have long been subject to discriminatory practices by both providers and policy makers.

From denying them treatment to encouraging sterilization post-delivery, women struggling with opioid dependency can be hard-pressed to find patient-centered health care.

But Dr. Thomas-Hemak says, she’s learned to set her opinions aside.

“I think one of the magical transformations that happens when you do addiction medicine really well is, it’s never about telling patients what to do.”

It’s about allowing them to make informed choices, she says, and understanding it’s not always the choice you think is best.

This transcript has been edited for clarity and concision.

The post For Pregnant Women, Stigma Complicates Opioid Misuse Treatment appeared first on Direct Relief.