A "frozen conflict" is not yet a reality, but the medical and life science systems of Ukraine and Russia have been permanently reshaped by the war.
Currently (late October 2026), the Russia-Ukraine conflict is in a phase characterized by "negotiation signals and ongoing mutual attacks." Ukrainian President Zelensky has signaled readiness to discuss a peace agreement based on "freezing the status quo" and maintaining at least 75% of the territory. Russia stated it was ready to resume trilateral talks in mid-November, centered on the "creation of a post-conflict security system." However, a formal political "frozen conflict" solution has not yet been signed, and fighting continues. Against this backdrop, the medical, life science, and scientific research systems of both countries have undergone profound and largely irreversible structural changes as a result of over four years of full-scale war.
Ukraine: Systemic Damage and Forced "Decentralization" Transformation
Ukraine's medical and scientific research infrastructure has suffered severe blows from the war, but the system's resilience is evident in extreme adaptations.
Clinical Research: From Mass Failures to Forced Decentralization. Before the war, Ukraine was a major destination for international clinical trials due to experienced researchers and efficient patient recruitment. A study focused on the Sumy region shows that of the 12 active clinical trial protocols for rheumatology before the war, only 2 were still operational in 2022-2023, and research staff was reduced from 10 to 4 people (a 60% decrease). Several studies had to halt recruitment due to safety concerns, and at least 5 participants had to be transferred to other research centers to maintain treatment. In response to the crisis, some Ukrainian centers have begun adopting telemedicine, decentralized monitoring, and other remote models to ensure continuity of follow-up. This war-induced "decentralization" could have a lasting impact on the design of clinical trials in the region long-term.
Oncology and Public Health: Long-term Burden. Ukrainian oncology research and care have been significantly impacted, with diagnostic delays, treatment interruptions, and damage to oncological facilities. Concurrently, unverified data from 2022 (gas gangrene infection, previously thought nearly eradicated before the war) suggest that front-line conditions favor the spread of anaerobic infections, further straining treatment capacity for rare infectious diseases. In 2022, pharmaceutical sales volume in Ukraine (by packs) decreased by 22%, and although it slightly increased by 4% in 2023, it remained at an all-time low, with a significant portion attributed to population loss (6.8 million refugees). The pharmaceutical market recovered in 2023 in local currency, but due to the hryvnia's devaluation, the volume in euros remained at 2020 levels, representing a three-year setback.
Capital and Talent Outflow. Ukrainian biotech company Biopharma is reportedly planning to build a production facility in Arad, Romania, with an investment of €85 million, scheduled for completion by the end of 2027. Although this information originates from Russian security circles, casting doubt on the accuracy of the perspective, it reflects the risk of capital and talent outflow from Ukraine in the biotech sector.
Russia: Decoupling from the Global Innovation Chain and Return to a Generic Economy
Russian medical and scientific research capacity has significantly shifted towards 'autarky' and 'downsizing' under sanctions.
Collapse of International Clinical Research. The data are unequivocal: in 2024, the Russian Ministry of Health approved 629 clinical trials (761 in 2023), with international multicenter trials collapsing from 367 in 2021 to just 23 in 2024. As early as March 2023, the number of clinical trials sponsored by foreign companies in Russia dropped to 7 (compared to 32 from September 2022 to February 2023 and 102 from March to August 2022). The withdrawal of major pharmaceutical companies has not only hindered trial execution but also significantly impacted the ability of Russian medical science to participate in cutting-edge global research data and international collaboration.
Structural dependence on imports. Although the Russian government is promoting domestic production through "import substitution" policies and the Pharma-2030 program, the dependence on imported drugs and raw materials persists. In 2025, imported drugs accounted for 49.8% of the Russian pharmaceutical market, and more than half of the drugs sold in the country are domestic products, but 80% of them depend on imported raw materials. For medical devices, imported equipment accounted for 75% in 2021, and due to sanctions, original spare parts are missing, while Chinese alternatives cannot be used for certain devices (e.g., those with original reagent recognition protection). In November 2023, the Russian Ministry of Health publicly acknowledged shortages of certain antibiotics, cancer drugs, insulin, and medical equipment.
Narrowing of innovation capacity. Russian clinical research activity is increasingly focused on generics and bioequivalence studies, while exposure to the global innovation chain is decreasing due to the reduction of multinational studies. Although domestic projects promoted by the Federal Medical-Biological Agency (FMBA) of Russia (such as the recombinant protein vaccine "Convasel" and allergic combination vaccines) show efforts towards self-sufficiency, international competitiveness and attractiveness for global talent remain significantly weakened.
Conclusion: Regardless of whether a formal "frozen conflict" agreement is signed in the future, the decoupling of the medical and scientific research systems of both countries caused by the war has occurred. Ukraine faces the challenge of retaining its research personnel and rebuilding infrastructure, and its clinical research capacity has been significantly weakened; Russia has been marginalized from the global innovation chain, and its scientific and technological development depends heavily on the performance of domestic generics production and the "friendly" supply chain. The long-term impact of these changes on public health and scientific competitiveness in the region will extend far beyond the timeframe of a political resolution to the conflict.
