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Ukraine has long had one of the highest HIV infection rates in Europe, with a prevalence as high as 1% in the mid-2000s, according to the Joint United Nations Programme on HIV/AIDS. But before the war with Russia began in 2014, the country looked like it was turning a corner. In 2012, rates of new infection declined for the first time, from more than 17,300 new cases in 2011 to 16,847 a year later. Overall, prevalence was pegged at 0.8%. This progress was likely a result of investments in antiretroviral treatment and, unlike in Russia, the use of opioid substitution therapy for intravenous drug users.

[Kevin Pottie] emphasises the importance of not retraumatizing Syrian refugees or forcing them to deal with the trauma before they are ready. \"We actually recommend not screening for trauma,\" he says. \"You take someone who has been struggling to survive, and then by screening them you can take them back into a really bad context.\" Meeting the health needs of thousands of Syrian refugees will not be easy, [Meb Rashid] admits. \"It's really the scope of this. If we're looking at tens of thousands of people, we haven't seen those types of numbers before.\" As well, he and other doctors are concerned that the current lack of full health coverage for privately sponsored refugees under the Interim Federal Health Program will make it difficult to meet Syrian refugees' health needs. Despite this, Rashid and his colleagues across the country, from Toronto to Vancouver to Halifax - where a new clinic for refugees has just opened - say they are ready for the challenge. \"We're starting to ramp things up,\" says Rashid. \"There's tremendous goodwill among all Canadians, and certainly within the health care community, to make sure these people get the health care they need.\" - Michael Colborne, Edmonton, Alta.

Two years after reforms started to curb corruption in the country's national drug procurement process, Ukraine's old guard is still pushing back -- and still holds court at the regional level. In 2015, Ukraine's Ministry of Health started a four-year program to outsource drug procurement to international organizations, including UNICEF and the United Nations Development Program. The goal was to root out longstanding corruption in the country's drug procurement process, wherein politicians, ministry bureaucrats and pharmaceutical distributors worked together to inflate prices. Thanks to the reforms this is no longer the case at the national level. In the first year with international organizations looking after drug procurement, the ministry saved the equivalent of almost $40 million.

\"I am not prepared to look back at my time here in this parliament doing this job, and say to my children's generation, 'I'm sorry, we knew there was a problem with sugary drinks, we knew it caused disease, but we ducked the difficult decisions and we did nothing',\" [George Osborne] told the British House of Commons in his yearly budget speech. \"We're obviously really happy about [the tax],\" said Jennifer Rosborough, a nutritionist and campaign manager at Action on Sugar, a charity concerned with sugar's effect on health. She notes that the two-year window before the tax is introduced will give manufacturers time to adjust and reduce the sugar content in their beverages, a move that will help Britons reduce their sugar intake.

Wages for doctors in Ukraine have been low since before the 2014 Euromaidan Revolution, a series of violent events culminating in the ousting of the president. According to the European Observatory's report, in 2013 the average monthly wage for a doctor in Ukraine was just over $400 a month, well behind that of professionals in many sectors of Ukraine's economy. Out-of-pocket payments have been a regular feature of Ukraine's health care system since the 1990s following the collapse of the Soviet Union, according to the European Observatory's report. During the subsequent severe economic downturn, doctors began levying informal payments to provide themselves with a more acceptable wage. Chronic government underfunding - including a 5% cut to health spending in 2016 - has contributed to these payments becoming an entrenched feature of the Ukraine's health system. \"The problem is that people [in Ukraine] don't get value for money.\" [Richard Styles] estimates that a substantial portion of Kyiv's three million people is overtreated and prescribed drugs or forced to pay for services they do not need. \"It's rather strange in a health care budget that's got its back to the wall.\"

For Dr. Ilmi Umerov, the Soviet-era practice of punitive psychiatry is alive and well. The former deputy chairman of the indigenous Crimean Tatars' self-governing body in Crimea, publicly spoke out against Moscow's annexation of the peninsula from Ukraine in 2014. Shortly after, Russian authorities charged Umerov with \"separatism,\" and in August of this year forced him into a psychiatric hospital for a month of observation. He was released after three weeks thanks in part to international pressure - and with no mental health diagnosis to speak of. Dr.Yuri Savenko, the head of Russia's Independent Psychiatric Association, agrees. \"A significant change has occurred,\" he said in an interview from Moscow. \"Punitive psychiatry has ceased to be used on a massive scale, but now it is used in a more targeted way.\" He notes it is difficult to evaluate the extent of the use of punitive psychiatry. \"Most of the political and other high-profile cases are usually hidden,\" Savenko says. \"We only find out about them when we're approached by their lawyers.\"

For the Kremlin, harm reduction is off the table. A recent report from a Kremlin-backed research institute recommended a \"categorical refusal of \"harm reduction\" programs,\" arguing that harm reduction is inconsistent with the \"Russian model\" of fighting HIV. The report went so far as to blame condom use for Russia's HIV epidemic; one of its coauthors claimed that promoting condom use encourages people to have sex, and argued that the best form of protection against HIV was to \"be in a heterosexual family where both partners are loyal to each other.\" For Dr. Vadim Pokrovsky, the head of Russia's federal AIDS centre, the Kremlin's focus on the idea of \"risk elimination\" instead of harm reduction is a recipe for failure. \"By 'risk elimination' they mean a complete rejection of extramarital sex and drugs. But the experts who understand this know that people just can't give up extramarital sex, and that people dependent on drugs just can't stop using them.\"

Dr. Ruth Wilson, the taskforce cochair from the CFPC, says \"Financial incentives aren't a panacea,\" noting that physicians recruited to work in rural communities often leave when incentives end. Recruitment and retention are not the only issues. Many young rural physicians are highly knowledgeable and competent as physicians, says [John Soles], but \"what they lack is confidence.\" \"We need to recruit more students from rural backgrounds and indigenous backgrounds, even in high school,\" she says. \"Sometimes the people who would make excellent doctors aren't even encouraged to think about it.\"