Lobbying comes out of the shadows: how the new law may transform Ukrainian healthcare?

Ukraine is entering a new political and institutional phase. What until recently existed largely in the form of informal arrangements, personal connections, behind-the-scenes influence, and situational access to officials is now beginning to transform into a formalized and public mechanism.

The Law of Ukraine “On Lobbying” was adopted on February 23, 2024, and entered into force on September 1, 2025. The law defines the fundamental principles of lobbying, establishes a Transparency Register, introduces reporting requirements, and specifies that the subject of lobbying is normative legal acts, including their development, amendment, or repeal.

This is not merely a technical novelty or a narrow legal issue. It represents a shift in the very logic of interaction between the state, business, professional associations, civil society, and industry experts. The Verkhovna Rada and the National Agency on Corruption Prevention (NACP) describe this new approach as a transition to open, transparent, and controlled rules of influence on the legislative process, as well as a tool to reduce corruption risks and increase transparency in public decision-making.

The European Commission, in its 2024 report, also noted that Ukraine has created its first regulatory framework for lobbying, covering a wide range of influence methods while establishing clear ethical boundaries and a high level of transparency.

Following the launch of the law, the system has begun to fill with real practice. According to the NACP, as of November 13, 2025, 101 lobbying entities were already registered in the Transparency Register: 51 legal entities and 50 individuals, with a total of 191 lobbyists authorized to influence decision-making. By February 2026, the NACP announced the completion of the first reporting campaign and confirmed that lobbying activity reports are publicly available in the register. This indicates that the market has not only formally opened — it has begun to function procedurally.

For the healthcare sector, this development is particularly significant. Healthcare in Ukraine has long operated within a highly regulated environment, where laws, government resolutions, Ministry of Health orders, National Health Service rules, licensing requirements, ethical procedures, clinical research standards, procurement mechanisms, professional certification, pharmaceutical regulation, and international obligations all intersect.

Within such a system, influence over policy has always existed, but it has often been unevenly distributed. Traditionally, the strongest voices have belonged to large pharmaceutical companies, certain professional groups, influential officials, or ad hoc coalitions. Meanwhile, patient organizations, emerging clinics, research initiatives, mental health experts, and innovators in new therapies have had significantly fewer institutional opportunities.

Therefore, the legalization of lobbying in healthcare is not merely about introducing “another procedure,” but about redistributing access to the formation of the rules of the game.

Today, Ukrainian healthcare is entering a period of major transformation. In January 2025, the government approved the Healthcare System Development Strategy until 2030, along with an operational implementation plan for 2025–2027. In the same month, the Law “On the Mental Health System in Ukraine” was adopted and came into force on February 7, 2026.

In addition, in 2024, the Cabinet of Ministers approved an action plan for 2024–2026 to implement the Mental Health Development Concept until 2030.

Together, these documents demonstrate that the state is no longer merely declaring the importance of mental health, but is actively building a new institutional architecture — including new registries, certification systems, coordination bodies, standards, regional responsibilities, and a cross-sectoral model.

Notably, the new mental health law goes beyond framework declarations. It establishes the legal foundations of the system, defines the powers of the Ministry of Health and local authorities, provides for the creation of a National Mental Health Commission, and introduces principles for professional certification and scientific support of the system.

On February 18, 2026, the Cabinet of Ministers established this National Commission, and on March 4, 2026, it approved the procedure for certification and continuous professional development of mental health professionals.

This demonstrates not just the adoption of legislation, but an active phase of its implementation.

It is precisely at this moment that lobbying acquires a new meaning for the healthcare sector. It is no longer sufficient to be a good physician, clinic owner, or expert in international practices. The decisive factor becomes the ability to translate professional knowledge into regulatory solutions.

Success now depends on who can not only articulate a problem but also formulate a legal norm, propose a package of changes, define funding mechanisms, design certification models, create patient pathways, or shape requirements for government programs.

In the new system, success belongs not only to those with strong expertise, but to those who can institutionalize that expertise through laws, regulations, ministerial orders, National Health Service packages, or government programs.

This marks the true emergence of professional medical policy lobbying in Ukraine.

The greatest potential of the new lobbying framework lies in areas where the Ukrainian system has not yet fully established rules. These include mental health, veteran-oriented care pathways, rehabilitation, clinical research, medical cannabis, hospital governance, and new models for access to innovative therapies.

In these areas, there is already state movement, but no finalized model yet exists. This creates a window of opportunity for those who can combine science, practice, ethics, economics, and public policy communication.

This fundamentally changes the role of expert communities. Previously, advocacy in healthcare was often perceived as a secondary activity: writing appeals, organizing roundtables, supporting public discussions, or occasionally participating in working groups.

This is no longer sufficient.

In the new reality, the key factor is not just visibility, but evidence-based and procedurally competent participation in rule-making.

Those who can build professional coalitions, enter the Transparency Register, prepare white papers, propose draft amendments, demonstrate budget implications, outline implementation pathways, and ensure compliance with European integration commitments will have a significantly greater impact on public policy than those who rely solely on emotionally compelling but institutionally unstructured positions.

For Ukrainian healthcare, this is also an opportunity to move beyond reactive governance. The war has forced the healthcare system to act quickly, often in emergency mode.

The next phase, however, is a transition to structural and institutional solutions:

· not merely filling gaps, but building sustainable institutions

· not only supporting individual projects, but transforming access rules

· not just discussing the needs of veterans or individuals with PTSD, but embedding these needs into budgets, licensing requirements, National Health Service packages, educational standards, regional care pathways, and legislative frameworks

In this context, lobbying ceases to be perceived as something questionable and instead becomes a tool of a mature democracy and responsible healthcare policy.

This leads to a broader conclusion.

Ukraine is not simply implementing individual healthcare reforms — it is shaping a post-war healthcare system model.

This means that those who are actively involved in shaping the rules today will determine the structure and logic of the system for years to come.

In this context, medical lobbying is not about “serving private interests,” but about providing professional communities, patient groups, and evidence-based innovations with a legitimate pathway to influence public decision-making.

For this reason, the new lobbying law may prove to be not just a supporting reform, but one of the most important institutional transformations in Ukrainian healthcare over the coming decade.