The invisible enemy in Ukraine? Superbugs  

“Germ warfare” conjures up wretched images of biological agents being deliberately unleashed against people, often during war.  

“One of the first recorded uses of biological warfare occurred in 1347, when Mongol forces are reported to have catapulted plague-infested bodies over the wall into the Black Seaport of Caffa—now a part of Ukraine called Feodosiya in Crimea,” according to Brittanica. “Some historians believe that ships from the besieged city returned to Italy with the plague, starting the Black Death pandemic that swept through Europe over the next four years and killed some 25 million people, about one-third of the population.”  

Ironically, and unfortunately, Ukraine today is facing a different kind of germ outbreak — not believed to be intentional but nonetheless threatening its troops and civilians during the war with Russia and risking a spread to other parts of Europe. 

According to the Centers for Disease Control and Prevention (CDC), hospitals in Ukraine are now fighting an “alarming increase” in germs that appear to be resistant to antibiotics — warning that the drug-resistant germs are spreading beyond the country’s borders. 

The findings come from joint studies by the CDC and Ukraine’s health ministry on over 300 Ukrainian patients. “What they found,” states U.S. News and World Report, “about 60% of these patients were battling germs resistant to carbapenem antibiotics, which are considered the last resort in treating bacterial infections.” 

“In Ukraine, the confluence of high prewar rates of antimicrobial resistance, an increase in the prevalence of traumatic wounds and the war-related strain on health care facilities is leading to increased detection of multidrug-resistant organisms with spread into Europe,” the study authors wrote in the Dec. 8 issue of the CDC publication “Morbidity and Mortality Weekly Report.” 

Antimicrobials are medicines used to prevent and treat infectious diseases and include antibiotics, antivirals, antifungals and antiparasitics. Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites stop responding to the drugs, causing the infections to become difficult — or even impossible — to treat. 

AMR is considered one of the top global public health threats, according to the World Health Organization. Bacterial AMR causes more deaths around the world than HIV or malaria, according to several studies. 

Infectious disease is one of the hidden nightmares of war; an army of superbugs can wear down soldiers and civilians. 

For Ukraine, this silent germ resistance to antibiotics first showed up in 2016 when Russian forces invaded Crimea and the Donbas, and German doctors began to see infections in patients evacuated from Ukraine.  

By that year, studies were emerging on the threats for countries that could not fight infections with basic antibiotics. One British study warned in 2014 that “failing to fight antibiotic-resistant superbugs risks causing 10 million deaths annually and could cost the global economy up to $100 trillion by 2050.” 

Today, with its healthcare system deeply strained by the current war, Ukraine is battling bugs, bombs and growing worries about military and civilian aid being cut off by a U.S. Congress suffering from war fatigue.  

So, what can be done? 

The World Health Organization has been quietly trying to help Ukraine, recently sending bacteriological analyzers and new agents to hospitals and regional health centers including 1,200 sets of test kits to examine samples in hopes of strengthening the infectious disease control measure in Ukraine. 

To fight the growing threat, the latest CDC report calls for an increase in the number of health officials in Ukraine who have training and supplied to treat infected patients. 

Most importantly, we can ensure that NATO and the United States do not allow Ukraine to lose the war to Russia. There is no doubt that the battle has shifted in favor of Moscow, and this is not the time for the West to let down its guard.  

Ukrainians are literally sick and tired from nearly three years of fighting on behalf of all of Europe. They have shown incredible resistance and resilience. But a superbug only adds to the trauma and puts more pressure on a Ukrainian economy that suffered more than a 30 percent decline in 2022 as millions of talented Ukrainians left the country. 

Christmas is coming to Ukraine. In July of this year, Ukraine’s president, Volodymyr Zelenskyy, signed a law moving the official Christmas Day holiday to Dec. 25 from Jan. 7 (the day when the Russian Orthodox Church observes it), to further stress the importance of Ukraine being part of the West. 

Ukrainians deserve to be healthy and secure in a cold winter that could test its resolve against a patient Russian military. Like so many transnational threats today, diseases are hard to contain. 

Tara D. Sonenshine is the Edward R. Murrow Professor of Public Diplomacy at the Fletcher School of Law and Diplomacy at Tufts University.