Ukraine continues to reform its military medical commissions (MMCs) to speed up the procedure for making decisions on the fitness of persons liable for military service. As part of this process, the timeframe for passing the MMC has been reduced to 2-3 days. However, as the analytical report of the Media Initiative for Human Rights shows, this speed results in risks: people with serious illnesses are sent to the frontline, which poses a threat not only to them, but also to their comrades-in-arms, combat missions and Ukraine’s defence capability.
Accelerated reform of the MMC: goals and consequences
The three-stage reform, launched by the Ministry of Health jointly with the Ministry of Defence, involves the introduction of electronic document management, new forms of accounting and a reduction in decision-making time to a few days. On paper, this was supposed to relieve the system, eliminate queues and speed up mobilisation. In reality, however, the procedure is often limited to a formal review of documents without a proper clinical examination, consultations with narrow specialists or medical history.
In many cases, medical examinations are carried out in the absence of key examinations, and some persons liable for military service undergo a MMC without meeting with a doctor. All this creates a large risk zone: even those with HIV, tuberculosis, hepatitis, psychiatric diagnoses or who are on substitution maintenance therapy (SMT) are considered fit.
Read also: Verkhovna Rada considers reforming the MSEC: experts express reservations
Invisible commissions and non-transparent statistics
Freelance military registration and enlistment commissions are massively created on the basis of civilian hospitals, where they are not directly subordinated to the military command. From 729 in 2022, the number of such commissions increased to 1041 in 2025. But even this extensive network does not guarantee quality. As noted by the MIHR, the Ministry of Health does not keep centralised statistics on the number of decisions issued, the structure of diagnoses or the frequency of declaring a person unfit.
The absence of unified reporting, audits or inspections of freelance MMCs makes it impossible to assess whether medical opinions are made objectively and with high quality. This situation creates “blind spots” in which – without external control – it is easy to hide abuses, mistakes or indifference.
See also: Sexual abuse on the Internet. How children in Ukraine face risks online
People with serious diagnoses on the front line
Practice shows that expedited decisions by the MMC lead to cases where people with serious psychiatric or neurological disorders end up in combat units. Kateryna Tsymbolynets, a former combat medic, recalls a man with multiple personality disorder who was found fit, although his behaviour posed a threat to his comrades in the first days at the front. He had to be evacuated and hospitalised, and only after several interventions by doctors and commanders did the MMC reconsider its decision.
Another case involved a fighter with moderate mental retardation who could not understand orders and had no independent writing skills. He was also declared fit and only after several weeks of psychological distress was he removed from combat missions.
Read also: Report on the state of civil society in Ukraine for 2023 published
Costs that do not even cover the tests
According to experts, the funding of the MMCs is inadequate for the task they are entrusted with. In 2024, the cost of one commission was approximately UAH 68, and in 2025 – UAH 197. These funds are not enough even for basic laboratory tests, let alone consultations with specialised experts.
This not only creates a low quality of expertise, but also leads to serious financial losses for the state. When a person with an undiagnosed disorder is sent to the frontline, he or she quickly becomes incapacitated, requires hospitalisation, evacuation, and rehabilitation – all at the expense of the Armed Forces budget.
Lack of control and appeal mechanisms
Another serious problem is the complete absence of an electronic or expedited mechanism for appealing against the decision of the MMC. A person who considers himself or herself unfit for service is forced to go to court, which takes time, lawyers, resources and does not guarantee a quick result. During this time, the soldier may already be on the front line.
What experts suggest
The MIPL report contains clear recommendations: to introduce a centralised system of accounting for the MMC, to establish standardised requirements for examinations, to create independent audit teams with the right to monitor, and to develop an electronic appeal mechanism for those who disagree with the commission’s conclusions. Particular attention should be paid to categories of people with HIV, SMT, and psychiatric diagnoses, who often do not receive adequate attention.
Read also: How to establish disability in 2025
