Planning for 2036 while budgeting for 2027
What Ukraine’s pharmaceutical sector is teaching European health systems about foresight
An article by Kateryna Ostrovska (author) and Anna Gallant (co-author)
WHO has recorded 3,257 attacks on healthcare in Ukraine since the start of the full-scale invasion, including four direct strikes on pharmaceutical warehouses in recent weeks, with 246 people killed and 1,079 patients and medical staff injured. Most sectors operating under those conditions would contract. Ukraine’s pharmaceutical industry is doing something harder: aligning its regulatory and institutional environment with European standards while planning for growth.
That tension was the backdrop to FARMBUDGET 2027, held in Kyiv on 8 September, where more than 200 pharmaceutical and health professionals gathered around a theme the organisers chose deliberately — productivity as a growth strategy. Every speaker converged on the same observation: they are budgeting for 2027 in conditions where key indicators can move several times within a single year.
From a staffing problem to a structural one
Kateryna Ostrovska used her contribution to take on workforce shortage, arguing that it has stopped being an HR issue and become a direct constraint on growth — one companies must navigate while simultaneously absorbing geopolitical, demographic, economic, technological and regulatory change. Her framing was a PESTLE scan with an ethical dimension layered on top, feeding into scenario planning rather than a single projection.
The decisive move was a change of question. Not “where do we find people?” but “what should the organisation become if people are structurally in short supply?” The old equation of more business requiring more people, she argued, is losing its footing. Her conclusion was blunt: “Growth without proportional headcount growth is no longer the exception. It’s the strategy.”
The same argument at a longer range
Six days later, Ostrovska published “The Future of Pharmaceuticals: Strategic Foresight in an Era of Uncertainty” in the Journal of Pharmaceutical Policy and Practice,[^1] which makes the same case at a different altitude. Drawing on the Rumsfeld Matrix, the menagerie of postnormal potentialities and the PESTEL framework, it maps the drivers shaping therapeutics and pharmaceutical policy through 2036 — and, more usefully, distinguishes between kinds of uncertainty: developments that are visible but insufficiently addressed, uncertainties that are foreseeable yet inadequately acknowledged, effects that emerge only from the interaction of otherwise recognisable drivers, and genuinely unforeseeable high-impact events.
Workforce shortage sits squarely in the first category. It is entirely visible. It is simply not being treated as the structural condition it is.
The apparent mismatch between a 2036 horizon and a 2027 budget cycle is not a mismatch at all. Short-horizon volatility is the argument for long-horizon scanning, not against it: weak signals harden into trends and eventually into megatrends, and the only way to catch that is to track drivers continuously rather than episodically.
Capacity, not technique
The sharpest warning in Ostrovska’s editorial article concerns adoption of technologies that might help cover the workforce deficit. Deloitte data shows only 20% of life sciences executives report full AI deployment across their organisation,[^2] just 11% have a predictive, data-driven R&D lab environment,[^3] and fewer than 10% report meaningful return on AI investment.[^2] Having AI, as she put it, is not the same as being AI-mature.
The same gap applies to foresight. Most health organisations have run a horizon-scanning exercise; very few have made it standing management practice. The constraint on anticipatory health policy in Europe is not analytical technique — the frameworks are mature and freely available. It is absorptive capacity: whether institutions are built to act on what scanning tells them.
Ukraine is not an exceptional case with lessons for nobody else. It is an accelerated version of pressures European health systems already face. If a country facing this level of uncertainty and war-related risks is learning to make scenario planning standard practice in its pharmaceutical sector, Europe may want to take note.
Notes
[^1]: Ostrovska, K. (2026). The Future of Pharmaceuticals: Strategic Foresight in an Era of Uncertainty. Journal of Pharmaceutical Policy and Practice. https://doi.org/10.1080/20523211.2026.2724624
[^2]: Lyons, P., Konersmann, T., Jacobson, S., Kleyn, N., Rekhraj, K., & Gosalia, D. (2025). 2026 life sciences outlook. Deloitte Center for Health Solutions. https://www.deloitte.com/cn/en/Industries/life-sciences-health-care/perspectives/2026-life-sciences-executive-outlook.html
[^3]: Morgan, J., Sharma, R., Bolt, A., Srinivasan, S., Miranda, W., & Jobanputra, D. (2025, 29 July). Pharma’s R&D lab of the future: Building a long-lasting innovation engine. Deloitte Center for Health Solutions. https://www.deloitte.com/us/en/insights/industry/health-care/future-proofing-pharma-rnd-labs.html