Ukraine: AI advances healthcare in the midst of war

Illia looks at me in a friendly way as I ask him my first question in English: “What is the best way to protect myself from HIV?” His response is perhaps unsurprising, and includes things like the importance of using condoms, considering Pre-Exposure Prophylaxis (PrEP) if at higher risk, regular HIV testing and reminds me that prevention is better than cure. What is very different about Illia is that he is not real, but an online digital assistant.

He is one of the six TWIIN digital assistants developed by Alliance for Public Health providing answers to users’ health questions. They include a young woman called Sofia, a man called Mykhaylo who uses drugs, Illia, who is an LGBTQ+ community representative and openly lives with HIV, and Sasha, a drag artist. The range of avatars helps audiences find their ‘match’ online. “It allows someone to find their twin – someone with lived experience of the same issues that clients come to them for help with,” said Maria Malakhova, Project Manager for Science and Health Innovations at Alliance for Public Health.

Ukraine faces a shortfall of doctors and healthcare workers

APH is hoping the AI digital assistants will meet a need for quick and accessible health information and support. Since the invasion on 24 February 2022, the country’s healthcare infrastructure has been attacked, leaving more than a thousand health facilities damaged and hundreds of healthcare workers dead. According to a recent Lancet article, Ukraine has a shortfall of as many as 4,000 doctors, with many healthcare workers saying they are overworked and poorly paid. While thousands of doctors have joined the military since the invasion, others have been displaced by the fighting or have left the country.

As a result, APH has recently launched two new digital assistants specifically aimed at veterans of the ongoing war: Pavlo, a veteran, and Evgen, who is both a veteran and a member of an LGBTQ+ military organisation. These two new avatars are increasingly relevant to the population, given that around 900,000 people are actively serving in the country’s military, with around 1.2 million soldiers part of the country’s reserve forces. The new avatars aim to meet the needs of veterans and those active in the military who are at risk of HIV infection due to having unprotected sex or using unsterile or used needles to inject drugs. Many veterans were wounded in the war; returning to daily life and their families can be a struggle.

The avatars can provide them with medical information on, for example, how to stay safe or get help when things become overwhelming. Vulnerable individuals might be referred to Help24, a Ukrainian telemedicine and 24-hour health platform that provides support, access to harm reduction commodities, HIV tests and referrals to relevant medical professionals and psychologists, as well as a comprehensive medical service online, including remote Antiretroviral therapy and PrEP initiation. The support of the Swedish International Development Cooperation Agency has helped APH develop the new veteran avatars and keep the service running.

Seeing TWIIN answer questions instantly, safely and anonymously showed me how powerful digital health can be — especially when people have nowhere else to turn.Maria Malakhova, Project Manager for Science and Health Innovations at Alliance for Public Health

The digital assistant aims to support the work of medical professionals and service providers, including social workers, outreach workers and case managers, by providing information that may not be freely available in rural and more conservative communities. For example, an LGBTQ+ person might be reluctant to seek HIV prevention or health advice from an older or conservative doctor or health professional in their rural community.

Initially pre-launched in September 2024, the digital assistants have been actively promoted and in use since July 2025. The avatars are based on real people, who were filmed and then the footage was digitalised by UNITH, using their digital human creation technology. Even the AI-generated voices are based on actual voice recordings.

The content used to generate responses is from a knowledge database with up-to-date and accurate information on HIV, TB, hepatitis, and how to respond to mental health and emergency situations. The AI’s role is to analyse the users’ request and then check the database of topics before responding. Clients are also able to have a freer and more open conversation beyond healthcare if they wish. “In wartime, access to health services can disappear overnight,” says Maria. “Seeing TWIIN answer questions instantly, safely and anonymously showed me how powerful digital health can be — especially when people have nowhere else to turn.”

pLAns to expand into Georgia, Moldova, Kazakhstan and Tajikistan

Despite the programme’s fast expansion, there is more to come. The team is constantly working to improve the functionality, to make it faster and the avatars even more proactive, natural and empathic in their responses. The TWIIN digital assistant programme will soon expand into Georgia, Moldova, Kazakhstan and Tajikistan, once they have cracked providing the AI in local languages. And they are hoping to expand beyond the existing browser-based AI assistant to an app. This will be available on Android supported devices soon, with iOS for Apple devices to follow a bit later.

Maria is optimistic about their upcoming plans: “TWIIN proves that even in wartime, Ukraine is not only surviving — it is building the future of digital health.”

Find out more: https://twiin.aph.org.ua/en/