Ukraine faces a triple health challenge from non-communicable diseases (NCDs), infectious diseases, and the demographic situation with low fertility, out-migration, and excess adult male mortality. It also has the challenge of re-focusing its health systems from a vertical hospital-based model with high hospitalization rates and length of stay to a community-based patient-centered model, emphasizing primary health care, out-patient care and health promotion. In short, it must move a system designed for injury and infectious diseases to one designed for better management of chronic care, prevention and promotion.