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The nature of the conflict in eastern Ukraine, within the unrecognized rebel “people’s republics” that broke away from rule by Kyiv in 2014 with military support from Moscow, is likely to change as a result of the coronavirus pandemic. The change will not stem from a shift in the political positions of the two main players, Ukraine and Russia. Both countries will be severely tested domestically by the new crisis, which means that they will likely pause their efforts to pursue the conflict either by negotiations or military means.

Instead, the challenge of coronavirus governance will reshape the conflict. The flimsy government structures in these breakaway territories have limited capacity and legitimacy and are heavily reliant on orders from Moscow. The breakaway regions would also likely to suffer a severe humanitarian crisis if the virus continues to spread there. They would need external support to deal with a health crisis, which would profoundly affect the course of the conflict.

The ongoing five-year conflict has cost 13,000 lives. Up to 3 million people live in parts of the Donetsk and Luhansk regions of eastern Ukraine, which officially are called “non-government-controlled areas.” (Estimates vary widely, but this number is around half the area’s population from before the conflict.) These regions—along with parts of the “government-controlled areas,” which are in only a marginally better situation—have a cocktail of three problems that make them especially susceptible to the worst effects of the pandemic. First, around 36 percent of the population consists of pensioners, many of them with acute health problems. Second, the health system has been severely degraded by five years of conflict and the out-migration of an estimated 1,500 healthcare professionals from the region since the fighting began in 2014. Finally, governance by the de facto authorities is very weak, which could hamper any efforts to respond to a health crisis in the region.

This collection of potential issues makes eastern Ukraine the most extreme example of five disputed post-Soviet territories that are all the subject of protracted conflicts, all of which have declared independence but have little or no international recognition. The others are Abkhazia (as described in this Carnegie analysis), Nagorny Karabakh, South Ossetia, and Transdniestria. Each is more or less stable, but all are internationally isolated and ill-prepared for external shocks. If their de jure “parent state” can find a way to provide effective assistance to them during the pandemic, it may be able to reestablish some legitimacy.

Thus far, the de facto authorities in each case have tried to use isolation to their advantage, closing borders and claiming less than ten coronavirus infections. However, most outsiders do not take these claims seriously. Unwilling to shut down their modest economy, the de facto authorities in eastern Ukraine have called for voluntary self-isolation instead.

“I’ll be totally honest,” Denis Pushilin, de facto head of the self-proclaimed Donetsk People’s Republic, stated. “For a range of reasons, including economic ones, we can’t afford to shut down businesses or announce a period of no work, especially as, I repeat, right now we have no one suffering from COVID-19,” the disease caused by the virus. A Ukrainian minister accused the breakaway territory’s leadership of concealing the true situation from the local population, claiming that “if someone contracts a virus or dies in the occupied territories, they call it a (H1N1) flu.”

The situation is almost as critical in Ukrainian government-controlled areas. The Office of the United Nations High Commissioner for Refugees reports, “If it were to spread to areas along the contact line, COVID-19 could have a devastating impact.” It notes that of 119 settlements near the front line, 71 now have no public transport, 54 have no food shops, and very few have pharmacies or proper medical facilities.

Even if there are no or only well-contained outbreaks, the prolonged isolation caused by the coronavirus almost certainly will have a serious humanitarian impact. Even before the pandemic, eastern Ukraine had, according to the United Nations, “the largest proportion of elderly in a single country affected by a conflict in the world.” Every month, around 550,000 pensioners cross the Line of Contact—the de facto boundary dividing the two sides in the conflict—mostly to receive Ukrainian pensions. The Line of Contact is now closed, depriving those pensioners of their livelihoods and the territories they live in of a cash flow of about $50 million per month. (There have been calls for Ukraine to pay pensions to its citizens remotely, and this now looks to be an imperative.) Even the OSCE Monitoring Mission is having problems crossing the Line of Contact.

The de facto governance structures almost certainly will not be able to cope with the crisis, and people will look either to the parent state (Ukraine) or patron state (Russia), or to the international community, to fill the vacuum. A Ukrainian initiative would be welcomed internationally but would encounter resistance on the ground and be a big challenge for the government in Kyiv, which is struggling to deal with the problems of its core territory.

A major Russian intervention in the territories would be expensive for Moscow and highly controversial but is a scenario that is worth anticipating. The international community seems unlikely to muster the resources or political organization to step in, beyond some limited if much-needed humanitarian assistance from UN agencies and the International Committee of the Red Cross, which has already delivered cargoes of aid. Yet the status quo in Ukraine’s breakaway territories is even more unlikely to survive the coronavirus.