Prime Minister of Sweden Ulf Kristersson meets with President of Ukraine Volodymyr Zelenskyy in Kyiv, February 2023 / President of Ukraine’s Office
Four years ago, like many in Sweden, I followed the first days of the invasion in disbelief. In the weeks that followed, conversations I had – with colleagues, with friends, later with people inside Ukraine – shifted quickly from geopolitics to continuity. Not “who is right”, but “how long can Ukraine hold?”
That question has not faded. It has become central to European security.
The language of solidarity still dominates much of the European debate. Sweden stands with Ukraine. Sweden supports Ukraine. Sweden contributes to Ukraine’s defence.
All of this is true.
But it is incomplete.
Since joining NATO, Sweden’s support for Ukraine is no longer primarily a matter of moral alignment or foreign policy positioning. It is part of our own security architecture. The question is no longer how generous we choose to be. The question is whether we understand what is structurally at stake.
Deterrence is often framed in military terms. As force posture, readiness, weapons systems. These matter. But they only matter if societies endure long enough for those capabilities to remain meaningful.
Military capability buys time.
Civil resilience determines whether that time exists.
Healthcare determines whether civil resilience holds.
Under sustained missile strikes, energy blackouts, and logistical strain, Ukraine has confronted a reality many European states have not yet internalised: societies do not fail at the moment of shock. They fail when civilian systems degrade to a point where people lose confidence in their continuity.
This degradation is rarely dramatic. It is cumulative. Services remain available but less reliable. Backup systems engage more frequently. Workarounds multiply. Fatigue spreads. Formal thresholds may not be crossed, but behavioural thresholds are.
Healthcare sits at the centre of this dynamic.
In discussions over the past years with medical professionals working under sustained pressure, one pattern has been consistent: what undermines stability is rarely the first shock, but the gradual unpredictability of systems people depend on.
When emergency and intensive care remain credible, families stay. When confidence erodes, departure becomes rational, particularly for households with children. This goes beyond ideology and is plain risk management.
Ukraine has therefore treated healthcare not only as a humanitarian necessity, but as stabilising infrastructure. Hospitals have been decentralised. Facilities have been hardened. Medical teams trained for degraded conditions. Continuity has become a strategic variable.
This only works if civilian systems are designed for endurance rather than peak efficiency.
It fails if redundancy is treated as temporary rather than structural.
These are not architectural choices. They are strategic ones.
For Sweden, the relevance is immediate.
Article 3 does not explicitly name healthcare. It obliges member states to maintain and develop their capacity to resist armed attack.
Resistance, however, is not sustained by military assets alone. It depends on whether civilian systems continue to function under prolonged pressure.
If energy fails, logistics stall.
If logistics stall, military capacity degrades.
If healthcare collapses, population stability erodes.
At that point, resistance exists on paper but not in practice.
A society that thins out under stress cannot be defended, regardless of its military inventory.
Supporting Ukraine is therefore not separate from strengthening Sweden’s own security. Ukraine is the most advanced real-world stress test of European resilience currently available. Its experience exposes which design assumptions hold – and which fail – under sustained disruption.
We can treat that experience as distant tragedy.
Or we can treat it as operational insight.
For me, that distinction has become impossible to ignore. The question is no longer whether Europe sympathises with Ukraine, but whether we are prepared to internalise what its endurance is teaching us.
Sweden’s support contributes to Ukraine’s ability to remain intact under pressure. That stabilises Europe’s eastern flank. And it reinforces a principle that remains underappreciated in much of the Western security debate: civilian endurance is not a humanitarian side issue. It is a condition for deterrence.
The debate about support should therefore mature.
The question is not whether solidarity will fatigue.
The question is whether we recognise that Ukraine’s endurance is structurally linked to our own.
True resilience is built in the systems that keep a nation alive, in hospitals that continue operating through blackouts, in communities that refuse to leave, and in the quiet decisions families make when everything tells them to run.
When medical capacity holds, people stay.
When people stay, societies endure.
When societies endure, deterrence remains credible.
If Ukraine holds, Europe holds.
If Europe holds, Sweden holds.
That is not solidarity.
It is strategy.
Jonas Hård af Segerstad
Author of Europe’s Invisible Shield
Independent analyst on civil resilience
