Following the TB Europe Coalition’s visit to Romania last year, the Coalition found itself collaborating with Romanian Angel Appeal (RAA), a charity working on health issues and a principal recipient of the Global Fund to Fight AIDS, TB and Malaria. RAA organised an advocacy training for members of the Stop TB Partnership Romania and asked TBEC to help facilitate the two-day workshop.
During the course of the workshop, it became clear that there is a lot of concern regarding the current TB situation in Romania, particularly around drug-resistant TB. Jonathan Stillo, a medical anthropologist studying TB in Romania who has recently joined TBEC, has described how Romania has one of the worst treatment success rates for multidrug-resistant TB (MDR-TB) in the world.
Jon explained why:
“This is due to a number of factors ranging from a severe lack of national funding and frequent drug stock-outs to stigmatization and a lack of knowledge about the disease and the severity of the situation, even among decision-makers.”
Members of TBEC were able to see this for themselves during a visit to the drug-resistant TB ward at a hospital in Bucharest. There, they met two young girls in their early 20s, both appearing otherwise healthy but both infected with drug-resistant TB.
One girl has recently been diagnosed with MDR-TB after her father died from it and the other has been battling XDR-TB for over two years now. She was a new case of XDR-TB, meaning she’s been extensively drug-resistant since she was infected rather than developing resistance over time. Her condition is serious, and she’s already had to have one surgically lung removed.
The Romanian National TB Programme does not provide one of the key drugs she needs for treatment – linezolid. Instead, she orders and pays for the medication online from India. The absurdity of someone in an EU country having to order their treatment from India is apparent and underlines how politics have kept TB a national public health threat in Romania.
Romania does not produce many of the drugs needed to treat MDR and XDR-TB and, due to political reasons, does not import the rest. This means that drugs which would result in a much higher treatment success rate that Romanian’s current rate 20% are simply not available in the country.
Although addressing drug-resistant in Romania has been challenging, there is hope on the horizon as the Government recently approved a national plan to fight MDR-TB. The plan aims to improve treatment, strengthen the laboratory network and will introduce rapid antibiotic resistance testing.
The Romanian Government committed to spend €5.75 million responding to drug-resistant TB for the next four years, but STOP TB Partnership Romania remains worried about whether these funds will actually be made available when Parliament decides the budget at the end of 2012.
The workshop presented a unique opportunity for a variety of organisations to come together to develop a plan of action to address some of these issues over the coming months. A few of the key areas that the group agreed to work on include advocating for effective MDR and XDR-TB drugs to be added to the national drug registry, advocating for more resources to fund the National TB Programme, passing legislation to provide social support to TB patients similar to what HIV patients receive and pushing for the creation of integrated treatment centres for related health problems such as TB-HIV co-infection.
Members of TBEC were able to see the passion and commitment of individuals in Romania first-hand, and we aim to support the inspirational work of the Stop TB Partnership Romania over the coming year.
TBEC