Within the tara dialogue on May 2014, it has settled regarding the assurance of the period of interventions with external financing destined to TB control, the elaboration and approval of the National Strategy of TB Control with a strategic and comprehensive plan and a multi-annual budget is necessary for Romania, regarding to the Global Fund giving a new grant within a new financing model.
National Strategy Control of TB 2015-2020 that was developed eventually and approved through a Government Decision represents the commitment of Romanian Government for taking legislative and political measures for reducing TB burden. It is based on the next principal pillars: centered approach on the patient and innovative policies.
The program funded by the Global Fund through this new grant addresses the gaps and challenges identified in TB control in Romania by increasing the efficiency of diagnosis and treatment of patients with TB , with a particular focus on key populations through a mix of strategic approaches involving rapid diagnosis and quality, providing appropriate treatment , improving treatment adherence and strengthening linkages between services , governance and policies in the field of TB control .
The program intends to spearhead reform in TB control , in order to streamline the treatment of patients by expanding investment in outpatient treatment and early detection of cases . Community systems strengthening and increasing the role of civil society during outpatient treatment for patients belonging to the most vulnerable is also one of the most important directions of the program financed by the Global Fund in the period April 1, 2015 – March 31, 2018 .
The purpose of the programme is to help decrease TB and of mortality because of TB, through improving intervention with high impact(Diagnostic, treatment and prevention) with special focus on affected population through the next objectives:
• Ensure quality early diagnosis and TB laboratories and capacity building ;
• Implement patient-centered intervention in six counties with high incidence of TB in Romania
• Improvement of outcome to treatment for patients with M / XDR TB treatment regimens by providing complete and continuous
• Strengthen the legal framework for regulating national TB control in Romania.
• Improving the length and accuracy of diagnosing TB by developing strategic guidelines for TB laboratory network ;
• Develop diagnostic capacity for TB and M / XDR TB genetic methods, liquid culture and antimicrobial susceptibility ;
• Improving the length and accuracy of diagnosis by detecting active TB cases among high-risk populations ;
• Improved support for patients and case management systems through care and prevention implemented in the community through mobile units and support services and ambulatory care
• Providing patients with M / XDR TB
• Strengthen the capacity of the National Tuberculosis Control Programme and human resources for TB control
Target group / beneficiaries:
• patients with MDR / XDR -TB ;
• injecting drug consumers
• poor populations ( including Roma)
Romania ranks first in EU in terms of incidence of Tuberculosis (TB ) and is in the list of 18 priority countries to stop TB in the European Region of the World Health Organization.
The overall incidence of Tuberculosis in Romania reached its climax in 2002 , with 142.2 cases per 100,000 inhabitants, followed by a decrease to 73.0 cases per 100,000 inhabitants in 2013. In 2013 the total new cases of TB , 17.9 % were extra- pulmonary and lung were 82.1 % , of which 76.6 % and 23.4% bacteriological confirmed clinically diagnosed . Most cases ( 77 % ) were classified as us, while 15.9 % were cases of recurrence and 7.1 % were other re-treatments.
Multidrug resistant tuberculosis (MDR -TB) is a major problem in Romania . Romania estimated 500 to 1.100 new cases of MDR- TB per year, but detects only 66 % of estimated cases . One of the most alarming problem is the very low rate of treatment success among patients with MDR -TB , which for the cohort of 2011 was only 26 % , while the success rate of treatment cohorts GLC funded by the Global Fund in recent years it has been approximately 70 % . Therefore , there is a need to implement firm measures to improve and align national TB control program and the program funded by the Global Fund and to ensure the sustainability of interventions.
Romanian Angel Appeal ( Principal Recipient )
Marius Nasta Pneumology Institute
Policy Center and Health Services
UNOPA ( National Union of Organizations of People Affected by HIV / AIDS ) in partnership with ASPTMR (Association of Support for Tuberculosis Patients with Multidrug Resistance )
ARAS (Romanian Association Against AIDS ) in partnership with ALIAT and PARADA
Save the Children