Quite unfortunately, Romania has some of the highest infant mortality and maternal mortality rates in Europe, and even more worrying, the downward trend seems to be continuing, most notably with significant measles outbreaks occurring in the country every year since 2016. Part of this distressing phenomenon relates to a growing anti-vaccine lobby that has sprung up in the country in recent years as well as historical problems with vaccine supplies and the general challenges of reaching impoverished rural communities.
It is almost impossible for us to reach more than 60 percent of the children on the vaccination lists
Nevertheless, through the joint efforts of key healthcare stakeholders, there is some positive news to share. Dr László Attila, president of the Committee of Public Health in the Romanian Senate, highlights, “vaccination rates have increased in recent years. In 2017, with the support of the Democratic Alliance of Hungarians in Romania (UDMR), the government adopted a draft bill on the organization and financing of vaccinations for the Romanian population.” Unfortunately, Dr Attila predicts, a challenging hurdle to cross is the high number of Romanian children living outside of the country’s borders, particularly in Italy and Spain. He supplements, “40 to 45 percent of the population along the Moldavian border requesting Romanian citizenship is not physically in the country. Therefore, it is almost impossible for us to reach more than 60 percent of the children on the vaccination lists.” One solution, he outlines, is to “gain access to the European vaccination registry” but discussions are still pending.
Pascal Robin, country chair of Sanofi Romania and Moldova as well as general manager of Sanofi Pasteur for both countries, is in the position to delineate some of the challenges depressing vaccination rates in the country. He suggests, “Romania has a vaccination system largely dominated by public acquisition [with] access to vaccines [being] free of charge at family doctors. As of today, it is considered a risky area for companies to invest in. Low prices undercut the innovative products but nothing is done to enhance patients’ access to newer products.”
In addition, he laments, “today, Romania does not vaccinate adults … only children. There is a systemic issue of access and education. The standard of care and facilities need to be improved in the public sector to incorporate an element of education. These health points are vital to delivering vaccinations and medicines, especially in rural areas. The same idea applies to private clinics and healthcare providers. These are underutilized resources that the government can capitalize on for the benefit of the general population.” To exacerbate matters, he warns, “the annual flu epidemic and [growing] anti-vaccine sentiments pull the system at both extremes. This requires a critical look at the ecosystem.”
For GSK general manager Dana Constantinescu, these challenges are precisely the reason GSK needs to invest in this area. She introduces, “vaccines have historically been a key strength of GSK, with a portfolio renowned throughout the world. For the 34 preventable diseases, GSK has vaccines for 22 of them. We are one of the largest providers of vaccines in the world [as well as] in Romania, and this year, the 18th vaccine —for meningitis B — was introduced in the country.”
Constantinescu highlights that vaccination concerns not only infants and children but also the elderly population: “In Romania, the vaccine coverage for seasonal influenza is below the recommended target of 75 percent for the elderly. Vaccination is a major health issue.”
Going above and beyond, she continues, “GSK has been working together with the industry, experts and authorities to draft a vaccination framework. Within this law, some guidelines will [better] structure the national immunization program as well as add more clarity [regarding] the interactions between key stakeholders involved in vaccination, [such as] the Ministry of Health, vaccine producers, physicians and parents. GSK [has] leveraged on its global network to put forward recommendations implemented in other markets.” She adds, “this will grant more predictability in the national vaccines acquisition procedures and regulate the supply of the recommended vaccines. This is a major step for the country” – and for Romania patients.