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March 24, 2023

The diseases of the health system

The Romanian health system is struggling between life and death, for a long time, mainly because of the rulers’ irresponsibility. Once they take the power, all politicians excuse themselves and accuse their opponents for the chronic under-financing of the health system. For many years, the system received approximately 2 pc of the GDP and, although the financing increased to 4 pc of late, the effects cannot be noticed. Everybody hides behind excuses, while accusing the others, because the money allocation process mainly reflects the political color of local administrations and of managers, rather than the constitutional imperative of granting all Romanians an equal access to health services. Thus, many hospitals were deprived of medicines. Even some hospitals that escaped closure were robbed of their land and were transformed into modest units providing social aid, rather than medical services. Under the pressure of these endless reciprocal accusations, politicians meanwhile reached a “specific” agreement. Instead of trying to solve the serious national problem of the health system, they resorted to a strange solidarity and got rid of medical units through privatisation, even against one dollar. However, even this “specific” agreement ran into trouble: the spontaneous, but acute protests of the Romanian population, which has to endure a situation characterised by worrying indicators like the highest child mortality rate in Europe, a high incidence of cardiovascular, lung and kidney diseases, diabetes, cancer, even AIDS. This state of facts contributes to the demographic disaster of the Romanian people.As a consequence, politicians now resort to a new subterfuge: they no longer manifest themselves through pathetical statements and no longer privatise for one dollar. Instead, lured by high commission fees, they yield to demands from abroad and, by means of a savage under-financing, push to collapse even large medical-pharmaceutical institutions that gained prestige abroad. Such moves explain why the famous Cantacuzino Institute of Bucharest stopped producing vaccines and serums. This renowned medical and pharmaceutical unit has a tradition of more than 90 years, and for almost a century – even during the last decade of the 20th Century – it brought financial and medical profit to the Romanian state. All the anti-epidemic campaigns aimed at protecting children and adults against various diseases were supported by the activity of this institute of European prestige. Its vaccines were even exported, due to their quality and their prices that were four times smaller than the equivalents produced abroad.Now, it is precisely this scientific and management tradition that fueled the envy of foreign pharmaceutical companies that feared this strong rival. Once admitted in the EU, Romania was “specifically” asked to adopt new, European standards in the production of medicines, which required big investments made by the Health Ministry. But although the plans for these investments were devised by our experts, they were rejected by the last two ministers of Health, who were involved in a regional competition hostile to any strategic national objective. This put an end to the production of vaccines by the Cantacuzino Institute.As a result, today we feel the absence of the Romanian vaccine against tuberculosis, although this highly-infectious “poverty disease” has an increasing incidence which places Romania on an unwanted first place in the EU. Other products that are badly needed now are the serums against prostate cancer, rabies, typhus and dysentery. Even the most usual means of immunizing children are missing. Now, the Cantacuzino Institute is no longer financed by the state and barely resists with the reduced output it still has. Part of its problems is the fact that its managers are appointed on political grounds, rather than by contest based on competence. Each new manager comes with a new policy that ignores what has been done in the past. Meanwhile, pharmaceutical companies import expensive medicines and celebrate the demise of the only local producer that could compete with them.This paradox is even more tragic when we learn that the scientists of the Institute conceived new remedies, but the money they should receive goes somewhere else. It is still unclear where, and to what purpose, but the competition of foreign companies is stronger each day, correlated with a criminal real-estate interest for the land covered by the Institute. The Cantacuzino Institute operates a farm of 11 hectares, and its monumental building covers 4 hectares of land at the very heart of Bucharest. This gives a total surface of 150,000 square meters. At 1,500 EUR/sq. m, it is obvious why real-estate sharks are closing in.The Academy of Medical Sciences and the Ombudsman intend to run a probe into this shady situation. However, until it reaches a conclusion, the poverty of Romanians widely opens the door to all kind of diseases. Romania has the lowest life expectancy in the EU, which turns it into a very attractive market for the international mafia of medicines. Naturally, this implies the collaboration of corrupt Romanian officials, which allow the prescription of expensive medicines from abroad. The recently enforced co-payment system favours these incorrect moves.Will the new government, born after the successful no-confidence vote in Parliament, be able to right the wrongs in the health system? Easier said than done!

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