B/|D E F G ren’s ealt National Initiatives Offer New Hope For Children (NPS)—Recently, at a United Nations Special Session on Children, former Romanian Presi- dent Ion Iliescu announced a milestone in his country’s fight against the world’s first pediatric IDS epidemic: The nation’s entire HIVpositive population who need treatment, including nearly 60 percent of Europe’s pediatric IDS cases, now has universal access to important antiretroviral IDS medications. President Iliescu’s announcement at the UN represents a dramatic shift from the healthcare catastrophe Romania faced just a few years ago. Thefall of communism in the late 1980s left Romania saddled with the legacy of a healthcare system that had encouraged wide-scale blood transfusions among malnourished chil- dren and the reuse of disposable syringes. These practices are largely credited with fueling the rapid spread of the HIV/IDS virus throughout Romania. Turning things around But the government has turned a dramatic situation into a public health success and is now oneof the few countries in the world—and the only one in Eastern Europe—to pro- vide its people with universal access to IDS medicines. Outside observers point to Romania’s political will to win the fight against IDS, as well as the partnerships it has forged with private sector organizations such as drug maker Merck, as a key contributor to the government’s success. “ key to addressing the HIV/ IDS pandemic is to establish effective and creative public-private partnerships,” said former U.S. Secretary of State Madeleine lbright, who has worked with the government of Romania on this issue. “ public-private partnership between the government of Romania and the Merck Company has developed a model program for really dealing with HIV/ IDS andthey have actually been able to control HIV/IDS among the children in Romania.” Essential resources The success of this partnership has comelargely through its focus on building a new and better healthcare infrastructure in Romania and on increasing the resources available for treatment andcare. For example, since 1997, the government of Romania has worked closely with Merck to support improvements in the country’s HIV/IDS care infrastructure. This has included establishing state-of-the-art treatment facilities, implementation of a national disease database, and an agreement that enables Romania to obtain HIV/IDS medicines at substantially discountedprices. Over the past few years, these programs have helped to create @ the environment that enables the government to offer universal access to HIV/IDS medicines, and ultimately to produce new hope for the people of Romania affected by the disease. In 1997, only about 30 adults and children were receiving care and treatment consistent with international standards. Today, more than 4,000 patients who need HIV/IDS medicines are being treated. Just the beginning While the results of the past few years represent a giant step forward for a country once overwhelmed by HIV/IDS, Romania’s president sees these accomplishments as just the beginningof his country’s larger fight to eradicate the illness. “More positive action steps are in the pipeline,” says Iliescu. “Coherent programs are being implemented for preventing HIV transmission, particularly among young people and other high-risk groups. The Ministry of Education and Research has launched a health awareness program in schools to provide basic information and increase the motivation for responsible sexual behavior.” Together, the government’s efforts to overcome this healthcare crisis and its ongoing partnership with Merck serve as a model for other regions of the world engaged in the fight against the HIV/IDS epidemic.
