Leaving no one behind in health has taken on a greater sense of urgency during the COVID-19 pandemic. On a country visit coinciding with World Health Day, the WHO Regional Director for Europe, Dr Hans Henri P. Kluge, highlighted the importance of equity in health to decision-makers, while also meeting with patients and health-care workers delivering health care to people who find themselves in difficult circumstances.
Vaccination against COVID-19 is an important part of bringing the pandemic to an end. But key to the ongoing roll-out is ensuring that priority groups are vaccinated no matter their status or living conditions.
In Romania, a chain of care has been established to link charitable organizations working with people living on the streets with health authorities, ensuring that homeless people with underlying health issues have been able to access vaccines. Dr Kluge visited one such organization, Carusel, who advise people living in difficult circumstances on health matters and provide them access to vital health services.
United Action for Better Health
One of the fundamental pillars of the European Programme of Work 2020–2025 (EPW) – “United Action for Better Health in Europe” is ensuring that more people are better protected from health emergencies. Working across sectors is an important way to provide people with equitable health care, even during a pandemic.
Collaborating with the Ministry of Internal Affairs and Ministry of National Defence, medical staff and community workers, the authorities in Romania have been able to roll-out vaccinations to priority groups. During a visit to Romexpo vaccination centre, Dr Kluge spoke with Dr Valeriu Gheoghita and Dr Andrei Baciu, leading the COVID-19 vaccination task force, who offered their perspectives on the successes of utilizing staff with different occupations to pool their expertise and achieve a common aim.
In addition, the National Centre for Intervention Coordination and Management in Ciolpani (CNCCI) works around the clock, in collaboration with all branches of the emergency services, to effectively coordinate COVID-19 response activities. Dr Kluge spoke with Dr Raed Arafat, who manages both the CNCCI and Department for Emergency Situations, about how their work allows for the monitoring and management of quarantined areas, and of intensive care capacity, as well as speeding up COVID-19 vaccination in areas with high transmission.
High-level meetings
During the country visit, Dr Kluge discussed health and health equity with the President of Romania, Klaus Werner Iohannis. The Regional Director and the President also attended a high-level meeting on climate change. This offered the opportunity to highlight how health inequities have exacerbated the pandemic, as well as illuminating the relationship between health and the environment.
Speaking at the meeting, the Regional Director said: “Climate change and COVID-19 are 2 converging public health crises, rooted in the profound alterations to the planet caused by human activities. We have seen existing climate vulnerabilities intensified by the pandemic, putting communities and health systems under unprecedented strain.
“COVID-19 is one of many reminders of insufficient environmental protection, of the troubled relationship between man and nature. Left alone, climate change will continue to drive the health profile of current and future generations, challenge already overwhelmed health systems, and undermine progress towards the Sustainable Development Goals and Universal Health Coverage.”
Furthermore, Dr Kluge’s contribution to public health and COVID-19 in Romania was officially recognized with the awarding of the National Order of Merit at Cotroceni Palace.
In addition to speaking with the President, Dr Kluge addressed the health commission’s members of parliament, recognizing the support that parliamentarians across the WHO European Region have provided to governments responding to the pandemic. Dr Kluge highlighted the importance of placing health high on the political agenda, as well as increasing investment in public health, with long-term benefits.
Speaking with health-care workers and TB patients
While visiting a tuberculosis (TB) dispensary in Bucharest, Dr Kluge had the opportunity to learn about the progress of the outpatient model of care piloted by Romania and to speak with the health-care workers who treat and care for TB patients, including those with multidrug-resistant TB (MDR-TB).
Health professionals explained that they sometimes face bureaucratic hurdles which can slow down treatment success for MDR-TB. Further strengthening universal access to diagnosis and effective treatment for TB patients is a key area for WHO–Romania collaboration.
Health-care systems are only as strong as the people who maintain them; the COVID-19 pandemic has placed an unprecedented strain on health workers across the Region. In a separate engagement, Dr Kluge spoke with the Order of Nurses, Midwives and Medical Assistants in Romania, highlighting how nurses and midwives remain central to the EPW. In this, Dr Kluge also highlighted the importance of nurturing and protecting the value and resources within the health workforce.