Feature Story

DOW has established close
partnerships with Romanian
physicians to strengthen the
National TB Control Program

Ask Professor Paul Stoicescu today, and he will tell you that DOW's tuberculosis project in Romania has been a trailblazing success that challenged perceived wisdom and proved that non-governmental organizations — not just the state — can work with the country's public health sector.

From 1997 to his retirement in 2006, Stoicescu oversaw Romania's TB control strategy as the director of the national Institute of Pulmonology, a job that entailed monitoring hospitals and doctors' offices in Romania's 42 counties.  He is now a member of the medical faculty at Bucharest University.

Having witnessed the Romanian health care system during the communist period, the East European economic crises of the mid-nineties and Romania's successful EU accession, Stoicescu is uniquely qualified to assess how a US-based organization like DOW performed in Romania from 2003 to 2007.

“DOW did a great job,” he said. “It has shown that a NGO can play an important role in TB control alongside the government."

NGOs do not typically work with Romania's health care system, Stoicescu said. Never before had an NGO taken such a forceful role in TB treatment and prevention. At first, Stoicescu admitted, he wasn't enamored with the idea.

"After the revolution of 1989, all these NGOs flooded in," he said. "It seemed they must have had their own interests. That was the mentality. So originally I was skeptical, as I had no experience working with an NGO.”

A former student of Stoicescu who now works for the World Health Organization convinced him he should think again. He saw how DOW was conducting surveys to discover which communities were most in need of help with TB, and how that help might be provided. Such planning was in stark contrast to how the Romanian Ministry of Health had previously worked.

The professor isn't exaggerating when he says TB in Romania needs to be tackled. The country has the highest incidence of the disease per capita in the European Union — 127 per 100,000 people.

Romania needs to train doctors, nurses and lay people to help educate citizens about TB symptoms before they acquire drug-resistant TB or carry it outside the country, Stoicescu said. He participated as a trainer in DOW sessions that helped educate other doctors, nurses and teachers about TB, and said those sessions were an excellent blueprint for how Romanian authorities might proceed in the future.

The former skeptic is now DOW's champion. He admits he is amazed at how a group from the outside managed to include so many Romanian stakeholders and work within the system to illustrate new ways to conquer TB, a disease that unfortunately has remained entrenched in Romania.

"DOW has taught me things I thought I knew," Stoicescu said. "They know our national program as well as we who made it."