Romania risks HIV epidemic

Until recently, Romania had dealt with its HIV epidemic relatively well. One of the surprise discoveries that emerged after Romania's bloody 1989 revolution was the large number of children who had been infected with HIV by contaminated blood since 1986. Many of these children have been kept alive by the supply of antiretroviral drugs since the early 1990s – a success story that is about to come to a sorry end.

With budget cuts, unsustainable debts, striking nurses and uncontrolled corruption, Romania's health service is in a state of disintegration. Supplies of regular drugs are running out in many hospitals, surgeons have to cancel urgent operations due to shortages, and doctors are emigrating. Other EU member states (including Bulgaria) have prioritised the treatment of people with HIV. Not so in Romania, where the government even ignored help from Germany under the "Affordable Medicine Initiative" which would have led to a cut price supply of antiretroviral drugs.

"It it is very regrettable that Romania did not act upon the support offered by the affordable medicines initiative put forward by the German authorities based on the Bremen Declaration. Whatever the reasons and details that have led to this untenable situation in Romania, the current situation constitutes a clear breach not only of the national commitments but also of the European Convention of Human Rights Article 3.1," the advisors' letter reads.

Compounding the problem is the threatened closure of Bucharest's "needle exchange" programme, a service that supplies just under half of the city's injecting drug users with clean syringes, needles and other essential supplies. The programme is run by six Romanian NGOs and is co-ordinated by the Romanian Angel Appeal, an NGO set up after the 1989 revolution by Livia Harrison, ex-wife of the famous Beatle. An estimated 7,300 drug users – consisting mainly of sex workers, street children and vulnerable roma men and women – use the service, which has been remarkably successful at keeping HIV levels down. It is also very cost effective, costing just €2 per addict per month.

For many years, funding for the needle exchange programme came from the Global Fund for Aids, Tuberculosis and Malaria, but this source will dry up at the end of June. According to Valentin Simionov, coordinator of Romania's Harm Reduction Network, "medical experts and donors have repeatedly warned Romanian authorities about the high risk of an HIV epidemic, but no measures for supporting these services has been initiated by central or local authorities."

Rupert Wolfe Murray is the central and east European representative of Castle Craig Hospital, a drugs rehab centre in Scotland.