Neftaly: Decreasing the Burden of TB in Romania Through Reforming the TB Control System and Strengthening the Management of Drug-Resistant Forms

Tuberculosis (TB) remains a critical public health challenge in Romania, which bears one of the highest TB burdens in the European Union. Despite progress in recent years, the emergence of drug-resistant TB (DR-TB) and systemic inefficiencies continue to threaten national TB control efforts. Neftaly is committed to supporting Romania in its fight against TB by contributing to the reform of its TB control system and enhancing the management of drug-resistant forms of the disease.

Addressing the Core Challenges

The current TB control system in Romania faces several key issues:

• Fragmented service delivery between primary care, public health institutions, and hospitals
• Insufficient diagnostic capacity, particularly for rapid drug resistance testing
• Gaps in patient-centered care, leading to poor treatment adherence
• Limited integration of social support and mental health services for TB patients

These challenges are compounded in the management of multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB, which require longer, more complex, and more expensive treatment regimens.

Neftaly’s Strategic Response

Neftaly’s strategy focuses on systemic reform and targeted capacity-building through the following pillars:

1. Modernizing TB Surveillance and Diagnostics

We support the scale-up of rapid molecular diagnostics (such as GeneXpert and line probe assays) to ensure timely and accurate detection of drug resistance. Enhanced electronic reporting systems will also enable real-time tracking and response.

2. Improving Access to Quality Treatment

Neftaly works with national partners to ensure that patients with TB and DR-TB receive WHO-recommended, shorter, and more effective treatment regimens. This includes improving drug supply chains, reducing treatment delays, and decentralizing care delivery.

3. Strengthening Human Resources and Clinical Management

Training healthcare providers on the latest TB and DR-TB management guidelines is key. Neftaly facilitates workshops and mentoring for clinicians, nurses, and community health workers across Romania, improving quality of care and case management.

4. Promoting Patient-Centered, Community-Based Care

Neftaly advocates for a shift from hospital-based to ambulatory, community-driven TB care. By involving civil society and patient organizations, we promote adherence, reduce stigma, and improve treatment outcomes.

5. Policy Advocacy and System Reform

Neftaly engages with government stakeholders to align Romania’s TB response with international best practices. This includes revising national protocols, securing sustainable financing, and integrating TB control within broader health system reforms.

Results We Aim For

Through this comprehensive approach, Neftaly aims to:

• Reduce TB incidence and mortality in Romania
• Improve detection and treatment success rates of DR-TB
• Strengthen national capacity for disease surveillance, treatment, and prevention
• Promote equity in access to TB services, especially for vulnerable and marginalized populations