Case Study – Romania

Countering bioterrorism, as other health threats caused by infectious agents, requires good preparedness, and early warning and response, which can be achieved by an efficient epidemiological surveillance system. In 1990, Romania inherited a functional and quite efficient epidemiological surveillance system from the former communist regime, based on pyramidal and autocratic principles where the state control was absolute. In 2001, the assessment conducted by WHO/Europe showed many unsatisfactory elements of the remaining epidemiological surveillance system for communicable diseases, with a lack of procedures, poor microbiology laboratory capacities, and overlapping responsibilities. The lack of a coordinating body was evident, especially during bioterrorist threats following 9/11 attacks in New York. In 2003 and 2004, the PHARE Project offered an important opportunity for Romania to improve the Romanian System of Epidemiological Surveillance and Control of Communicable Diseases. At the end of this project many of the technical capacities had been improved, specialized trainings of epidemiologists and microbiologists were carried out, and a coordinating body of the epidemiological surveillance network was established [1]. Furthermore, a National Plan of Action was approved by the Minister of Health with the declared objective to improve the system in order to comply with EU standards. At present, the National Institute of Public Health hosts the National Center for Communicable Diseases Surveillance and Control which coordinates the epidemiological network and serves as the Romanian focal point for international institutions such as WHO and ECDC. Each year, comprehensive reports regarding surveillance in Romania of many communicable diseases are published, including diseases potentially related to bioterrorism. Until now, no evidence of a bioterrorism event has been registered in Romania.