MOLDOVA REGIONAL ECONOMIC FORUM 2025

19th Edition – Vatra Dornei, July 9–13, 2025

Thematic Panel:

Healthcare and Medical Services in the Moldova Region

Speaker:

Dr. Carmen Dorobăț – Infectious Diseases

Topic of the speech:
“Lessons from the COVID-19 pandemic for the infectious disease network. Preparing units for potential health crises”

Dr. Carmen Dorobăț, a renowned infectious disease specialist from Iași, highlighted the lessons learned from the COVID-19 pandemic and future perspectives for Romania’s infectious disease network. Her speech, supported by concrete data, clinical examples, and current legislative information, outlined a strategic vision for reorganizing the healthcare system in this field.

From Pandemic to Reform: Legislative Proposals for a Functional Network

Dr. Carmen Dorobăț announced, for the first time, that a legislative proposal is currently under discussion in the Health Committee of the Romanian Senate. It aims to establish, by ministerial order, several centers of excellence in infectious diseases in each of the seven regional university centers across the country. These will operate in coordination with the “Prof. Dr. Matei Balș” National Institute of Infectious Diseases, forming an integrated model of intervention and expertise.

“A unified electronic file will be created for patients with HIV, hepatitis B and C, enabling real-time digital monitoring. Thus, regional centers will be directly connected to the ‘Matei Balș’ Institute and can promptly intervene in complex cases.”

These centers of excellence will primarily serve immunocompromised patients and those with chronic infectious diseases. The initiative brings a completely new approach to the Romanian medical landscape: the centers will operate under public–private partnerships, fully respecting the confidentiality of medical data, and will offer integrated services including screening, diagnosis, treatment, and prophylactic counseling.

Alarming Data: HIV Incidence Rising in the North-East Region

In her address, Dr. Carmen Dorobăț presented a concerning set of data regarding the evolution of HIV infection, both globally and nationally.

Globally, over 39 million people are currently living with HIV, and annual deaths exceed 600,000, despite progress in treatment and prevention.

In Romania, approximately 10,000 active cases are registered, with over 1,000 new cases annually, showing a steady growth trend. The north-east region ranks second nationally in incidence, after Bucharest, with 1,870 active patients being monitored by the Regional Center in Iași.

“These patients require an interdisciplinary approach – from infectious disease specialists to cardiologists, radiologists, and neurosurgeons. We face complex cases, such as patients with HIV and cerebral toxoplasmosis, requiring quick, coordinated intervention across specialties.”

This reality underlines the urgent need for effective medical coordination mechanisms and the development of specialized centers, ensuring timely access to multidisciplinary diagnosis and treatment.

Expanded Screening and Integrated Treatment for HIV, Hepatitis B and C – Priorities for an Effective Network

Dr. Carmen Dorobăț emphasized the importance of redefining prevention and treatment policies regarding chronic viral infections, advocating for firm, systemic measures at the national level.

Key priorities mentioned include:

• Expanding mandatory screening in high-risk transmission areas and contexts (including invasive medical procedures or regions with high population mobility);
• Introducing pre-exposure prophylaxis (PrEP) for people in high-risk groups;
• Ensuring integrated counseling and treatment in specialized centers equipped with closed-circuit pharmacies dedicated to specific antiviral medication.

“Of the 18,000 HIV patients in Romania, nearly 10,000 have undetectable viral loads. That means they are non-contagious. Two HIV-positive individuals can have a healthy, uninfected child – a remarkable success of modern medicine.”

Her message highlighted the essential role of a coherent system of prevention and early intervention, capable of reducing the burden of chronic infections and ensuring improved patient quality of life.

Viral Hepatitis – An Underestimated and Often Underdiagnosed Risk

Dr. Carmen Dorobăț drew attention to the importance of viral hepatitis as a major public health issue, with significant impact both globally and regionally.

Regarding hepatitis B, she highlighted the following key points:

• Approximately one-quarter of the global population is infected with hepatitis B virus;
• In Romania, and especially in Suceava County, the prevalence exceeds the national average;
• Vertical transmission (mother to child) and unprotected medical procedures remain real and persistent risks.

“We identified three patients simultaneously infected in the past at the same dental office, which underscores the need for rigorous screening. Proper treatment can keep the virus latent and prevent complications.”

Regarding hepatitis C, her message was optimistic:

• Modern antiviral therapy offers the possibility of a complete cure, provided there is early diagnosis;
• North-East and Dobrogea regions report a high incidence of cases;
• Additional investigations such as FibroScan and FibroMax are essential to assess liver fibrosis levels and estimate cirrhosis risk.

Post-COVID Vaccination: Between Hesitation and Medical Necessity

Dr. Carmen Dorobăț addressed, with realism, the challenges related to vaccine trust, heavily impacted in the post-pandemic period:

• Vaccination rates against influenza and COVID-19 remain low;
• While effective antiviral treatments exist for both conditions, rapid and accurate testing is essential for optimal management;
• Decisions regarding SARS-CoV-2 vaccination should be based on antibody levels and the patient’s immune status.

“If the patient has an adequate antibody level, antiviral treatment can be initiated directly. If antibodies are absent and the patient is not immunocompromised, vaccination is recommended. It’s crucial to base this decision on a clear evaluation, not arbitrarily.”

Conclusions:

Dr. Carmen Dorobăț’s speech highlighted the need for an integrated and strategic approach to infectious disease management, strengthened by legislative reform and the implementation of regional centers of excellence. Emphasis on digital monitoring and interdisciplinary collaboration reflects a modern vision tailored to current medical system needs.

At the same time, the importance of expanded screening, personalized treatment, and informed vaccination underlines the commitment to prevention and optimizing clinical response in the context of post-pandemic challenges. This comprehensive perspective offers a solid foundation for developing a functional and efficient infectious disease network in Romania.