Enlarge image
Ioana Oprea, 37: Her son Teodor was diagnosed with a brain tumor - but the necessary drugs are not available in the EU country Romania
Photo: Petrut Calinescu
Her son Teodor has a brain tumor.
When she received this gruesome, deeply frightening news in autumn a year ago, Ioana Oprea, 37, initially had no time to deal with the shock.
First she has to find a suitable clinic for the then six-year-old in the Romanian capital Bucharest, then help him with chemotherapy and radiation for months. Treatment is going well, but Oprea still cannot calm down. Because her boy, she learns, will need medication to prevent the tumor from growing again. A medicine that cannot be found in Romania. "I started looking for it straight away," says the mother of two.
That was in June 2021. At the end of September, Oprea is sitting in the bright consultation room of the Magic organization and shows photos of Teodor on her cell phone: a slim boy with large dark glasses who is now much better. It was here, in the pale green building with the outlines of children's hands on the facade, that she had finally received the medication that her son so urgently needed.
To help cancer patients like Teodor, the Bucharest-based organization set up an international network of volunteers seven years ago. The helpers bring the medication to Romania - from Austria, Germany, Hungary, France, Great Britain or Bulgaria. "As long as we get a prescription from the patient, we can get the medication anywhere in the EU," explains Adriana Andrei, project manager at Magic. On average, they receive ten inquiries a day. This year alone, the organization has already helped almost 2,000 patients.
In the middle of the EU there has been a lack of vital therapies for years.
An analysis of missing cancer drugs showed that 24 of 113 drugs in Romania were difficult or impossible to get, and a further 13 showed a shortage, reported the Romanian Health Observatory, a pharmacy-critical organization in Bucharest in 2018.
From 2015 to 2017, the National Medicines Agency received 2,600 missing medication notifications, most of them for the treatment of cancer.
According to a European report, there was an average shortage of medicines in Romania for 6.5 months, the cancer drug bleomycin was even not available for two years.
For Teodor too, things initially looked bad. The only Bulgarian pharmacist in the international network did not have the cancer therapy ready, neither did a Hungarian colleague, nor a pharmacist from Vienna. Project manager Andrei only found what she was looking for in Germany: A pharmacist in Hof was able to get the medication. However, Teodor's mother had to pay the 750 euros for the 20 capsules herself because the health insurance does not cover the costs for medicines from abroad.
"We parents of children with cancer are too exhausted to protest against the conditions," says Oprea. She wears a black jacket and gray sweatpants, the logo of a discount store can be seen on her yellow backpack. In hardly any other EU country do people have to pay as much for medicines out of their own pockets as in Romania. And in no other does the state spend so little per capita on it.
Since the financial crisis in 2009 in particular, the Romanian government has been trying to save on drug costs. As is generally the case, the costs are based on the drug prices in other EU countries, and so far it has always taken the lowest price from a selected group of twelve countries, including Lithuania, Hungary and Poland. "What sounds sensible at first, is exactly the problem: The drugs in Romania are too cheap," says Razvan Pavel from the Department of Medicines Regulation at the Ministry of Health in Bucharest.
The classic cancer drugs that have been used for chemotherapy for years are now so cheap in Romania that it is simply no longer worthwhile for pharmaceutical companies to market them there. The result: the drugs never even come onto the market or at some point they will disappear. Often, other companies buy the drugs in Romania and then sell them at significantly higher prices in other EU countries, for example in Germany. It is not forbidden.
However, it would be possible to block the export. At least in theory. When there is a lack of medicine in the country. In practice, however, there is so far no register that records the stocks of drugs in their entirety in Romania, just as there is no national cancer register. "We neither know how many people suffer from which cancer, nor how many drugs we have in stock at what time in Romania," says Pavel.
The 32-year-old opens his laptop, opens a page on the intranet and scrolls column by column through a table.
Pavel, a dark jacket, crease-free shirt, well-groomed five-day beard, used to work for the Magic organization, but is currently working day and night to develop a kind of alarm system that will display in yellow, orange and red when the Country is threatened with a shortage of a drug.
Already today, all around 10,000 pharmacies in Romania have to report to the ministry which drugs they currently have in stock.
Pavel's new algorithm should help to collect and evaluate this information.
In addition, the Romanian government changed the legislation to improve the situation a little. Since July, the Ministry of Health has no longer had to orient itself towards the cheapest drug prices in the twelve EU countries. Instead, the average price from the three cheapest countries is used for a selection of particularly important drugs. What that means? That the drugs are a little more expensive. "This makes the Romanian market more attractive for pharmaceutical companies," says Vlad Voiculescu, who has already been Minister of Health twice, most recently until April 2021.
In contrast to many predecessors in office, Voiculescu had publicly addressed the shortage of cancer drugs and suggested the new regulation.
But there was little he could change, explains Voiculescu, he got rid of his job too quickly.
"All in all, I only have ten months in office," says the 38-year-old.
Which is not unusual in Romania, as more than 30 health ministers have been appointed and dismissed in the past 25 years.
It was Voiculescu who began transporting cancer drugs to Romania years ago.
In 2008, long before he became a politician, he worked as a bank clerk in Vienna.
A former classmate who was now a doctor had asked him to bring essential medicines for six children with cancer.
“Until then, I had no idea that the medication was missing,” recalls Voiculescu.
A little later he met a woman who had only received chemotherapy because she was the youngest of three cancer patients on the ward.
The other two had come away empty-handed.
Voiculescu still supports the organization with ideas and contacts, and Magic now has 35 employees.
In the meantime, other organizations are also imitating the network, such as the drug box, also an initiative from Bucharest.
In contrast to Magic, the patients here do not have to pay for the medication themselves, the medication is financed from donations.
And some pharmacies in Romania even produce some medicines themselves, such as Corina Salagean from the city of Brașov. In the back, in the windowless laboratory of the gray concrete building, an assistant is filling a hundred brown and white capsules with a powder - an antibiotic for cancer patients with a weakened immune system. An ointment for a patient with black skin cancer is in a plain plastic container on a white shelf. "Ten years ago we could still order the ointment, today it is no longer available in Romania," says Salagean. Therefore, the pharmacist often steps in.
Teodor's mother also wants to help.
She is even willing to share some of her boy's 14 remaining capsules with others.
In fact, she has already received the request for exactly this cancer drug, reports Adriana Andrei.
Another patient has run out of supplies and urgently needs a capsule.
This contribution is part of the Global Society project
Expand areaWhat is the Global Society project?
Reporters from
Asia, Africa, Latin America and Europe
report under the title “Global Society”
- on injustices in a globalized world, socio-political challenges and sustainable development.
The reports, analyzes, photo series, videos and podcasts appear in the international section of SPIEGEL.
The project is long-term and will be supported for three years by the Bill & Melinda Gates Foundation (BMGF).
A detailed FAQ with questions and answers about the project can be found here.
AreaWhat does the funding look like in concrete terms?
The Bill & Melinda Gates Foundation (BMGF) is supporting the project for three years with a total of around 2.3 million euros.
Are the journalistic content independent of the foundation?
Yes.
The editorial content is created without the influence of the Gates Foundation.
Do other media have similar projects?
Yes.
Big European media like "The Guardian" and "El País" have set up similar sections on their news sites with "Global Development" and "Planeta Futuro" with the support of the Gates Foundation.
Have there already been similar projects at SPIEGEL?
In the past few years, SPIEGEL has already implemented two projects with the European Journalism Center (EJC) and the support of the Bill & Melinda Gates Foundation: the “Expedition ÜberMorgen” on global sustainability goals and the journalistic refugee project “The New Arrivals” within the framework several award-winning multimedia reports on the topics of migration and flight have been produced.
Where can I find all publications on global society?
The pieces can be found at SPIEGEL on the topic Global Society.
