Essay Prevention Is Better Than Cure

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Several diseases and injuries are preventable, and can be managed much better if identified earlier on.

It is common for people only to go to the doctor when they are feeling unwell.

Vaccination against the human papilloma virus (HPV), the main cause of cervical cancer, is an option to further reduce incidence.

However, currently due to the inefficiency of the screening programme “detection of cervical cancer is delayed and cervical cancer is diagnosed in advanced stages,” Popescu says.

“All in all, we have stayed at the level of cancer prevention via mass media campaigns and periodical check-ups of women for the early detection of cervical pre-cancer lesions,” says Popescu.

Romania has the highest mortality rate for cervical cancer in the WHO European Region, despite the fact that the deaths from cervical cancer can be substantially reduced by screening programmes with referral for treatment services.The focus on treatment, especially tertiary (hospital) care, rather than prevention and early detection at the primary health care level is reflected in the government’s health expenditure too, which focuses narrowly on hospitals at the expense of primary health care.For Dr Liviu Stafie, at the Regional Health Insurance House (Casa Judeteană Iasi de Asigurări de Sănătate or CNAS) in the city of Iasi, this focus on hospitals is one of the biggest problems Romanian health care faces.This he blames on the lack of national cardiovascular disease prevention efforts, which, he says, have been limited to a few media campaigns.“There was a national initiative that started with a pilot programme in the Prahova County focused on the prevention of cardiovascular diseases,” he says, but it did not progress much beyond good intentions “due to a combination of cost and a not very positive evaluation of the pilot.”Professor Dan Gaita, president of the Romanian Heart Foundation, echoes Popescu’s view, noting that poor people are particularly affected.“Poor people have limited access to information and, consequently, have a low level of awareness,” he says. Poor people also smoke more and suffer more from stress which significantly influences the major cardiovascular disease risk factors.”For Gaita the lack of prevention campaigns is only one part of the problem.Dr Maria Suciu, a general practitioner based in the western city of Arad, says: “The amount of money we receive from the National Health Insurance House is very small and we cannot equip our office.” Suciu says that she is unable to carry out even basic diagnostic procedures such as measuring blood sugar and cholesterol levels.She estimates that it would cost €30 000 to equip her office for such tasks with a minilab, and with that equipment 40% of the noncommunicable diseases she sees could be managed much better over the next 10 years.Broader collaboration can make a difference, according to Dr Kwok-Cho Tang, a health promotion expert at WHO.“To sustain positive behavioural change, media campaigns alone, more often than not, will not work.” The problem with this approach is that it misses important opportunities for risk reduction.There is a clear need for prevention of a disease developing in the first place and, once it has developed, early diagnosis and treatment.

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