Healthcare: European Commission report : Life expectancy in Romania remains among the lowest in the EU

Life expectancy in Romania remains among the lowest in the EU, expenses for inhabitant head are the lowest in the EU and the vaccination rates among children are very low, 67% of all measles cases in the EU are registered in Romania, according to a report released by the European Commission.   According to the document, poor nutrition, smoking, alcohol consumption and physical inactivity contributed to almost 30% of all deaths in 2021, another 6% can be attributed to air pollution. The report notes ‘ special concerns about the current and future supply of family doctors’.   After the abrupt decline during the COVID 19 pandemics, life expectancy came back and reached a new peak of 76.6 years in 2024, but it continues to be over five years under the EU average. The cardiovascular diseases and cancer are the main causes for morbidity and disability. Behavioral risks—poor diet, smoking, alcohol, and physical inactivity—contributed to nearly 30% of all deaths in 2021, and another 6% of deaths can be attributed to air pollution.   Public health efforts and primary prevention are still limited, only 1% of the total expenses for health being allocated to prevention in 2023. The new initiative for primary care ‘ Riskogramme’, launched in 2024 aims at early discovery of chronic diseases and behavioural risk factors with adults over 40.   Health expenditure per capita is the lowest in the EU. In 2023, it was less than half the EU average. Out-of-pocket payments accounted for over 23% of total expenditure, higher than the EU average of 16%, mainly due to direct payments for outpatient medicines.   Unmet medical and dental needs are among the highest in the EU, with particularly high rates among people at risk of poverty.   Health systems remains focused on hospitals. Avoidable hospitalisation for many chronic diseases are high, reflecting historic deficiencies in the capacity and coordination of primary care. Through the National Plan for Recovery and Resilience (PNRR) and other European funds, Romania invests in infrastructure development for primary care, promotion of intergration of services and financial stimulation for prevention.   Vaccination rates among children are very low, despite recent public policy measures. The measles vaccination rate was the lowest in the EU in 2024, and Romania accounted for 67% of all measles cases in the EU between August 2024 and August 2025. Influenza vaccination in the elderly and HPV vaccination also remain well below EU averages, due to vaccine hesitancy and systemic barriers.   Antimicrobial resistance (AMR) is a major problem. Romania reported the highest level of bacterial resistance in the EU in 2022–23. After a slight and temporary decline during the pandemic, antibiotic consumption has risen again, moving the country further away from its 2030 reduction target.   New monitoring rules, introduced in 2024, require pharmacists to record and report antibiotic dispensing to limit inappropriate use.   Retention issues continue to contribute to the shortage of doctors and nurses, with particular concerns about the current and future supply of family doctors.   Poorer regions have the lowest density of family doctors, exacerbating primary care needs. Teleconsultations and other digital health tools could improve access, but their use is limited by low digital literacy and poor infrastructure. EU funds, including the Recovery and Resilience Facility, provide financial support to Romania for modernizing hospitals and primary care practices, accelerating digital transformation, training staff, and setting up integrated community centers.   Retail pharmaceutical expenditure per capita is lower than the EU average, but accounts for 26% of total health expenditure—the third highest share in the EU. Patients pay out of pocket approximately half of the cost of medicines in pharmacies, reflecting limited reimbursement for prescription medicines and high purchases of non-prescription medicines, which are not covered by public funds. Access to innovative medicines is slow, but use of compassionate use and early access mechanisms speeds up access to promising therapies for patients with serious conditions before they are officially included on reimbursement lists.