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The paper presents a comprehensive overview of the public health system in the separatist Trasnistrian region of Moldova, an analytically unorthodox undertaking, as this entails looking at the health system of a fragile breakaway state-like entity, a set of circumstances that — rather inevitably, it seems — may define certain basic features of the health system at hand. Attention will be dedicated to outlining the main challenges the region's public health system faces, for instance, concerning the spread of infectious diseases such as tuberculosis, HIV/AIDS, and SARS-CoV-2. Studying the impact of the coronavirus pandemic can especially serve as a litmus test of the available capacities in Transnistria to deal with public health challenges: facing a novel pathogen, and the related disease and epidemic which threaten to overburden the local institutions. A key question examined here, through the example of Transnistria, is the degree to which international support to the region and the increasing cooperation with the internationally recognized state of Moldova are indispensable for public health security in the unrecognized state.

Transnistria's public health system and SARS-CoV-2: The challenges of an unrecognized state facing a global pandemic