The data show an average annual 5% decline in TB incidence across the Region over the last decade. The countries of the European Union and European Economic Area (EU/EEA) observed a 6% decrease in TB cases with 68 000 reported cases in 2012. Overall, the EU/EEA countries met their target of an average five-year decline. However, Europe has not yet met the set targets for successful treatment of multidrug-resistant TB.
Much has been done to control TB in countries of the European Region since the launch of the Framework Action Plan to Fight Tuberculosis in the European Union in 2008 and the adoption in 2011 of the Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-resistant Tuberculosis in the WHO European Region 2011–2015. Access to MDR TB treatment has been scaled up three-fold compared to 2011, but challenges still persist: every single day nearly 1000 people across Europe are estimated to fall sick with TB. Particularly multidrug- and extensively drug-resistant TB (M/XDR TB) pose a serious risk to the goal of eliminating TB across Europe by 2050.
Of the 27 countries worldwide with a high burden of MDR TB, 15 belong to the WHO European Region, accounting for an estimated 76 500 MDR TB patients. Not even half of these have been diagnosed due to limited laboratory capacity in the countries, and only 50% of the MDR TB patients in the Region are reported to have been successfully treated. In the EU/EEA, the treatment success rates of MDR TB patients have remained stable at very low levels: only one in every three (34%) patients in the reporting EU/EEA countries completes MDR TB treatment successfully. More than half die, are not treated successfully, or are lost to follow-up. At 25%, the treatment success rate for XDR TB patients was even lower.
“There is an urgent need for new anti-TB medicines with shorter and more effective treatment regimens and we must reach all patients, not only half of them and ‘half the way’”, says Zsuzsanna Jakab, WHO Regional Director for Europe. “For the first time in 40 years, new TB drugs have become available but their scope is limited to specific groups of patients. Other drugs are currently under clinical trial. A key objective for new treatments should be to reduce the duration from two years to two weeks. We need to put patients at the centre of care in the spirit of Health 2020.”
The Director of ECDC, Marc Sprenger, stressed: “If we are not able to diagnose and treat patients with MDR TB early and successfully, this not only puts patients’ lives at risk but also paves the way for XDR TB. This is why it is essential to enable healthcare workers across Europe to fully support all MDR TB patients during the full course of treatment and make sure they finish it successfully.”
The goal to eliminate TB by 2050 depends on the development of new drugs together with diagnostics and vaccines. WHO is working in close collaboration with the Stop TB Partnership to enable and promote research towards developing new diagnostics, drugs and vaccines. In 2013, WHO developed guidance for the introduction of new medicines. ECDC plans to develop specific guidance to assist EU Member States with the introduction of new TB drugs.