On World Tuberculosis (TB) Day 2023, the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe are issuing a sobering warning that, despite having the tools to end TB, the European Region remains a long way from meeting its 'End TB Strategy' targets of reducing TB incidence by 80% and TB deaths by 90% before 2030.
Although this is partly due to the COVID-19 pandemic’s region-wide impact on health systems, including the capacity to prevent, diagnose and treat TB, countries still need to urgently renew their efforts if these targets are to be met.
The latest ECDC/WHO report on TB surveillance and monitoring shows that, despite an overall downward trend in the incidence of TB in the WHO European Region, the current rate of decline will not be sufficient to meet targets under the United Nations Sustainable Development Goals for ending the TB epidemic by 2030.
Diagnosis and treatment are key
To end TB, it is necessary to interrupt transmission by identifying people with active TB in time and preventing the development of TB in those already infected. Despite many countries in the WHO European Region reporting a year-on-year increase in the number of notified TB cases, the Region still recorded 23% fewer TB cases in 2021 than in 2019. The Region comprises 53 countries with a population of nearly 900 million people, around 508 million of whom live in the EU/EEA (27 EU Member States plus Iceland, Liechtenstein, and Norway). Other major challenges in the Region include an increased burden of drug-resistant cases and below-target treatment success rates, combined with the disruption to TB services caused by the COVID-19 pandemic.
According to ECDC Director, Andrea Ammon, “In 2021, the raging COVID-19 pandemic continued to heavily affect our Member States. TB resources were diverted, and patients experienced difficulties in accessing clinical services, possibly resulting in delayed diagnosis and treatment of some TB cases. Therefore, we need to increase the number of people diagnosed and successfully treated. ECDC remains committed to partnering with and supporting EU/EEA countries in their efforts to end the TB epidemic.”
Just three years ago, prior to the pandemic, the Region was experiencing the fastest decline in TB incidence and mortality in the world. Yet in 2021, TB mortality in the Region increased compared to 2020, and the declining incidence curve has stalled for the first time in 20 years.
“Despite the challenges, these are remarkable times,” said Dr Hans Henri P. Kluge, Regional Director at WHO/Europe. “We must take full advantage of new technologies, such as rapid molecular diagnoses; better and shorter regimens for prevention, treatment and care; and innovative digital health solutions.”
Dr Kluge pointed out: “We have the scientific and medical tools to recoup lost ground, but we urgently need stronger, consistent, invested partnerships between Member States, donor agencies and affected communities if we are to reach everyone living with TB to give them the treatment and care they need. This September, at the second UN High-Level Meeting on TB, leaders from Europe and beyond will commit to new targets and set new milestones to end TB. These commitments will be a promise we make to help people who are most in need – as TB is largely a disease of poverty and neglect, shrouded in stigma and discrimination, affecting some of the most vulnerable. Now is the right time to chart a renewed trajectory towards ending TB in the European Region, and globally, once and for all.”
