Romania boosts efforts against drug-resistant tuberculosis
Today (2 October), Romania launches a four-year national plan to fight tuberculosis, during the visit of the WHO Regional Director for Europe and the European Commissioner for Health and Consumer Policy. The Romanian national action plan to prevent and manage multidrug-resistant tuberculosis (MDR-TB) is a timely response to a growing public health threat, to which over 80 000 people in the WHO European Region fall victim each year.
The plan demonstrates Romania’s political will to curb this major threat to public health, which most affects its most disadvantaged citizens. The aim is to contain the spread of MDR-TB and extensively drug-resistant TB (XDR-TB) by achieving universal access to prevention, diagnosis and treatment. By 2015, the plan aims to ensure that at least 80% of estimated cases in Romania are diagnosed and treated, and that the rate of treatment success is 75%. The plan will be implemented with a budget of more than €23 million over four years.
While TB is steadily and slowly declining in the WHO European Region, the highest numbers of cases in the European Union are found in Romania, where every day 77 people become ill with and 4 die from TB, and every year 1300 patients develop TB that is resistant to drugs that have been effective for decades. In the European Region, 86% of TB cases and 98% of MDR-TB cases are found in the 18 high-priority countries for TB control: Armenia, Azerbaijan, Belarus, Bulgaria, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, the Republic of Moldova, Romania, the Russian Federation, Tajikistan, Turkey, Turkmenistan, Ukraine and Uzbekistan.
“The rise of M/XDR-TB has created a new, shared sense of urgency. Romania’s action against M/XDR-TB is a concrete response to the unanimous pledge that all 53 European countries made in last year’s WHO Regional Committee for Europe: to contain the spread of this disease by 2015,” said Zsuzsanna Jakab, WHO Regional Director for Europe. “Action to prevent and control TB is a win–win situation, as it improves TB treatment and at the same time reduces the chances of TB progression into drug-resistant disease. This is also a prudent investment, since treating regular TB can be more than a hundred times less costly than treating M/XDR-TB.”
John Dalli, European Commissioner for Health and Consumer Policy, said: “Drug-resistant tuberculosis is a serious cause of concern in Romania and in Europe as a whole. To fight it, we need political will, solid cooperation and efficient tools. I welcome the action plan that Romania launched today and stand ready to support the Romanian Government in implementing it. The European Commission is committed to playing its part in fighting tuberculosis and is investing substantial efforts in research, surveillance, prevention and control of this disease.”
“The Ministry of Health, in collaboration with the European Union and WHO/Europe, has developed an M/XDR-TB action plan, aiming at the identification, treatment and monitoring of TB patients. On M/XDR-TB, the Ministry of Health intends to provide resources for targeted treatment for all those in need, accounting for 4% of the total TB cases notified each year,” said Vasile Cepoi, Minister of Health of Romania.
A strong control programme is the best way to prevent drug-resistant TB, and a well-functioning health system is critical to sustaining such a programme. Well-trained health and social workers need to support and monitor patients to make sure they are taking their medicines. Procurement systems must be able to ensure an uninterrupted supply of high-quality drugs that are available to patients free of charge. The health system needs to provide early diagnosis and effective treatment to each and every patient, especially vulnerable and marginalized people. Enhanced infection control must be in place in health care settings. Cross-border response is also critical: every country should feel the urgency to develop and implement a national plan contributing to TB control in the European Region.
The Romanian plan includes enhancing the overall TB control system, strengthening laboratory capacity and scaling up human resource capacity for managing M/XDR-TB. Furthermore, it seeks to ensure the uninterrupted supply and high quality of anti-TB drugs, using a centralized procurement system, and to establish a patient support system to improve adherence to treatment. Finally, it also highlights community-level measures with the involvement of civil-society organizations.
Note to editors
- Over half of the world’s countries with the highest rates of MXDR-TB are in the WHO European Region. M/XDR-TB arises due to improper use of antibiotics in the treatment of drug-susceptible TB patients. Such improper use results from a number of actions, including administration of improper treatment regimens and failure to ensure that patients complete the whole course of treatment. Essentially, drug resistance arises in areas with weak TB control programmes. A patient who develops active disease with a drug-resistant TB strain can transmit this form of TB to other people.
- The European Commission:
1. has allocated more than €125 million to TB research over the past 10 years;
2. has allocated close to €1 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria since 2002; and
3. is ready to mobilize all available instruments, such as European Union structural funds (areas eligible for funding include: investment in health infrastructure, patient care, access to health care by vulnerable social groups, health promotion and disease prevention, and education for health professionals).
WHO Europe
