Tuberculosis: Europe’s ticking timebomb

1.  Drug-resistant forms on the rise in Europe; treatment costs to increase 50 times if epidemic left unchecked
2.  MEPs get involved in the fight against deadly strains of the disease
3.  Photo exhibition held in European Parliament to call attention to the issue

Brussels, 20th March 2013 – On World Tuberculosis Day the TB Europe Coalition called on the European Commission to substantially increase funding to fight tuberculosis in Europe. Tuberculosis causes not only illness and death, according to estimates, it costs EU Member States €15 million every week and €750 million every year.

Most people consider TB a disease of the past, yet this ancient disease is posing new challenges for countries across the globe as TB becomes more and more resistant to existing drugs. Europe is no exception – the World Health Organisation reported an estimated 76,000 cases of multi-drug resistant TB in the WHO European Region in 2011, accounting for a quarter of the global burden [1].

While TB can be treated, multi-drug resistant TB (MDR-TB) and extensively-resistant TB (XDR-TB) are much more costly and difficult to treat and present an emerging health threat to the general population. Indeed Eastern Europe and Central Asia now have the world’s highest rate of new TB patients with MDR- and XDR-TB, as a third of all TB cases are resistant to at least one first-line drug [2].

Fifteen of the 27 MDR-TB high-burden countries worldwide are located in WHO European region and include five EU Member States: Romania, Bulgaria, Estonia, Lithuania and Latvia [3].

Even in terms of treatment success rates Europe is lagging behind in its response to TB: some European countries rank much lower than African countries. The treatment success rate for MDR-TB in Romania is 20%, compared to 50% in the Democratic Republic of Congo[4]. The greatest reason for this is a failure to provide patients with an adequate level of MDR-TB treatment, mainly due to drug stock-outs.

Curing a “normal” case of TB in the EU costs €1,000 on average, compared to €50,000 for MDR-TB. “Domestic governments often do not have the resources or the political will to adequately fight MDR-TB. The current health, development and research policies of the European Commission must help countries to address this re-emerging cross-border health threat“ says Fanny Voitzwinkler, Coordinator of the TB Europe Coalition.

“Unless we urgently scale up our efforts, the MDR-TB epidemic could grow out of control and if that happens, the consequences for Europe would be very serious indeed” says Lucica Ditiu, Executive Secretary of the Stop TB Partnership. In 2011, WHO Europe launched a $5-billion Action Plan to Combat MDR-TB in the years 2011-2015 in the Region, which if not implemented will cost the Region $12 billion in lost productivity and treatment of new cases.

An end to TB is possible, progress has already been made: the TB death rate worldwide dropped 41% between 1990 and 2011[5]. With adequate political and financial commitment for research and development into new drugs, diagnostics, and vaccines but also for fully-funded national TB programmes, the fight against TB could be an easy win in global health. WHO and partners estimate that there is a €1.2 billion annual gap in international support to TB on top of a €1 billion annual gap for TB research and development for the period 2014-2016. The next EU Research Framework Programme “Horizon 2020” should prominently feature tuberculosis as a priority in its societal challenges pillar.

The Coalition welcomed the growing engagement of Members of the European Parliament to solve this issue. Fourteen MEPs recently agreed to sponsor a Written Declaration on Multi-Drug Resistant TB in Europe, which will be launched and open for signatures in the spring in the European Parliament.

European Parliament Member from Romania Claudiu Tănăsescu says he will not cease to draw attention to this issue at a policy level:

“Some people think TB only affects people with ‘poor lifestyles’ – by which they often mean Roma, or prisoners or migrants. But TB can affect any of us. TB anywhere is TB everywhere, and I will continue to raise the issue in the European Parliament”.

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[1] WHO Global TB report 2012 http://www.who.int/tb/publications/global_report/gtbr12_annex4.pdf

[2] In Belarus the percentage is 32.3%; in Kazakhstan, 30.3%; Kyrgyzstan, 26.4%. WHO Global TB Report 2012 http://www.who.int/tb/publications/global_report/gtbr12_main.pdf

[3] World Health Organisation Europe (2010). “Multidrug and extensively drug-resistant TB: 2010 Global Report on Surveillance and Response”.

[4] WHO Global TB report 2011 http://www.who.int/tb/publications/global_report/2011/gtbr11_full.pdf

[5] http://www.who.int/mediacentre/factsheets/fs104/en/

Source: TB Europe Coalition