Cases of tuberculosis have decreased 19% in the WHO European Region in four years, according to the latest data.
The WHO/European Centre for Disease Prevention and Control (ECDC) report Tuberculosis surveillance and monitoring in Europe 2021 (2019 data) shows that regional TB mortality has also declined by 9.4% between 2018 and 2019.
The report says this is higher than the average global decline in TB mortality of 3.7% and is enough to have reached the End TB Strategy milestone of a 35% reduction by 2020 compared to 2015.
However, drug resistance is a major concern and there are also concerns that the COVID-19 pandemic may stall progress or cause significant setbacks in the fight against TB.
There were an estimated 20,000 TB deaths in the WHO European Region in 2019, equivalent to 2.2 deaths per 100,000 people, while in the European Union/European Economic Area (EU/EEA) there were 3,560 TB deaths, 0.7 deaths per 100,000.
The report shows that in 2019, there were 216,000 new TB diagnoses – 23.2 cases per 100,000 – in the European Region and 29 countries in the EU/EEA reported a total of 47,504 cases, 9.2 cases per 100,000.
About 83% of estimated cases occur in 18 countries, where incidence is five times higher than the EU/EEA average, with five of the 18 high priority countries within the EU/EEA, and 13 in eastern Europe and central Asia.
The report says that despite universal access to quality-assured anti-TB drugs, treatment outcomes in the WHO European Region remain suboptimal.
It says 77% of patients successfully completed treatment in 2019, compared with the global rate of 85%, while treatment success in the EU/EEA was recorded as 64%.
The authors say that across the Region, treatment outcomes for multidrug-resistant tuberculosis (MDR-TB) remain suboptimal, with unsuccessful treatment being one factor that drives resistance, often due to lack of effective TB medicines in treatment regimens for drug-resistant TB, and low adherence to therapy.
Overall, in the Region, every third pulmonary TB patient has a drug-resistant form of the disease and a quarter of drug-resistant TB patients have extensively drug-resistant tuberculosis (XDR-TB). 70% of the world’s XDR-TB patients live in the European Region.
Dr Hans Henri P. Kluge, WHO Regional Director for Europe, said it was “of huge concern” that COVID-19 has drawn attention and resources away from TB services.
“I have no doubt that we’ll get COVID-19 under control. But the price of that can never be losing hard won progress with other health threats, like TB,” he said.
“Today, the risk of drug-resistant TB becoming even more resistant is real, and it’s not a risk we want to take. People need to realise this and understand the urgency of the action required and also know that we already have new opportunities and tools.
“Working towards ending TB is a crucial part of WHO’s European Programme of Work and, having treated TB patients myself as a doctor, it is something that’s very close to my heart. Great progress has been made in recent years, but challenges remain nonetheless. I therefore applaud the huge efforts made by countries in our region to overcome TB, a terrible and yet curable disease that causes great suffering.”
Dr Andrea Ammon, ECDC director, added: “The wide-scale disruption to TB services due to the COVID-19 pandemic will make it even more difficult for Member States to reach the SDGs and treatment targets, but now is the time for countries to accelerate their progress towards eliminating TB.”
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