European health services are struggling to treat TB successfully as drug-resistant strains spread, according to the World Health Organisation.
The continent was urged to step up efforts to eliminate the disease in an assessment published for World TB Day on Saturday.
Cases of TB have declined slowly across Europe but treatment success rates have also fallen, WHO says.
Some 309,648 cases were reported in 2010, a 2.9 per cent reduction on the previous year.
But health services now report treatment success rates of 68.7 per cent for new cases and 47.6 per cent for patients with recurrent disease.
Rates of TB are highest in eastern Europe – but WHO urged western countries with large urban centres such as London, Rotterdam, Barcelona and Milan to take on the "final challenge" of eliminating the disease.
Marc Sprenger, director of the European Centre for Disease Prevention and Control, said: "In this setting, key populations – like people who inject drugs, homeless people and migrants – are disproportionally affected by TB.
"That is why we have to exchange best practices from across Europe: if services are not tailored to the needs of urban risk groups, there is a continuing risk of higher rates of TB in general and drug-resistant TB in particular.”
WHO regional director Zsuzsanna Jakab said: "Our Region has the lowest TB treatment success rate and the highest multi-drug and extensively-drug resistant TB rate in the world."
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