Tuberculosis on the rise in Central and Eastern Europe

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EU data and a World Health Organisation (WHO) report have highlighted the need for improved health systems to deal with a rise in drug-resistant tuberculosis in Eastern Europe and former Soviet states.

While Europe has concentrated a great deal on TB in recent decades, “we have collectively failed to reduce the number of relapses of the disease,” said WHO Regional Director for Europe Marc Danzon, presenting the report on Global Tuberculosis Control 2008.  

He said that Europe had failed to ensure that health systems can guarantee correct dosages and durations of treatment. It had also failed to tackle the drug-resistance issue, he added. 

Published a week before this year’s World TB Day on 24 March 2008, the report reveals a slowdown in progress on TB control throughout the world. In particular, this deadly infectious disease is being diagnosed more slowly than before. 

The WHO report also reveals that multidrug-resistant tuberculosis (MDR-TB) has reached the highest levels ever recorded, which could further slow progress in controlling the disease. 

According to the report, MDR-TB has risen sharply within Europe over the last decade and many countries are struggling to manage this increase. Eastern European countries are particularly affected, with 12 of the 14 most affected areas in that region alone. 

Cases of drug-resistant tuberculosis are particularly prevalent in the former Soviet republics, where health systems are frequently too under-staffed and under-funded to deal with the disease adequately. Specialised agencies dealing with tuberculosis often do not contact general health services, allowing TB cases to slip through the net. 

Additionally, cases have arisen in the socially disadvantaged sections of Western European societies, where migrant workers and asylum seekers are often not covered by healthcare. 

Health systems across Europe have focused on this treatable disease extensively in recent years, yet relapses continue to occur. “We often fail to focus on how the health system can tackle the drug-resistant issue,” said Dr. Danzon. 

Just days before World TB Day, the EU-funded EuroTB network released separate data on TB cases recorded in the EU. The annual report shows that nearly 90,000 cases were reported in the EU in 2006 alone. The disease “has declined slightly in the EU in recent years, but we are a long way from stopping it,” said the director of the European Centre for Disease Prevention and Control (ECDC), Zsuzsanna Jakab. She particularly urged action on MDR-TB, which “is still rare in most EU countries”. 

The ECDC action plan to fight TB in the EU, also published in the run-up to the global event, provides a roadmap to control and ultimately eliminate TB in the EU. ECDC recognises that most of the activities set out in the plan “rely on national efforts” but proposes “a catalyst role for EU organisations and other partners”.

The plan states that rapid detection and effective treatment of TB cases are the keys to stopping the disease and preventing the further emergence of MDR-TB, or even Extensively Drug Resistant TB (XDR-TB). 

The plan’s four key areas for action are: ensuring prompt and quality TB care for all, strengthening health systems, development and assessment of new tools and building partnerships and international collaboration.

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