Call for coordinated European response on tuberculosis

DISCLAIMER: All opinions in this column reflect the views of the author(s), not of EURACTIV Media network.

MEPs want to launch informative campaigns on vaccines. [Partha S. Sahana/Flickr]

Every year on World Tuberculosis (TB) Day, the World remembers those who have died and the millions that suffer every year from of an infection that is both preventable and curable, write a group of health experts.

Ivan Solovič is the president of the European region of the Union Against Tuberculosis and Lung Disease & chair of the ERS Ad hoc Working Group on TB Advocacy. Giovanni Battista Migliori is the Secretary General of the European Respiratory Society.

One week on from World TB Day (24 March) we call on the European Institutions and on the European member states to fulfil their international obligations and take immediate and decisive steps to tackle the threat of TB. We ask for the development of a coordinated European public health mechanism to guarantee TB diagnosis, treatment and care across European borders.

TB is neglected by European society as it is seen by many as a disease of the poor and many believe it only exists in developing countries. Yet, that is far from the truth. In Europe in 2014 alone, over 340,000 people were diagnosed with TB and more than 40,000 died. Even worse, Europe has the world’s highest burden of drug-resistant TB, which is far deadlier and requires treatment that is more complex, expensive and with no guarantee of success.

In May 2014, at the World Health Assembly (WHA), EU member states approved a new World Health Organisation (WHO) strategy to eliminate TB by 2035. But two years later, very few steps have been taken to make this a reality.

It could be said that the long-lasting financial crisis in many EU member states, coupled with the refugee emergency Europe currently faces, have taken all of the EU’s attention. Yet this situation is not unrelated to the TB crisis: areas of poor sanitation, caused by economic, social and political degradation, instability and upheaval, are precisely the kind of situations in which infectious diseases like TB thrive.

There are currently millions of vulnerable individuals in the EU, including, but not limited to, refugees and migrants. These people have an increased risk of suffering from TB and other communicable diseases. If this issue is not addressed, we could see increases in the number of TB-related illness and death, European healthcare systems stretched to breaking point, and the further development of drug-resistant strains.

Even when we do not take into account the recent refugee emergency, the European Union is characterised by high population mobility and cross-border movement. It therefore follows that disease control across the entire continent is only as effective as the weakest national health policy in place.

A recent survey by the European Respiratory Society (ERS) and WHO Europe has identified that every European country has a different system for the prevention, diagnosis and treatment of TB and latent TB infections. This creates unnecessary disparities and gaps, lowering the effectiveness of high-quality health interventions and creating unnecessary risks to the entire European population, since infectious diseases know no borders.

As clearly set out in Article 168 of the Treaty on the Functioning of the European Union (TFEU), the EU has the legal basis and the obligation to protect human health and combat major cross-border health threats like TB. All that is needed is political will. We call on governments and the European institutions to take meaningful action against the scourge that is TB before it is too late.

This editorial is signed by the following health experts:

Prof. Dr. Giovanni Battista Migliori, secretary-general of the European Respiratory Society & director of the WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy.

Prof. Dr. Christina Gratziou, professor of Pulmonary Medicine, Medical School, Athens University & chair of Advocacy Council, European Respiratory Society.

Prof. Dr. Ivan Solovič, president of the International Union Against Tuberculosis and Lung Disease European Region & chair of the Working Group on TB Advocacy, European Respiratory Society.

Prof. Dr. Fernando Maria de Benedictis, head of the Italian Paediatric Society, Section Marche.

Dr. Stefano Aliberti, Head of Respiratory Infections Assembly, European Respiratory Society.

Prof. Dr. Tom Schaberg, executive committee member of the Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose & scietific board member of the German Respiratory Society.

Prof. Dr. Delia Goletti, head of unit at the National Institute for Infectious Diseases (INMI) ‘Lazzaro Spallanzani’.

Prof. Dr. Raquel Bessa de Melo, assistant coordinator of National TB Programme, Directorate-General for Health, Portugal & coordinator of the National Reference Centre for Multi-drug Resistant TB, Portugal.

Prof. Dr. Ibrahim Abubakar, professor at University College London.

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