Important note: Information in this article was accurate in 2007. The state of the art may have changed since the publication date.
International Federation of Red Cross and Red Crescent Societies - March 22, 2007
The World Health Organization (WHO) Regional Office for Europe and the International Federation of Red Cross and Red Crescent Societies are calling upon governments in Eastern Europe1 to accelerate reforms in their TB control practices, including countries in the European Union. The reforms are needed to save thousands of TB patients from preventable deaths each year and to halt the dangerous spread of virulent drug-resistant TB strains across the region. The call supports key findings in the WHO Global TB Control Report for 2007, which will be presented this afternoon in a scientific seminar at the European Parliament in Brussels and other public events across Europe to mark World TB Day.
At the global level, the WHO report confirms impressive progress has been made in recent years to curb the TB pandemic and that benchmark targets set for 2005 were nearly achieved. But the European region2 fell far short of these targets, with the lowest detection rate of infectious TB cases under the internationally recommended Stop TB Strategy, and the highest level of treatment failures.
As a consequence, fully 15% of all new TB cases in the Baltic States, Eastern Europe and Central Asia are now multidrug-resistant tuberculosis (MDR-TB), a rate that is three times higher than any other region in the world. "Drug resistance is the clear indicator we have of poor TB control," said Dr Marc Danzon, WHO Regional Director for Europe. "If the health systems are not strong enough and if our Member States do not make a greater commitment to reforming their control practices in line with international standards, progress against TB will be limited and the disease will continue to pose a serious threat to European citizens."
1 Armenia, Azerbaijan, Belarus, Bulgaria, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, the Republic of Moldova, Romania, the Russian Federation, Tajikistan, Turkey, Turkmenistan, Ukraine, and Uzbekistan.
2 The Member States of the WHO European Region are: Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Luxembourg, Malta, Monaco, the Netherlands, Norway, Poland, Portugal, the Republic of Moldova, Romania, the Russian Federation, San Marino, Serbia and Montenegro, Slovakia, Slovenia, Spain, Sweden, Switzerland, Tajikistan, The former Yugoslav Republic of Macedonia, Turkey, Turkmenistan, Ukraine, the United Kingdom and Uzbekistan.
According to the WHO report there were 445,000 cases of TB and 66,000 TB deaths in the whole European region in 2005, the latest year for which data are available. Of these cases, nearly three quarters occurred in six countries: Kazakhstan, Romania, the Russian Federation, Turkey, Ukraine and Uzbekistan. There were 14,000 new TB cases among HIV-positive adults, who are especially vulnerable because of weakened immune systems, and 70,000 new cases of MDR-TB.
Federation Secretary-General Markku Niskala said that civil society and community-based organizations could help ministries of health strengthen TB control services, pointing to the positive experience of the Russian Federation.
"For the past several years, Russian Red Cross volunteers have supported thousands of TB outpatients in priority regions of Russia through the course of their six to eight months of treatment," he said. "Their support has greatly improved treatment compliance by TB patients, which has increased cure rates, saved lives and prevented the development of drug resistance. These combined benefits are so convincing that local authorities are now co-financing the Red Cross activities."
To move TB forward on European policy agendas, the WHO Regional Office for Europe in collaboration with partners is organizing a Ministerial Forum on TB on 22 October 2007, which will be hosted by the German Ministry of Health in Berlin. The Forum will be a high-level dialogue among stakeholders in health, development and research, and is expected to produce a declaration outlining political and financial commitment and concrete actions to strengthen TB control and research.
The Forum will take place one year after WHO and the Federation established the Stop TB Partnership for Europe, an alliance of 30 leading European agencies and NGOs aimed at forging a more effective response to the TB epidemic in Europe. The regional alliance operates under the umbrella of the global Stop TB Partnership and promotes full funding and implementation of its Global Plan to Stop TB 2006-2105.
More information on TB, MDR and XDR TB, as well as DOTS and New Stop TB Strategy in our fact sheets on http://www.euro.who.int/Document/TUB/TB_fact_sheet.pdf and http://www.euro.who.int/Document/TUB/XDR_TB_fact_sheet.pdf
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