Despite important progress achieved in the response to the tuberculosis (TB) epidemic in the WHO European Region over the past decade, including the ongoing decline in incidence and mortality, TB and its drug-resistant forms still pose serious public health challenges, particularly in the eastern European part of the Region.
In 2018, nearly 270 000 TB patients were reported across the Region, of which more than 80% were notified from countries in the eastern part . Overall, a 19% decrease was observed in the notification rate of incident (new and relapsed) TB cases during the period 2014–2018, from 30.3 to 24.5 cases per 100 000 population, significantly influenced by a decrease in notification rates in the eastern part of the Region.
TB/HIV co-infection is common with an estimated 12% of incident TB cases being co-infected with HIV across the WHO European Region in 2018 .
Eastern Europe is particularly challenged by a very high burden of multidrug-resistant (MDR) TB and is home to nine of the 30 countries globally with the highest RR/MDR TB burden. Prevalence of MDR TB among new and previously-treated pulmonary TB cases was 18% and 49%, respectively, in 2018. There has been an increasing trend in extensively-drug-resistant TB (XDR TB), with 19% of pulmonary MDR TB cases having XDR TB in 2018 .
The treatment success rates for incident cases, MDR TB patients and TB/HIV co-infected patients remain below regional and global targets, standing at 77%, 57% and 51%, respectively, in 2018. In terms of mortality, there were an estimated 23 000 TB deaths among HIV-negative TB patients in 2018, with considerable variation across the Region and over 80% of TB deaths occurring in eastern Europe .
Research and innovation are needed to continuously improve the design, implementation and scale-up of new and existing tools and interventions, tailored to the local context and supporting the involvement of civil society.
1. European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2020 – 2018 data. Stockholm: ECDC; 2019.