WHO : Drug-resistant TB in Europe

Media release from WHO's Europe division :

" Drug-resistant TB in Europe

MDR-TB is spreading at an alarming rate in the WHO European Region. In countries outside western Europe, diagnostic and susceptibility-test services are extremely limited and so cannot reflect the whole picture, but officially reported numbers of XDR-TB cases nevertheless increased more than sixfold between 2008 and 2009. The Region includes not only the 9 countries leading the world in rates of drug resistance among newly diagnosed patients (40%) but also the 6 countries with the world’s highest rates of MDR/TB among TB patients currently in treatment (up to 70%).

TB also affects western Europe. For example, London, United Kingdom has the highest TB rate of any capital city in western Europe: nearly 3500 cases annually, an increase of about 30% in the last 10 years. MDR-TB in London doubled between 2005 and 2009, and now represents nearly 2% of all cases.

Treating MDR-TB patients takes up to two years, using second-line drugs and/or surgery. Because some patients’ circumstances do not facilitate treatment, the success rate for MDR-TB patients in some western European countries is under half that of countries in eastern Europe and central Asia. In western Europe, treatment fails in 23% of patients; 26% are lost in follow-up; 19% die, and only 32% are successfully treated. In contrast, the success rate in eastern Europe and central Asia is estimated to be 65%.

The new action plan

“The new consolidated action plan has been developed with unprecedented consultation, including with patients and communities suffering from the disease,” said Hans Kluge, the Regional Director’s special representative on M/XDR-TB at WHO/Europe. “This problem is a man-made phenomenon resulting from inadequate treatment or poor airborne infection control and we need wide involvement to tackle the damage that humankind has done.”

The plan takes account of new diagnostic techniques, patient-centred models of care and services tailored to particular populations. It includes budgets, targets and timelines; six strategic directions, such as collaboration on more effective drugs, vaccines and testing; and seven areas of intervention, such as improving access to testing and treatment. Countries will commit to making national TB action plans, dedicating facilities, improving public awareness using the Internet and liaison with civil society, and working across sectors, for example, with services for people with HIV."