With the release of its latest briefing “Multi-drug resistant tuberculosis (MDR-TB): A European cross-border health threat requiring a regional response”, the TB Europe Coalition calls the European Union (EU) institutions to take an increased role in the fight against MDR-TB in the European Region. While TB rates have been steadily decreasing in Europe, multi-drug resistant TB remains a major public health concern in several countries in the region, including in the European Union.

According to the WHO 2013 report, the European Region bears a quarter of the global MDR-TB burden, with 74,000 cases estimated in 2012.Eastern Europe and Central Asia (EECA) have the world’s highest rates of new TB patients with MDR-TB, with 20% of new cases having MDR-TB. Consequently, 15 of the 27 MDR-TB high-burden countries worldwide are located in the European region and five of these are EU Member States:Romania,Bulgaria,Estonia,Lithuania andLatvia.

TB not only causes devastating loss of life and immeasurable suffering but also bears a catastrophic cost for the people affected and their families. The cost of treating MDR-TB cases in the 18 wealthier EU countries is estimated at €54,779 per case, seven times more than treating standard TB. Summing direct and indirect costs of TB, a recent study[1] calculated that TB costs €5.9 billion per year to the European Union.

Currently, countries are handling the epidemic on their own with very mixed results and huge disparities in terms of success rates. Furthermore, the phasing out of international donors and the lack of domestic funding for TB programmes in many countries of the region poses an increased risk of the MDR-TB epidemic spreading throughout the European Union on an even greater scale.

The TB Europe Coalition believes that the magnitude, cost and consequences of the MDR-TB epidemic in Europe require a regional response. In this sense, the EU institutions are best placed to provide the necessary political leadership and cross-border coordination to fight this killer disease. We believe that the EU institutions should:

> Recognise MDR-TB as a cross-border health threat and fully exploit the competences given by the Treaty on the Functioning of the EU to coordinate member states’ interventions against MDR-TB and make the regional response to this dangerous epidemic more efficient.

> Organise a European summit on domestic financing for TB and HIV, under the leadership of the European Commission, involving Ministers of Health and Finance, international donors and organisations involved in the fight against TB/HIV in the continent.

> Create and lead a regional high-level political task force on MDR-TB with high-burden countries of the WHO European region to strategize on common actions and generate political will to prevent further spread from the disease.


For more information, please read our briefing here.

[1] Costs of tuberculosis disease in the EU – a systematic analysis and cost calculation, Roland Diel, J Vandeputte, G de Vries, J Stillo, M Wanlin and A Nienhaus, European Respiratory Journal, 15 August 2013.

Picture of a sanatorium in Romania. Credits to Jonathan Stillo.