14 September 2011 - London - With multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant TB (XDR-TB) spreading at an alarming rate across the European continent, the World Health Organization's Regional Office for Europe has crafted an ambitious plan to arrest the pandemic in its tracks.
The Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-resistant Tuberculosis in the WHO European Region 2011 - 2015 sets out to prevent 263 000 cases of MDR-TB and XDR-TB and 120 000 deaths from the two conditions.
"This action plan breaks new ground," said Zsuzsanna Jakab, WHO Regional Director for Europe. "TB is an old disease that never went away, and now it is evolving with a vengeance. We have to find new weapons to fight it. We know what works - the action plan is built on the evidence. WHO/Europe and its partners will provide technical support to our Member States as they commit themselves to implementation."
The need is urgent: Fifteen of the 27 countries with the highest burden of MDR-TB are in the eastern portion of the European continent. More than 80 000 MDR-TB cases occur in the region each year - which is one-fifth of the world's total. Precise figures for XDR-TB are not available because most countries in the region other than those in Western Europe lack the facilities to diagnose it; but officially reported cases of XDR-TB increased six-fold in the region between 2008 and 2009.
In Western Europe TB is widely perceived as a problem of the past, but the disease remains active, mainly in cities. London has the highest overall TB rate of any capital city in Western Europe, with 3500 cases annually. London has seen a 30% increase in TB cases over the past decade and a doubling of MDR-TB between 2005 and 2009.
Although countries in Eastern Europe and Central Asia are hardest hit by drug-resistant TB, they are treating MDR-TB with greater success than their neighbours in Western Europe. The treatment success rate in Eastern Europe and Central Asia is an estimated 65%. In Western Europe, treatment success rates vary widely by country, but just 32% of MDR-TB patients are successfully treated overall.
"People everywhere across the European region should take this plan, and the need to fully implement it, very seriously. We will share great risks and great responsibilities if we fail," said Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership. "To be successful we will need engagement of all needed partners, including and especially civil society, as the plan stresses."
If the plan is fully implemented, 127 000 people will be successfully treated for drug-resistant TB and 120 000 deaths will be averted. The plan will cost an estimated US$ 5 billion, but this cost will be recouped, since 250 000 MDR-TB and 13 000 XDR-TB cases will be prevented, resulting in a savings of $US 7 billion. Prevention of premature deaths among patients with drug-resistant TB, with consequential increased productivity for the region, will generate an additional US$ 5 billion.
The Global Fund to Fight AIDS, Tuberculosis and Malaria has said it backs the action plan and is ready to provide financial support in affected countries that step up their own financial commitments on MDR-TB.
The London press event was generously hosted by Kempinski Hotels, a close partner of the Stop TB Partnership.
"The action plan shows a fantastic collaboration between WHO/European Region Office and its partners in the region," said Dr Ditiu. "In addition, the events in London are a great example of the Stop TB Partnership working with WHO regional offices and the private sector - in this case Kempinski Hotels - to press for action to stop TB in its tracks."