Statement made by Ms Zsuzsanna Jakab to the European Parliament on World TB Day 2010

24 March 2010

Symposium: Innovate to eliminate tuberculosis
European Parliament

Delivered by Dr Risards Zaleskis, Medical Officer, Communicable Diseases

Distinguished participants,
Ladies and Gentlemen,

On the occasion of World TB Day, I would like to thank the organizers of this symposium who, under the patronage of Françoise Grossetête, MEP – and in collaboration with the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases – invited me to address this important meeting. The European Parliament’s continued interest is very important for the cause of tackling tuberculosis-related challenges, and my sincere apologies for not being with you this time, as in previous years – much as I would have liked to. However, I do hope that you will allow me to share with you some thoughts on this very important day.

World TB Day is held every year on 24 March to mark Robert Koch’s discovery of the tuberculosis (TB) bacilli and to build public awareness around this disease. 128 years on, TB still remains a serious public health problem both in the WHO European Region and globally. In the WHO European Region, there are 18 countries in which the situation is alarming (countries of the former Soviet Union, Bulgaria, Romania and Turkey) and despite some recent progress, these countries account for 88% of the TB burden in the entire Region.

As we can see in the latest Tuberculosis Surveillance in Europe report, published jointly by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe, the good news is that in the WHO European Region, as a whole, the increase in TB notification rates between 2004 and 2007 has stopped, and now there is a decrease of 2.6%. However, unfortunately, the bad news is that this Region has the lowest treatment success rate in the world compared to other WHO regions – only a little over 70% of new TB cases. Furthermore, even in the Member States of the European Union (EU) and the European Economic Area (EEA) – although the declining trend in TB incidence continues – the decrease between 2007 and 2008 was only 1.2%, the smallest decline during the past four years.

We also know that poor adherence to TB control practices is generating high levels of manmade multidrug and extensively drug-resistant TB (MDR- and XDR-TB) – putting an extensive additional burden on health systems. Among the 27 high-priority countries that collectively account for 85% of the estimated MDR-TB cases globally, 15 are unfortunately in our Region. Here, the rate of XDR-TB is one of the highest in the world. This grave situation was also highlighted at the ministerial meeting on drug-resistant TB, which I attended in Beijing in April 2009.

So why has the “innovate to accelerate action” motto been chosen for this year’s World TB Day? Because we are facing a 21st century disease, and unfortunately the diagnostic, prevention and treatment tools we are working with are extremely outdated – some of them are at least a hundred years old.

I strongly believe that we need to find new and better ways to fight TB so that we can rapidly and effectively control this disease. More resources will be needed to convert scientific discoveries into new and better drugs, diagnostics and vaccines. Also, we need to make TB services more accessible and efficient. In the WHO European Region, we plan to focus on TB-related research for policy and performance improvement and the development of new tools for TB control.

But in the meantime we have to support people with TB, and provide care to every individual and child, irrespective of where they live and what financial resources they have. We need to pay particular attention to vulnerable and poor communities. To improve access to TB diagnosis and treatment, the focus should be on the development of inter-sectoral collaboration, the strengthening of health systems, and in particular the integration of TB control into primary health care services. I am personally committed to these priorities – just like I was while I served as director of ECDC and while the European TB Action Plan was developed for EU countries, following the request of the EU Health Commissioner.

I believe we should endeavour to forge new, strong partnerships to reach the targets of the Global Plan to Stop TB.

The WHO Regional Office for Europe is working closely with our Member States, in partnership with the Global Fund, the European Commission, EU Institutions, United Nations agencies, nongovernmental organizations (NGOs) and other stakeholders to provide the necessary technical support for TB control, and to follow up on the Berlin Declaration endorsed at the WHO European Ministerial Forum in 2007.

As WHO Regional Director for Europe, I will ensure that WHO continues to make TB control a high priority in Europe and elsewhere. This is not only a matter of solidarity but also of “selfishness” in a globalized world! I have asked for the comprehensive Action Plan to tackle MDR-TB – developed in Beijing – to be urgently adapted to the needs of the European Region. With this and other actions, I hope we can reduce human suffering and the overall MDR-TB burden in this Region. We need to turn around the alarming current situation whereby more than 60% of the world’s highest MDR-TB countries are in our Region.

I am confident that with the help of all our partners – including those organizing this symposium, who can specifically help with new research, technologies and innovation – we will be able to achieve all our goals and targets on TB control and elimination.

Thank you for your attention.