European Member States show new resolve in tackling multidrug-resistant TB
120 000 lives and $US 5 billion (and a further $US 7 billion) can be saved
London/Baku, 14 September 2011
This week, at the sixty-first session of the WHO Regional Committee for Europe, held in Baku, Azerbaijan, the 53 countries that make up the governing body for the WHO European Region are set to endorse an ambitious and rigorous action plan to combat multidrug- and extensively drug-resistant tuberculosis (M/XDR-TB).
“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.”
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 threefold between 2008 and 2009. The Region includes not only the 9 countries leading the world in rates of drug resistance among newly diagnosed patients (up to 40%) but also the 6 countries with the world’s highest rates of MDR/TB among previously treated TB patients (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.
The European action plan’s areas of intervention are aligned with and have the same aim as the Global Plan to Stop TB 2011–2015 and World Health Assembly resolution WHA62.15: universal access to diagnosis and treatment of M/XDR-TB. The European targets, to be achieved by the end of 2015, are:
- to decrease by 20% the proportion of MDR-TB cases among previously treated patients;
- to diagnose at least 85% of estimated MDR-TB cases; and
- to treat successfully at least 75% of patients notified as having MDR-TB.
Action plan will save lives
Implementation of the consolidated action plan would lead to the prevention of the emergence of 250 000 new MDR-TB patients and 13 000 XDR-TB patients, the diagnosis of an estimated 225 000 MDR-TB patients and successful treatment of at least 127 000 of them. This would interrupt the transmission of MDR-TB and save 120 000 lives and US$ 5 billion. This is calculated by taking into account direct savings by averting the loss of productive lives. There would be US$ 7 billion additional savings by averting future M/XDR-TB cases. Therefore the cost of not implementing the plan for the Region would be US$ 12 billion in total.
The Global Fund to Fight AIDS, Tuberculosis and Malaria has indicated that it strongly backs the action plan and is ready to provide financial support, where the affected countries step up their own financial commitment.
For further information, contact:
Viv Taylor Gee
WHO Regional Office for Europe
Tel.: +45 39 17 12 31, + 45 22 72 36 91 (mobile)
Special Representative of Regional Director to Prevent and Combat M/XDR-TB in WHO European Region
WHO Regional Office for Europe
Tel.: +45 39 17 13 96, + 9595154158 (mobile)