Berlin, Copenhagen, 22 October 2007

Today in Berlin, over 300 delegates at the WHO European Ministerial Forum “All against Tuberculosis” have adopted the Berlin Declaration on Tuberculosis, which describes the disease as “an increasing threat to health security in the WHO European Region”. The Declaration calls for urgent action to halt and reverse the high levels of tuberculosis (TB), including its man-made multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains. In the Declaration, Member States and international partners commit themselves to providing more political support and resources to control and eventually eliminate the disease.

The Forum, which sought to place TB control higher on public health agendas, attracted health ministers and high-level decision-makers from 49 of the 53 Member States in the WHO European Region, along with representatives from other United Nations bodies, intergovernmental agencies and nongovernmental organizations (NGOs). The agenda of the Forum addressed current challenges facing health systems in responding to TB and achieving Target 8 of Millennium Development Goal (MDG) 6: to have halted and begun to reverse the incidence of TB by 2015.

At present, the European Region is the only WHO region other than Africa where TB rates are declining too slowly to reach Target 8. The Declaration sets out several directions to speed up action, mainly relating to each country’s responsibility to strengthen political will, public health and social services systems, human resource capacity, TB surveillance and monitoring and intersectoral collaboration, and to the need for a Region-wide approach to control the disease, which respects no borders. Allocating more funding from appropriate multilateral mechanisms at the global and European levels is also important.

While recognizing previous achievements, the Declaration calls for more action in specific areas. Some actions, such as investing in and strengthening health systems for better TB control, form part of a Region-wide commitment for the first time. Others are well known: applying the high-quality directly observed treatment, short-course (DOTS) strategy launched by WHO in 1995; addressing MDR-, XDR- and HIV-related TB, removing stigma and promoting research into new diagnostic methods and tools, drugs and vaccines.

A mechanism involving the European Union, other organizations, civil society, communities and private sector will be put in place to ensure that the Declaration is implemented efficiently and promptly. Progress will be assessed at the regional level every second year, starting in 2009.

The process of developing the Declaration took over a year. The WHO Regional Office for Europe consulted countries and partners in devising and revising drafts. The consultation in The Hague, Netherlands on 6 July 2007 was organized in collaboration with KNCV Tuberculosis Foundation.

Speaking about the Declaration, Dr Marc Danzon, WHO Regional Director for Europe, said: “Will this Declaration make a difference to the more than 445 000 TB patients in the WHO European Region? It will if governments carry out the decisions made in Berlin. And we in WHO are committed to helping with programmes that target areas where we have something substantial to contribute and where we can make a difference. The good news is that many of the challenges that have been pointed out in Berlin can be tackled with good political will and commitment. The reason we called this Forum was to draw attention to TB problems that health systems in our Member States have to face so that governments can do something about them.”

Dr Jorge Sampaio, the United Nations Secretary-General’s Special Envoy to Stop TB and former President of Portugal, added: “European ministers are today demonstrating their commitment to fighting TB through their participation in this forum. This event is an important step towards greater international partnership and coordination.”

On behalf of the host country, Federal Minister of Health of Germany, Ulla Schmidt stressed: “The successful fight against TB is always rooted on two levels: medical progress and support by public health policy; one is unthinkable without the other. Germany has already bundled TB-related activities for World TB Day this year in March, and run a TB symposium. Today’s Ministerial Forum in Berlin gives the political signal for an enhanced fight against TB.”

More from the Declaration

The Declaration spotlights the scale of the TB challenge in the WHO European Region.

• In 2005, there were 445 000 new cases of TB and 66 000 TB-related deaths in the Region.
• Of the 53 countries in the Region, 18 have a high TB burden and thus are of high priority for TB control: Armenia, Azerbaijan, Belarus, Bulgaria, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, the Republic of Moldova, Romania, the Russian Federation, Tajikistan, Turkey, Turkmenistan, Ukraine and Uzbekistan. The disease is not confined to one part of the Region, however: "even in some countries with a relatively low burden, there has been a reversal of the previous decline".
• TB rates are soaring among groups at high risk, such as migrant populations, homeless people, prisoners and other socially vulnerable groups in countries across the Region.
• Although TB strains are changing, no new diagnostic methods and tools, drugs or vaccines have been developed over the past several decades.
• Many countries in the Region face a shortage of human resources for TB control.
• TB is the most prevalent cause of illness and death in people living with HIV/AIDS in the Region, and few countries address TB/HIV coinfection in a comprehensive way.

Civil-society satellite event

On 21 October 2007, the Open Society Institute organized a civil-society meeting, which brought together representatives of communities particularly affected by TB and health professionals that work with them. The meeting focused on mobilizing a broad network of NGOs to accelerate progress, strengthen advocacy and increase funding against TB in Europe. The participants prepared an offer of partnership that was presented today to the participants in the WHO European Ministerial Forum.

Ms Sandra Elisabeth Roelofs – First Lady of Georgia, Chairperson of the Country Coordinating Mechanism in Georgia for the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Stop TB Ambassador – welcomed civil society’s efforts: “We’ll start making progress in fighting TB from the moment we realize that we have to go beyond medical care by investing time and energy in providing social and community services for each individual patient.”

For further information, contact:

TECHNICAL INFORMATION:

Dr Risards Zaleskis
Regional Adviser, Tuberculosis Control
WHO Regional Office for Europe
Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark
Tel.: +45 39 17 13 35. Fax: +45 39 17 18 18
E-mail: RZA@euro.who.int

Dr Lucica Ditiu
Medical Officer, Tuberculosis Control
WHO Regional Office for Europe
Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark
Tel.: +45 39 17 13 78. Fax: +45 39 17 18 18
E-mail: DLU@euro.who.int 

PRESS INFORMATION:

Ms Liuba Negru
Press and Media Relations Officer
WHO Regional Office for Europe
Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark
Tel.: +45 39 17 13 44. Fax: +45 39 17 18 80
E-mail: LNE@euro.who.int