Europe recorded a 23% drop in new or relapsed tuberculosis (TB) cases in 2021 compared to 2019, but is still a long way from the UN Sustainable Development Goals of reducing incidence by 80% and deaths by 90% by 2030.
In 2021, TB mortality in the WHO European Region increased compared to 2020, and the declining incidence curve has stalled for the first time in 20 years.
The figures, together with a sober warning, were published in a joint report issued on Friday on World Tuberculosis Day 2023 by he European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe (WHO/Europe).
World TB Day is observed annually on 24 March to raise awareness about TB and efforts to end the global epidemic, marking the day in 1882 when the bacterium causing TB was discovered by the German physician and microbiologist Dr. Robert Koch.
The theme of World TB Day 2023 was 'Yes! We can end TB!' and aimed at ramping up progress ahead of the UN General Assembly High-Level Meeting on TB on 22 September 2023.
TB is an infectious disease and typically affects the lungs (pulmonary TB) but can also affect other sites (extrapulmonary TB). The disease is spread when people who are sick with pulmonary TB expel bacteria into the air, for example by coughing. Keeping a distance and using face masks, as during the COVID-19 pandemic, could prevent transmission.
“In 2021, the raging COVID-19 pandemic continued to heavily affect our Member States," commented ECDC Director, Andrea Ammon. “TB resources were diverted, and patients experienced difficulties in accessing clinical services, possibly resulting in delayed diagnosis and treatment of some TB cases.”
“Therefore, we need to increase the number of people diagnosed and successfully treated. ECDC remains committed to partnering with and supporting EU/EEA countries in their efforts to end the TB epidemic.”
The latest ECDC/WHO report on TB surveillance and monitoring shows that, despite an overall downward trend in the incidence of TB in the WHO European Region, the current rate of decline will not be sufficient to meet targets under the UN Sustainable Development Goals for ending the TB epidemic by 2030.
Taking stock of the situation, the two health agencies said at a virtual press conference on Friday that the figures indicate that the progress made before the COVID-19 pandemic had stalled or even reversed but admitted that the statistics should be interpreted with caution. Figures for 2022 are still being validated by the member countries and not available yet.
Furthermore, the situation is complex with significant differences between Western European and Eastern European countries.
Despite the worrying figures, the ECDC director told The Brussels Times that there is still a chance to reverse the trend and get back on track. However, 2023 will be a critical year. On the positive side, the development of new 6-month long treatment systems with higher success rates could be a game changer.
In 2021, some 230,000 people contracted the disease in the 53 countries that make up the WHO/Europe region. The area, which is home to about 900 million people, registered 27,300 deaths in 2021 compared to 27,000 in 2020. Despite this slight increase (+1.1%), “Europe is on the right track,” says Stela Bivol, a specialist at WHO/Europe.
The decline in the incidence of TB has been slowed in particular by the war in the Ukraine and the Covid-19 crisis. Indeed, “the pandemic has severely impacted health systems,” says ECDC spokesperson Marieke van der Werf. Resources for detecting TB were diverted to detecting the novel Coronavirus, resulting in “delayed diagnosis and treatment of TB,” she explains.
WHO/Europe region still has nine of the 30 countries with the highest burden of multidrug-resistant TB in the world, but incidence remains below 10 cases per 100,000 inhabitants in 24 of the region's 53 countries, ECDC figures show.
In Belgium, the rate is eight cases per 100,000 inhabitants, and 87 new cases of TB or relapses were reported there in 2021, according to figures published on the ECDC website.
Update: The article has been updated to include information from the joint ECDC/WHO Europe press conference on World TB Day on 24 March.