Tuberculosis (TB) and multi-drug resistant (MDR) TB are making a comeback across Europe. Although TB is entirely preventable and curable, data from 33 countries show that 155,000 people still fall ill each year, of whom 10,000 will die. And that's in countries which have low infection rates.
The figures may not be dramatic but the trend is heading in the wrong direction. Part of the challenge of dealing with TB is that many Europeans think it's a disease from a bygone era. This has led to political complacency in many countries, with the assumption that TB is something that doesn't happen in the here and now.
"Although TB is entirely preventable and curable, data from 33 countries show that 155,000 people still fall ill each year, of whom 10,000 will die"
However, as more and more people move countries for work, this has enabled TB, an airborne disease, to continue to spread across communities and countries. Among the people most likely to be affected are the poor, homeless, migrants and members of ethnic minorities. In addition, drug users, prisoners and people with weak immune systems (for example, people living with HIV, smokers and diabetics) all have a much greater risk of getting it.
The financial crisis has not helped the situation, as cuts to government budgets and a scarcity of jobs means many of the most vulnerable people can't get the healthcare they need or have to quit TB treatment before it's finished if they need to relocate for work. This has led to a spike in MDR TB which is almost always linked to human error - such as poor diagnosis, being prescribed the wrong antibiotics, or patients failing to complete the full course.
In France, the number of multi-drug resistant TB cases has increased year on year since 2010 by an average of 21 cases per year. A similar example may be drawn upon from Belgium where there was a 42 per cent increase in the number of cases of MDR TB between 2007 and 2012. These instances illustrate the real need to tackle this strain of the disease, in particular.
"In France, the number of multi-drug resistant TB cases has increased year on year since 2010 by an average of 21 cases per year"
The only way to wipe out TB for good is for countries that have low rates to partner effectively and coherently with high-incidence countries.
A recent framework from the world health organisation (WHO) and the European respiratory society (ERS) outlines an initial 'pre-elimination' phase, which aims to have fewer than 10 new TB cases per million people per year by 2035 in the 33 countries classified as 'low burden', which includes many countries in Europe. The goal is to then achieve full elimination of TB by 2050, defined as less than one case per million people per year.
As the WHO and ERS note, it will hinge on all parties agreeing a joined-up approach based not only on funding but also effective screening, surveillance and treatment for active and latent TB infection in those most at risk of infection.
"The costs of inaction are massive. The more we delay the more difficult it will be to manage the TB comeback"
The WHO/ERS framework will build on approaches that are already proving successful in many countries. However, when it comes to fighting a disease which has no respect for borders, we need a collective European approach that acts as the first line of defence rather than the last resort.
MEPs must step up efforts to both raise awareness in the EU and press the commission to dedicate more resources and research to fighting TB. The costs of inaction are massive. The more we delay the more difficult it will be to manage the TB comeback.