Realisation that TB is re-emerging as a major public health issue has grown over the year. Publication of the World Health Organisations (WHO) Global Tuberculosis Control report in April alongside a report detailing TB incidence across the WHO Europe region highlighted the growth of TB. These reports were launched on World TB day on March 24th 2007 which had the theme of “TB anywhere is TB everywhere”. The day saw many events across the world including an event in the European Parliament launching both reports. In April the European Parliament Development Committee had an address on TB detailing the extent of the public health problem the disease presents globally by the United Nations Special Envoy on TB.
But for the European region the key development was a ministerial forum in Berlin on 22 October 2007 which saw the adoption of a Declaration strengthening commitments to combat TB. The WHO notes that detection rates of TB by the simple and inexpensive method of sputum microscopy is the lowest rate of any region in the world. The average rate of treatment success is 74%, the same as that reported from the African Region with its high prevalence of HIV infection. Europe thus leads the world in promoting multi-drug resistant TB (MDR-TB) prevalence and incidence. Hopefully, the political will necessary to turnaround this situation, highlighted as necessary in the Declaration, will continue to be evident in 2008 across the region.
At an EU level the European Commissioner for Health, Markos Kyprianou has requested the European Centre for Disease Prevention and Control (ECDC) to elaborate an action plan to fight TB for the EU. The ECDC has prepared a draft of this action plan and circulated it to stakeholders for comments at the end of 2007. The goal is to get the Action Plan adopted at the start of 2008.
What all of these actions lack thus far, however, is the policy engagement to implement the measures needed to reverse the increasing public health problem of TB in Europe. An example of the low profile TB actions receive is found in the EU Health Strategy "Together for Health" 2008-2013.. TB receives scant attention in the strategy, and there is not even a mention included for the Action Plan that the ECDC was mandated to develop for the Commission. 2008 will therefore mark a key year for the fight of TB in Europe. The theme of World TB day in 2008 will be “I’m stopping TB”. Making this statement a reality for EU policy makers will mean translating the fine words of the Ministerial Declaration into significant action to address the key determinants of TB such as poverty, social exclusion and weak public health systems.
