A joint report between the WHO Regional Office for Europe and the European Centre for Disease Prevention and Control released on World Tuberculosis Day (24 March) shows that without urgent action the WHO European Region is on course to miss Sustainable Development Goal 3 Target 3.3, which lists tuberculosis (TB) among diseases to be eradicated by 2030.
The report Tuberculosis surveillance and monitoring in Europe has monitored rates of TB since 2008, showing a significant drop in cases since 2010 – from 460 232 cases to 269 859 – across the WHO European Region.
This year, under the theme “It’s Time”, WHO is highlighting the need to accelerate the TB response in order to save lives and end suffering, building on high-level commitments by heads of state at the 2018 United Nations High-Level Meeting on TB.
Nurses on the front line
2020 is the International Year of the Nurse and the Midwife. “Nurses play an essential part in detecting people with TB, and in the treatment and care of those with the disease,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. Nurses work in households, promoting health and well-being, and contribute to identifying infected individuals. They support patients throughout their recovery, providing encouragement and reassurance when treatment becomes challenging, and alert physicians if serious side effects arise.
“Because of the active role that nurses play in designing people-centred services, providing health education and community engagement, TB rates in our Region are declining fast. On the occasion of the Year of the Nurse and the Midwife, I extend my warmest thanks to the nursing profession for the progress we have made to end TB. Nurses are on the front line in the fight against our old enemy, TB, and their experience, expertise and dedication are essential to our efforts to fight the new enemy, COVID-19,” he concluded.
Gaps in diagnosis and missed treatment
TB is a contagious bacterial disease usually spread by coughing and sneezing. Early diagnosis of TB is therefore vital to preventing further transmission. However, while there has been an increase in diagnosis coverage from 45% to 66%, without 100% coverage eradication of TB becomes nearly impossible.
Furthermore, a new regimen composition for treatment of drug-resistant TB can be shorter than ever before and no longer require injections. This makes treatment effective, easier and more comfortable for patients. The WHO European Region is leading the way with 40 000 in treatment, but many continue to slip through the net.
One example of this is Latent Tuberculosis Infection (LTBI), a condition that affects many children. Those with LTBI may feel healthy and well – which means they do not access treatment – but may become ill later in life. Finding and treating those with LTBI is one of the key recommendations from WHO to end TB. This includes providing treatment for children under five years of age who have had close contact with a TB patient – 12 countries in the WHO European Region have adopted this approach but only two countries meet the 100% coverage target.
Further recommendations include contact investigation, whereby everyone in close contact with a TB patient is contacted and tested for the disease. This is vital to quickly diagnosing and applying preventive treatment for people at high risk. However, only 11 countries in the WHO European Region meet the 100% target for contact investigation.