Tackling TB in Europe : treatment gaps and deteriorating treatment availability is undermining progress

Abstract

The precipitous decline in TB incidence in Europe (European Union/European Economic Area) is an extraordinary success story, with a 52% cumulative decrease in TB incidence since 2012. The average annual decrease of 7.7% – compared to only 1.9% globally – is the fastest of all world regions (Figure 1). However, the declining TB rates are positively correlated with diminishing commercial incentives to supply treatments, which represents a blind spot for TB control. As countries advance towards elimination targets, absolute case numbers shrink, optimal treatment provision becomes harder and targets are more difficult to achieve. In recent years, the European Centres for Disease Control has warned that EU countries are ‘not on track to reach the goal of ending the TB epidemic by 2030’. Europe already struggles to prevent TB progression, treat TB in children and tackle disease resistance. At the United Nations (UN) High-Level Meeting (HLM) on TB, the donors will prioritise TB in high-burden settings. However, there are also challenges to meeting the targets to eliminate TB in low-incidence countries. Here we highlight these issues and suggest how the challenges could be overcome.