Europe misses every fifth case of tuberculosis amid rising drug resistance

One in every five cases of tuberculosis in Europe remains undiagnosed. Against this backdrop, drug resistance levels continue to rise, warn the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC) in a new joint report, Euronews reports.

Although the total number of cases is decreasing, tuberculosis remains a serious public health issue in Europe. Unfortunately, progress toward its elimination remains insufficient.

Tuberculosis is the leading cause of death from a single infectious agent globally. The disease is transmitted through the air when an infected person releases bacteria into the air by coughing. Symptoms vary depending on the affected part of the body. The most common include a persistent cough lasting over two weeks, fever, night sweats, and weight loss.

The incidence of the disease in the WHO European Region, which covers 53 countries in Europe and Central Asia, has decreased by 39% since 2015, and mortality by 49%. However, both indicators remain below the targets of the WHO End TB Strategy for 2025, which envision a 50% and 75% decline, respectively.

In the European Union, cases have decreased by 33%. The decline in deaths is 17%, which is also insufficient to achieve the 2030 targets. “This leads to thousands of new infections and deaths that could have been prevented,” the health agencies state.

In 2024, over 160,000 new cases of tuberculosis were registered in the region. However, their actual number is estimated at around 204,000. This means that only 79% of cases were officially reported.

According to the WHO Regional Director for Europe, Hans Kluge, undiagnosed cases represent not only a failure in detection but also a missed opportunity for early treatment and containment of the spread. “By investing in rapid diagnostics, shorter all-oral therapies, and better monitoring, countries can reach more people in time, improve outcomes, and return to achieving the goals,” he emphasized.

Delayed diagnosis not only complicates treatment but also increases the risk of transmitting the infection.

Drug-resistant tuberculosis continues to be a serious challenge in Europe. The proportion of multi-drug-resistant forms reaches 23% in new cases and 51% in previously treated patients—significantly above the global averages of 3.2% and 16%, respectively.

Standard treatment for drug-susceptible tuberculosis involves a six-month course with four primary medications and has a success rate of over 85%. For resistant forms, therapy is longer, more complex, and has a lower success rate.

In most European countries, incidence is low, but tuberculosis primarily affects vulnerable groups such as migrants, incarcerated individuals, and people with HIV co-infection.

According to Ralf Otto-Knapp, an expert from the German Central Committee against Tuberculosis, lower levels in Western Europe divert attention from the disease and complicate the fight against new cases of multi-drug-resistant tuberculosis.
“We must be prepared by strengthening treatment and prevention, ensuring access to new medicines, and enhancing cross-border cooperation,” he emphasized.