Tuberculosis has come back in a new, more
deadly form to pose the disease's greatest
threat to Europe since World War II, world
health officials said.
Drug-resistant strains of the disease are
lurking just beyond the
European Union's borders, in countries
where AIDS blossomed
following the collapse of the Soviet Union,
according to U.N. and Red Cross health officials.
"The drug resistance that we are seeing now
is without doubt the most alarming TB situation
on the continent since World War II, and our
message to EU leaders is: Wake up. Do not
delay. Do not let this problem get further
out of hand," said Markuu Niskala, secretary-general
of the International Federation of Red Cross
and Red Crescent Societies.
The high levels of multi-drug resistant tuberculosis
in Baltic countries, Eastern Europe and Central
Asia, and the emergence of a new, extremely
drug-resistant strain of TB have led international
health officials to create the "Stop TB Partnership
in Europe" to fight the epidemic.
Tuberculosis, a respiratory illness spread
by coughing and sneezing, is the world's deadliest
infectious disease that is curable. The
World Health Organization estimates
that 1.7 million people died from TB in 2004.
Of the 20 countries in the world with the
highest rates of multi-drug resistant tuberculosis,
14 are in "the European region," according
to a recent global survey by the WHO and the
U.S. Centers for Disease Control and Prevention.
European countries also have the highest
rate of extreme drug-resistant tuberculosis
known as XDR-TB.
"TB has always been low on the European Union
agenda. It's a mystery there has been so little
concern in addressing the TB epidemic in Europe,"
said Michael Luhan, an official at the Geneva-based
Red Cross federation. "The purpose of this
partnership is to stimulate a much greater
sense of concern, engagement and commitment
on the part of the European Union to address
this problem in its own region."
Luhan said the bulk of technical support
in the European region and central Asia is
currently provided by the United States, which
is also a major financial contributor.
"In the last few years, there's been more
contribution from EU countries, but they still
are a fraction of those provided by countries
outside the region," he said.
In Europe, 50 people get sick with TB and
eight people die of the disease every hour,
said Pierpaolo de Colombani, a WHO tuberculosis
expert. About 15 percent of all TB cases in
Europe are multi-drug resistant.
But the incidence of TB varies widely from
West to East. For instance, Sweden has four
new cases per 100,000 people a year, compared
with 177 for Tajikistan.
The rate of incidence of TB in the Western
European countries that belonged to the EU
before it enlarged in 2004 is 13 cases per
100,000 people every year. That number doubles
in the 10 new EU members.
It doubles again to 53 in Romania and Bulgaria
and yet again to 98 in the former-Soviet republics
farther East.
But migration and EU expansion could change
things.
"Not a large number of cases are being imported
into the EU from Eastern Europe but it's not
necessarily going to stay that way with continued
enlargement," Luhan said.
He said TB cases in London have been increasing
every year for almost 10 years. In some London
areas with many immigrants, rates are as high
as 100 per 100,000.
Luhan said that TB had ceased for decades
to be a problem in the region, but that it
doubled over the past 10 years in the former
Soviet Bloc as public health systems collapsed.
If diagnosed at all, patients were treated
late, with little follow up to make sure they
completed their courses of medication, increasing
the drug-resistance of some TB strains.
Luhan said Europe ranks with Africa as areas
where TB is a big problem.
