In Europe, tuberculosis (TB) is often considered a disease of the past, what people used to call 'consumption.' But in reality, TB remains with and among us. One third of the world's population is infected with Mycobacterium tuberculosis, the bacterium that causes TB, and one tenth of these people will become sick from the illness during their lifetime. In Europe there are over 1,000 new TB patients every day. Despite major progress in cutting TB-related deaths in the last two decades, TB remains the second-largest infectious disease killer, after HIV/AIDS. 44,000 people in the European Region died of TB in 2011.
The disease often places an unbearable strain on those infected and their families. Effective treatment takes from 6 months to 2 years, and can have severe side effects. Beyond the physical burden, people face financial burden and emotional set back - they are unable to work, isolated from their social network and often face discrimination and stigma.
Today we are confronted with forms of TB that do not respond to conventional treatment, but can still be passed from person to person through breathing the same air. The multi drug- and extensively- drug resistant (M/XDR) TB are becoming more widespread across the European Region, particularly in eastern countries. As we travel increasingly for business, pleasure, pilgrimages, large-scale events and migrate across borders, TB has the potential to move with us more quickly. Currently almost 80,000 people become sick from the resistant forms of the disease every year.
WHO is raising the alarm about MDR and XDR-TB. We can no longer afford to be complacent and must take effective steps to screen and treat people with these new forms of the disease, to stop them spreading further. Global investment in fighting these forms of TB must focus on Europe, as over half of the countries in the world with the highest rates of MDR/XDR-TB are here. One billion dollars is needed annually to screen and treat people with MDR and XDR-TB in Europe.
In 2011, European governments acknowledged the threat, endorsing a 5-year plan developed by WHO's Office for Europe, to diagnose 85% of MDR/XDR-TB cases, and successfully treat 75% of them by 2015. It is an ambitious plan, but desperately needed, covering upgrading diagnostic techniques, making new medicines and treatment programs available, and opening access to treatment to everyone. This would save an estimated 120,000 lives which translate into 5 billion dollars. In the future, this gain can become ten times as much.
Yet the goal still remains far off. Only one in three people with MDR/XDR-TB are currently being diagnosed, according to estimates, and half of patients are treated successfully. The projected funding gap - over 60% - is considerable.
The Global Fund can and is making a difference on TB and MDR-TB diagnosis and treatment. In some countries and settings supported by the Global Fund, 78% of MDR/XDR-TB patients are successfully treated, compared to 20% in other settings. This shows that we need to mobilize substantial funding from international donors as well as from national resources to reach our goals. We need to invest in health systems that put the patient first, in the spirit of WHO's new European Policy Framework, Health 2020.
We strongly support the Big Push initiative. European leaders now have a unique opportunity to join international partners and renew their efforts to fight TB. Investing wisely and strategically is essential in the current economic climate. I call on European governments to make good on their commitment: provide funding now to avoid an epidemic that tomorrow will be hundreds of times more costly to tackle. Join the Big Push - TB in all its forms should have no place in our modern world.
References
1 Multidrug-resistant TB (MDR-TB) is a form of the disease that is resistant to at least two of the most potent anti-TB drugs. Extensively drug-resistant TB (XDR-TB) is resistant to both first- and second-line drugs, and is in effect almost untreatable.
2 The section of the Huffington post where this op-ed is going to appear is called The Big Push http://www.huffingtonpost.com/thebigpush