HealthManagement, Volume 11, Issue 2 / 2009

The Political Fight Against TB

Political pressure is growing on the European Union and national governments to increase resources in the fight against tuberculosis as new research reveals that 55 people are diagnosed with the disease every hour in Europe.

 

A cross-party group of members of the European Parliament has tabled a written declaration calling on the European Commission and Member States to take a leading role in coordinating the control of TB. They are looking for sufficient resources to be allocated from the EU’s multiannual research programme, its Innovative Medicines Initiative and the European Research Council to promote research into multi or extensively drug resistant TB (MDR/XDR). This would mean increasing existing EU spending on TB research from the current 20 million to 100 million.

 

The call for greater funding is being voiced even more strongly by Médecins Sans Frontières. Dr Tido von Schoen-Angerer, the director of MSF’s campaign for access to essential medicines, estimates that globally some 1.45 billion needs to be spent on TB research and development, of which the EU share should be over 400 million annually. “We desperately need new vaccines, drugs and diagnostics for TB. This will only happen with more research. Countries right on Europe’s doorstep – and even within the European Union – are struggling against resistant strains of the disease. But research budgets remain pitifully low. Tuberculosis is knocking loudly on the door, but the European Commission is playing deaf,” he said.

 

The MEPs are also advocating that illegal immigrants entering Europe and suffering from the disease should have proper access to, and possibility of completing, the necessary treatment, which for non-drug resistant cases can last as long as eight months.

 

The call for a higher political priority to be attached to tackling TB, especially the multidrug resistant kind, coincides with publication at the end of March by the World Health Organisation and the Stockholm-based European Centre for Disease Prevention and Control of their first joint Tuberculosis Surveillance Report on the scale of the disease. According to the new data, there were 477,327 TB cases in Europe in 2007 – the equivalent of 55 every hour. More worryingly, about 43,600 cases are suspected of being multidrug resistant.

 

The new data confirm that most European countries are continuing to experience a steady decrease in overall TB notification, but wide differences remain with just five new TB cases per 100,000 population in Iceland, but over 100 per 100,000 in Kazakhstan, Kyrgyzstan, Moldova and Romania.

 

Commenting on the findings, the ECDC’s Director, Zsuzsanna Jakab, said: “Although the overall number of TB cases being reported in the European Union has declined slightly, the proportion of MDR-TB being found is cause for concern. More attention needs to be paid to ensure early diagnosis and treatment, as well as equity of access to treatment for vulnerable populations.”

 

Dr Nata Menabde, WHO’s deputy regional director for Europe, reminded the 53 WHO European member states of their commitment in Berlin two years ago to provide more political support and resources to control TB. “Health systems face serious challenges in responding to TB and achieving Millennium Development Goal 6: to have halted and begun to reverse the incidence of TB by 2015. We have to make significant efforts if this Goal is to be met,” she said.

 

It is not just governments and international and non-governmental organisations that are active in the fight against TB. Private companies are also lending their support. In 2003, the American pharmaceutical manufacturer, Eli Lilly created the Lilly MDR-TB Partnership. The public-private initiative has 18 partners, ranging from the International Hospital Federation to the World Economic Forum. It provides access to medicines, transfers manufacturing technology of Eli Lilly’s two antibiotics for MDR-TB (capreomycin and cycloserine) to the developing world, trains healthcare workers, raises awareness and promotes prevention and research. While present in over 60 countries, the Partnership is particularly active in India, South Africa, China and Russia, which have particularly high incidences of TB.

 

The European Commission is also looking to boost efforts to tackle TB. At the end of June, it will jointly organise a meeting in Luxembourg with the WHO and the ECDC gathering together health ministries, national TB managers and civil society to consider new ways to combat the disease.

 

Following publication last year of the Framework Action Plan to fight Tuberculosis in the EU, the Commission is helping to build new partnerships between European scientists, industrial partners and researchers from endemic countries. One example is the European and Developing Countries Clinical Trials Partnership which helps test new drugs and vaccines for poverty related and other neglected diseases. 

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