The 2024 monitoring report from the European Centre for Disease Prevention and Control indicates that, despite some progress, the EU/EEA countries (which include European Union nations and those in the European Economic Area) are not on track to achieve the Sustainable Development Goal (SDG) 3.3 targets related to HIV, tuberculosis (TB), viral hepatitis and sexually transmitted infections (STIs). This report, which is based on data from 2022 to 2023, evaluates progress across five key areas: incidence, prevention, testing, treatment and mortality. It notes a decline in certain trends but highlights significant deficiencies in others, worsened by data gaps and inequalities between countries.
Mixed Progress in Incidence Reduction
The incidence of new HIV and TB infections in the EU/EEA has decreased significantly over the last decade. HIV incidence fell by 35% from 2010 to 2023, while TB incidence declined by the same margin from 2015. These reductions, however, fall short of the 2025 targets of 75% and 50% reductions, respectively. The report identifies that a large portion of these reductions occurred before 2020, with more recent progress stagnating. Furthermore, the COVID-19 pandemic disrupted detection and reporting mechanisms, complicating trend assessments.
Reliable incidence data for chronic hepatitis B (HBV), hepatitis C (HCV) and STIs remain elusive. Despite the absence of incidence estimates, notification data suggest increasing numbers of acute hepatitis B, syphilis and gonorrhoea cases. Gonorrhoea in particular has seen a dramatic rise, making 2023 the year with the highest reported caseload since surveillance began. These trends indicate that while some gains have been made in HIV and TB, the region is off course in its broader aim to reduce new infections across the board.
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Prevention and Testing Gaps Persist
Preventive interventions, although expanding, are falling short of targets. The uptake of pre-exposure prophylaxis (PrEP) for HIV prevention grew modestly, with 160,000 users reported in 2023. However, this figure remains far below regional goals and a lack of data on the population in need hinders coverage assessments. Harm reduction programmes, such as needle and syringe distribution and opioid agonist therapy, show a patchy landscape. While fifteen countries met the needle distribution target, only five reached adequate opioid therapy coverage.
Testing outcomes present a similarly uneven picture. HIV diagnosis rates are close to the target, with 92% of people living with HIV aware of their status. TB testing exceeded expectations with a 94% case detection rate, suggesting effective diagnostic systems. However, hepatitis B and C testing rates lag significantly, and few countries provided sufficient data to evaluate progress. Testing coverage for STIs among key populations is unknown due to the absence of reporting, severely limiting oversight of prevention efforts.
Treatment Shortfalls and Mortality Concerns
Treatment outcomes illustrate significant divergence between diseases. HIV care approaches target the 95-95-95 framework—diagnosis, treatment and viral suppression. As of 2023, 93% of those diagnosed received antiretroviral therapy, and 93% achieved viral suppression. Despite this progress, about 21% of people living with HIV still have transmissible levels of the virus. TB treatment outcomes, however, are concerning. Only 68% of new and relapse TB cases successfully completed treatment in 2022, well below the 90% target.
Treatment coverage for hepatitis B and C remains insufficient, with none of the countries meeting the 50% treatment targets. Data scarcity further limits accurate assessments of regional progress. Mortality figures underline the persistent public health challenge. AIDS-related and TB deaths have decreased by 30% and 15%, respectively, yet neither is on track to meet the 2025 mortality reduction goals. Hepatitis-related mortality remains disproportionately high, accounting for the majority of the nearly 57,000 annual deaths from these infections in the EU/EEA. With no evident downward trend in hepatitis-related deaths, the situation reflects a pressing need for renewed focus and investment.
The EU/EEA's trajectory toward the 2025 SDG 3.3 targets is marked by modest successes and considerable shortcomings. While HIV testing and treatment rates offer a glimmer of progress, other areas—including TB treatment success, hepatitis diagnosis and care and STI surveillance—fall short of expected benchmarks. The limited availability and comparability of data across countries and diseases further complicates a unified response. Addressing these gaps requires robust investment in surveillance infrastructure, targeted prevention efforts and expanded access to testing and treatment services. Only through coordinated, data-informed action can the EU/EEA hope to meet its public health commitments and protect vulnerable populations across the region.
Source: European Centre for Disease Prevention and Control
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