Rede – Pressekonferenz anlässlich der Konferenz der Internationalen Union gegen Tuberkulose und Lungenkrankheit, Region Europa

Dr Zsuzsanna Jakab, WHO Regional Director for Europe

22 June 2016, Bratislava, Slovakia

It is a great pleasure to be in beautiful Bratislava, where our joint meeting of the WHO National Tuberculosis Programme Managers and the EU/EEA Tuberculosis Surveillance Network focal points took place, back-to-back with the 7th Europe Region Conference of The International Union Against Tuberculosis and Lung Disease (The Union).

Together with His Excellency Mr Andrej Kiska, President of the Slovak Republic, and Dr E Jane Carter, President of The Union, we opened the conference that brought clinicians and other health care experts from across the European Region to your capital to present and discuss the latest scientific developments.

The theme of the conference – "Know–Share–Act in the fight against TB and lung diseases" – illustrates very well the path we are embarking on together. It reflects how important it is to know the epidemic of TB and lung illnesses, in particular its root causes including social determinants and inequitable access to health care. Sharing strategies and practices, which has proven to work well, contributes to successfully tackling TB and lung diseases by helping to inspire and guide our joint efforts. Knowing and sharing inform acting, which is key in our work.

All of this is very relevant now – a momentous time in which the 15-year period set out to achieve the UN Millennium Development Goals has come to an end. We are now in a new era, defined by the Sustainable Development Goals (SDGs).

I want to stress that the SDGs provide an ambitious and comprehensive plan of action that includes tackling TB, one of the indicators of SDG Goal 3. To be able to attain the SDG targets and end the TB epidemic by 2030, we need to address the lack of access to health and social well-being, including issues related to housing, employment, health determinants and risk factors such as tobacco, alcohol, poor nutrition and diabetes. Reaching these goals takes a whole-of-society and whole-of-government approach, guided by the principle of equity and our dedication to leaving no one behind.

This year, WHO and its Member States started to implement the global End-TB Strategy. In the Region, this goes hand-in-hand with the implementation of the Tuberculosis Action Plan for the WHO European Region 2016–2020, endorsed with its accompanying resolution at the 65th WHO Regional Committee for Europe in September 2015. The Plan is in line with the Health 2020 European policy framework.

The targets set in these documents will be achieved if we all act to address the following challenges.

  • According to the latest estimates, approximately 340 000 new TB cases and 33 000 TB-related deaths were reported in the Region in 2014, mostly within eastern and central European countries.
  • The Region has the highest rate of drug-resistant TB in the world; of the 30 countries with a high burden of drug-resistant TB, 9 are in the Region. The percentage of drug resistance in new TB and previously treated TB cases in the Region was respectively 19% and 46% in 2014.
  • While almost all drug-resistant patients now have access to treatment, the rate of success is approximately 50%. This is well below the 75% target defined in the Tuberculosis Action Plan for the WHO European Region 2016–2020.
  • There is a growing rate of HIV/AIDS in eastern European and central Asian countries that requires integrated care.

We cannot expect to meet these challenges with business-as-usual approaches. We must change both the way we think and the way we act. Our vision is to end the TB epidemic and to stop the spread of drug-susceptible and drug-resistant TB by achieving universal access to prevention, diagnosis and treatment in all Member States of the Region.

In order to make this vision come true:

  • we need to ensure a health system approach with people-centred models of care that bring services closer to patients and their families;
  • we need to continue to scale up rapid and early diagnosis, reduce unnecessary TB transmission and improve treatment outcomes;
  • we need to introduce shorter and more effective treatment regimens, including the rational use of new medicines;
  • we need to expand preventive therapy and research for new tools to prevent TB more efficiently; and, last but not least,
  • we need to boost intersectoral approaches to addressing inequities and involve ex-patients and civil society organizations in improving the psychosocial support systems for this often-social disease. 

It is important to stress that, to be successful, the implementation of this vision needs the engagement of our whole society. All stakeholders need to live up to the challenge, show good will, and engage.

Slovakia, as a low-TB-incidence country with a successful TB programme, is clearly in the driving seat when it comes to addressing TB and lung diseases. Your experts contribute tremendously to fostering strategy development and experience exchange in the Region.

In the second half of 2016, Slovakia will be holding the EU presidency. It can play a crucial role in ensuring commitment to ending TB in the Region, in line with the Riga Declaration of the 1st Eastern Partnership Ministerial Conference on Tuberculosis and Multidrug-Resistant Tuberculosis.

My teams in Copenhagen and in the WHO Country Office will continue close collaboration with the Slovak government and national experts.

Thank you for your attention.