Speech – Opening of the International Union Against TB and Lung Disease (The Union) Conference, Europe Region

Dr Zsuzsanna Jakab, WHO Regional Director for Europe

22 June 2016, Bratislava, Slovakia

Your Excellency President Andrej Kiska,

Professor Stanislav Špánik, State Secretary of the Slovak Ministry of Health,

Dr E Jane Carter, President of The Union,

ladies and gentlemen, good evening.

It is my pleasure to be here with you today to jointly open the 7th Europe Region Conference of The International Union Against Tuberculosis and Lung Disease (The Union) with President Kiska, Professor Špánik and Dr Carter. This conference is bringing scientists, clinicians and experts from across the WHO European Region to beautiful Bratislava to present and discuss the latest scientific developments in the field of tuberculosis (TB) and lung diseases.

The conference, under the theme "Know–Share–Act in the fight against TB and lung diseases", is relevant and timely. I would like to commend The Union and, in particular, Professor Solovic, Chair of The Union Europe Region, for great preparatory work in organizing this important conference.

Ladies and gentlemen, based on lessons learned in the implementation of the Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-Resistant Tuberculosis in the WHO European Region 2011–2015, we developed a 5-year action plan in line with the global End-TB Strategy and the Health 2020 European policy framework. The Tuberculosis Action Plan for the WHO European Region 2016–2020 and its accompanying resolution were fully endorsed at the 65th WHO Regional Committee for Europe in September 2015.

During the last 2 days, and in the joint meeting of the WHO National Tuberculosis Programme Managers and the EU/EEA Tuberculosis Surveillance Network focal points, achievements and the way forward were discussed. We noted that most countries have finalized or are in the process of updating their national action plans and interventions in line with the Regional Plan. We need to build on this great momentum to further advance the progress made in combating tuberculosis and lung diseases in our Region, and to address remaining gaps and challenges.

Ladies and gentlemen, knowledge is key when it comes to addressing these health problems – namely knowing the epidemiology of the diseases in our setting, identifying the most vulnerable groups and understanding underlying causes, including social determinants. Sharing efficient strategies and practices is necessary to successfully tackle TB and lung diseases, and to help inspire and guide our joint efforts. Together, knowledge and sharing will inform action, which is key in our work. We need to be strongly focused on these elements to ensure the highest possible achievements for health.

The Conference is particularly relevant at this moment, as the 15-year era set out to achieve the UN Millennium Development Goals has come to an end. We are now bound to the project of establishing better lives and well-being for all as framed by the Sustainable Development Goals (SDGs). Recognizing the interdependence of health and development, the SDGs provide an ambitious and comprehensive plan of action for people, planet and prosperity that aims to end the injustices that underpin poor health and development outcomes. TB, a disease influenced not only by access to health but also by social well-being including housing, employment and other determinants and risk factors such as tobacco, alcohol, poor nutrition and diabetes, has been clearly included as one of the indicators of SDG Goal 3. It will take a whole-of-society and whole-of-government approach, guided by the principle of equity and our dedication to leaving no one behind, to end the TB epidemic by 2030.

Ladies and gentlemen, there is good news. For example, since 2005 new TB cases have been falling at an average rate of 5.2% per year in the WHO European Region. This is the fastest decline of all 6 WHO regions. On the other hand, according to the latest data there are still approximately 340 000 new TB cases and 33 000 TB-related deaths per year in the Region. Our Region has the highest rates of drug-resistant TB in the world; of the 30 countries with a high burden of drug-resistant TB, 9 are in our Region. The percentage of drug resistance for 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, and while there are improvements in treatment outcomes in some countries, the rate of successful treatment for multidrug-resistant TB patients overall is as low 50%. This is well below our target of 75%.

We are also the only region experiencing an increase in cases of HIV/AIDS, which further challenges TB prevention and control efforts. As such, integrated care with the full engagement of civil society organizations and other sectors and partners is crucial.

Ladies and gentlemen, we cannot expect to overcome these challenges with a business-as-usual approach. We need to be bold and to seek to apply out-of-the-box approaches. We need innovations in thinking and in acting to realize our vision of ending TB and truly rendering it a disease of the past.

To realize this vision we must undertake the following measures.

We need to further scale up rapid and early diagnosis, reduce unnecessary TB transmission and improve treatment outcomes.
We need to expand people-centred care by moving it nearer to patients and their families and introducing shorter and more effective treatment regimens, including the rational use of medicines to avoid further development of antimicrobial resistance.
We need to expand preventive therapy and research for new tools to prevent TB more efficiently.
Last but not least, we need to boost intersectoral approaches to addressing inequities and involve ex-patients and civil society organizations in improving psychosocial support systems for patients and their families.

We need to spark enthusiasm in everyone. We need all stakeholders to live up to the challenge, show good will and engage in strong partnerships.

Ladies and gentlemen, Slovakia is one of the countries clearly occupying the driving seat when it comes to tackling TB and lung diseases. The country is a leader in fostering strategy development and experience exchange, and it benefits from a high-level political commitment. This commitment is clearly underscored by the fact that this conference is taking place under the patronage of His Excellency President Kiska.

I would like to commend President Kiska and the Slovak government for their achievements. During my visit I have also met with Slovak health authorities, and I would like to take the opportunity to once more commend them for their great success in reducing the burden of TB in recent years.

Last but not least, I am encouraging all conference attendees to continue their great work, to pursue scientific excellence, to create further evidence and to share knowledge in the field of TB and lung diseases throughout the coming days and beyond.

Ladies and gentlemen, as ever, you can count on the full support of WHO to add years to life and life to years.

I wish you all a successful conference, and I thank you very much for your attention.