Discours – Stratégie régionale de lutte contre la tuberculose et la tuberculose multirésistante,1ère conférence ministérielle du Partenariat oriental sur la tuberculose et la tuberculose multirésistante

Ladies and gentlemen, Commissioner Andriukaitis, your Excellencies

Dr Muradyan and Dr Šalaševičiūtė, distinguished panelists and delegates:

Despite notable accelerated progress in detection and the care of individuals with tuberculosis (TB) in Europe, 1000 people still fall sick with the disease each day. By the end of the year, 38 000 lives will have been lost unnecessarily to TB. TB is also the leading cause of mortality among people living with HIV, and the prevalence of this deadly combination is growing in the Region. Multidrug-resistant TB (MDR-TB) poses a serious burden to patients and their families, as treatment lasts about two years and has many serious side effects. Household and national economies are negatively impacted due to loss of work and the direct loss of productivity. Despite progress in increasing case detection and universal access to treatment in most Member States, more than 50 per cent of estimated MDR-TB cases are still not detected in our Region, and of those detected, less than half are cured. 

In today's world, travel has become more accessible than ever, and is part of what drives economic growth. However, with the exchange of labour, commerce and skills also comes the risk of the cross-border spread of infectious diseases, including TB. TB has no borders. Yet borders are what often hinder the effective diagnosis and care of those who have the disease. In order to achieve the elimination of TB, cross-border collaboration between national health authorities is needed to ensure early diagnosis, uninterrupted treatment and the support of patients and families alike. This also includes equity in access to care among vulnerable populations, such as migrants, or those who travel temporarily to other countries. 

The WHO Regional Office for Europe, in line with Health 2020, has been supporting Member States to work in partnerships in order to facilitate effective and sustainable mechanisms to coordinate patient-centred, integrated interventions for TB. To this end, my office has established the Regional Collaborating Committee on Tuberculosis Control and Care (RCC-TB). The key objective of the RCC-TB is to strengthen involvement and foster collaboration between national and international partners in TB and M/XDR-TB prevention and care. The Committee also raises awareness about TB, advocates for resource mobilization and catalyses the exchange of best practices across the Region.

With regard to migration, in 2012, under a Wolfheze  taskforce, the WHO Regional Office for Europe facilitated discussions among national TB programme managers and finalized a minimum package for cross-border TB prevention and care. This package includes multidisciplinary interventions to address TB among migrants. It encompasses political commitment, including the implementation of a legal framework for TB cross-border collaboration, financial mechanisms and adequate health service delivery, including prevention, infection control, contact management, diagnosis, treatment, and psychosocial support. 

Through different mechanisms, including the International Health Regulations and direct contact with national programmes, the WHO Regional Office has linked health authorities within and beyond Europe. Through a partnership between WHO and the European Respiratory Society, the electronic consilium tool (e-Consilium) has been developed to facilitate cross-border consultation for clinicians.

Ladies and gentlemen,

In order to achieve the elimination of TB in our lifetimes, in addition to inter-regional cooperation for patient care, collaboration to accelerate the development of new tools, interventions and strategies is urgently needed. 

Since the discovery of Mycobacterium tuberculosis in Berlin in 1882 by Robert Koch, Europe has been at the forefront of innovations for TB prevention and care. The strain used for the BCG vaccine was first isolated by Calmette and Guérin at the Pasteur Institute in Lille, France in 1908, and first used as a vaccine in human infants in Paris in 1921.With the introduction of antibiotic treatment in the 1940s and the improvement of socioeconomic conditions in Europe, we observed the fastest decline of TB ever recorded. 

Today, in light of the challenges we face with drug-resistant TB in this Region, we need to continue and accelerate regional collaboration among scientists. Hand-in-hand with this goes the need for investment in research to strengthen the foundation for innovation. I would like to acknowledge the efforts of the European Union in supporting the research and development of new tools, particularly vaccines. 

The WHO Regional Office, together with partners, has been working to promote greater collaboration for science and research in TB, which is one of the three main pillars of the global End TB Strategy and the new Regional Action Plan for TB and MDR-TB, 2016–2020. The development of the new Plan has taken an inclusive approach, with active and rigorous consultations with partners and Member States through two meetings of the Advisory Committee led by the Regional Office. The Plan will be sent to all our 53 Member States and partners, including civil society organizations and community representatives. I would like to encourage you to send us your input and suggestions. After revision, the Plan will be finalized and presented for endorsement to the 65th session of the WHO Regional Committee for Europe in Vilnius, Lithuania, in September 2015.

Europe is in a position to lead prevention, care and the innovation of new tools in the fight against TB, and to pave the way for TB elimination. It is only through regional collaboration and cooperation that we can achieve this goal, so that our children will live in a world free of TB.

Ladies and gentlemen, the 1st Eastern Partnership Conference on TB and the Riga Declaration are important milestones on this path.

I wish you fruitful discussions and thank you for your attention.