Guest Blog: It’s time the EU takes responsibility for drug-resistant TB

Fanny Voitzwinkler is the Head of the Global Health Advocates Brussels Office and coordinator of the TB Europe Coalition, a civil society platform with 150 members across the European region. She also chairs the WHO Europe Regional Collaborative Committee on Tuberculosis and coordinates the Secretariat of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases.


Fanny was interviewed on this topic by European Voices Magazine:

If you got sick tomorrow and someone asked you to choose between being treated in Africa or in Europe, I presume you would answer without a doubt: Europe! And so would I. It seems like an easy choice, but if you are infected with drug-resistant tuberculosis (TB), you may want to think twice.
Latest figures from the European Centre for Diseases Control and Prevention show that only one in three patients with drug-resistant TB (DR-TB) successfully finish treatment in the European Union (EU). That’s scary when you consider that the European region bears a quarter of the world’s DR-TB burden. The situation in some Eastern European countries is particularly worrying: Bulgaria and Romania successfully treat less than one in five of their DR-TB patients, while the Democratic Republic of Congo, one of the poorest countries in the world, successfully treats one in two.[1]
How did Europe get to this dangerous place where drug-resistant TB is outrunning our attempts to control it?
DR-TB is a manmade disease and a marker of how many European countries have failed to invest in their health systems. DR-TB has grown in the past decade because people sick with regular TB were either being given the wrong medicines or wrong doses or did not complete their treatment. The collapse of the Soviet health care system in the 1990s and endemic poverty escalated incidences of DR-TB to epidemic proportions.
Unsuccessful treatment for TB means death, and the airborne disease can decimate entire families. Safar Naimov, a former DR-TB patient from Tajikistan who lost two brothers to TB, knows this well. At a World TB Day event organised by WHO Europe, he told the story of a man who lost seven of his children and his wife to tuberculosis. That’s eight deaths in just one family caused by a disease that is, or should be, curable.
Oxana Rucsineanu, a DR-TB survivor from Moldova who founded a local TB patient group during her recovery, shared the story of her battle to keep her husband, who suffers from extremely drug-resistant TB, alive. People continue to die in Moldova because they do not have access to new drugs that will treat the most resistant forms of the disease.
Yet despite the shocking statistics and the heart-wrenching stories, drug-resistant TB continues to go unnoticed on the European political radar. Tuberculosis is not a sexy disease and regional political commitment to address the rising DR-TB epidemic has been seriously lacking.
But let me ask you this: can you think of another disease in Europe that you can catch simply by breathing, and which kills four people an hour? Aren’t the facts described serious enough to spur concrete political action? Why has the EU, the single most powerful political and economic power in the region, not taken concrete actions yet?
A prominent EU-affairs newspaper, European Voice, has started to explore this gap. At a high-level debate in Brussels, panellists from the WHO, the European Commission, the European Parliament, industry, and civil society recognised that TB was a cross- border health threat and that action at regional level was necessary.
But this is easier said than done. According to the Lisbon Treaty, the primary responsibility for the provision of healthcare lies with governments, and is not a competence of the EU.
However, article 168 of the Treaty of the Functioning of the European Union explicitly acknowledges that Union action can complement national policies when faced with major health threats. The recent European Commission Action Plan on HIV/AIDS in the EU and neighbouring countries provides a good example of how the EU can make the best use of its powers in this policy field. On top of it all, a decision on cross-border health threats was adopted last year by the Council of the EU and the European Parliament, giving increased power to the European Union to protect citizens from a wide range of threats, including pandemics and communicable diseases.
New high-level political initiatives would be a sign of hope for Europe. For instance, the EU should organise and lead a regional summit on domestic financing for TB and HIV in the EU and neighbouring countries, which would involve Ministers of Health and Finance and urge countries to take action.  
Another opportunity is Latvia’s upcoming EU presidency. Latvia has made great progress against DR-TB; by pushing TB up the EU’s political agenda during its term, Latvia could lay the groundwork for further EU action.
With EU elections coming up soon, there is a great opportunity for the new European Institutions to take concrete initiatives on drug resistant tuberculosis: the only ingredient missing so far is political will. Ahead of the polls, the EU should clearly show that it cares about its people. EU citizens in turn will care for the EU.