1. Three key messages on tuberculosis control World Tuberculosis Day 2010 ECDC TB Team European Centre for Disease Prevention and Control Stockholm, 24 March 2010

2. Message 1 The treatment success rate in the EU/EEA is too low to meet global targets

3. 1a. The treatment success rate in the EU/EEA is too low to meet global targets Reported treatment success rates in the EU/EEA are far below the 85% target set by the WHO World Health Assembly. Only three EU/EEA countries recorded a treatment success rate over 85% or more for new laboratory-confirmed pulmonary TB cases. * Treatment success rate among not previously diagnosed cases. Source: ECDC 85% target set by the Stop TB Partnership. Only Iceland, Portugal and Slovakia meet the 85% target. Figure 1a: Treatment success rate among new laboratory- confirmed pulmonary TB cases, 2007

4. 1b. The treatment success rate in the EU/EEA is too low to meet global targets Figure 1b: Percentage success rate among laboratory- confirmed new pulmonary TB cases, EU/EEA, 2007 71 to 84% ≥ 85% 60 to 70% < 60% Not included or not reporting Source: ECDC

5. 1c. The treatment success rate in the EU/EEA is too low to meet global targets Treatment success among previously untreated laboratory-confirmed pulmonary TB remains low in the EU/EEA and is below the 85% target. No changes in the trend were seen in the last five years. Figure 1c: EU/EEA treatment outcome among laboratory- confirmed pulmonary cases 2003–2007 Success Died Failed Defaulted Still on treatment Transferred or unknown * Excluded: Austria, Bulgaria, Cyprus, Finland, France, Greece, Italy, Liechtenstein and Spain 100 90 80 70 60 50 40 30 20 10 0

6. Message 2 Multidrug-resistant tuberculosis (MDR TB) remains a problem in the EU/EEA

7. 2a. MDR TB* remains a problem in the EU/EEA Figure 2a: Proportion of notified TB cases with primary multidrug resistance, EU/EEA, 2008 2 to 5.9% > 10% 1 to 1.9% > 6-10% < 1% Not included or not reporting * Multidrug-resistant tuberculosis (MDR TB) is defined as TB that is resistant at least to isoniazid (INH) and rifampicin (RMP), the two most powerful first-line anti-TB drugs.

8. 2b. MDR TB remains a problem in the EU/EEA Treatment success rate among MDR TB cases is extremely low (31%). 78% 31% 7% 17% 3% 17% 6% 13% 2% 17% 5% 0 10 20 30 40 50 60 70 80 90 MDR SuccessDiedFailedDefaultedStill on treatment Transferred or unknown Figure 2b: Treatment outcome of all* MDR TB cases, compared to all non-MDR cases, EU/EEA, 2006** * Pulmonary and extra-pulmonary** Both groups are 2006 treatment cohorts Non-MDR

9. Message 3 The decline in tuberculosis has levelled off in the EU/EEA

10. 3a. The decline in tuberculosis has levelled off in the EU/EEA Figure 3a: TB notification rates by incidence grouping, 1995–2008 and 2002–2008 Source: ECDC The decrease in TB notification rates has stagnated in the EU/EEA. The decline seen in countries with high and intermediate incidence rates contributes substantially to the average EU/EEA decline. <20/100 000 EU/EEA >20/100 000 Notification rate (per 100 000 population)

11. 3b. The decline in tuberculosis has levelled off in the EU/EEA 1995 1996 1997 1998 1999 2000 25 20 15 10 5 0 2001 2002 2003 2004 2005 2006 2007 2008 Notification rate (per 100 000 population) Figure 3b: TB notification rates, 1995–2008, EU/EEA