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Resolution 2219 (2018)
Drug-resistant tuberculosis in Europe
1. In 2016, tuberculosis caused 1.7 million
deaths worldwide, making it the world’s leading infectious killer. The
World Health Organization’s European Region, where the disease was
thought to be a thing of the past, has the highest rates of multidrug-resistant
tuberculosis in the world. These are strains that are particularly difficult
and expensive to treat.
2. Tuberculosis is a “social” disease which disproportionately
affects socially and economically disadvantaged groups, such as
homeless people and drug users. It often has a devastating impact
on the lives of patients, who face months, and sometimes years,
of often difficult treatment with multiple side effects. Many end
up suffering from long-term physical and psychological consequences
of this disease.
3. The high rates of multidrug-resistant tuberculosis in the
European region are due to a number of factors which can differ
from country to country, including outdated health policies, weak
and under-financed health-care infrastructures and a large number
of undiagnosed patients, all of which also contribute to the transmission
of the disease. The stigma associated with tuberculosis and the
resulting social isolation often lead to non-adherence to treatment,
one of the main drivers of drug resistance. People living with HIV, prisoners,
refugees and migrants are particularly vulnerable groups in the
region, with higher risks of tuberculosis morbidity and mortality.
4. There is a significant lack of investment in research and
development for new tuberculosis medicines, diagnostic tools and
vaccines. The current pharmaceutical innovation model does not offer
enough incentive for investing in a disease like tuberculosis: it
is risky and costly because ideally it requires investment in new combination
therapies rather than a single new product, and unprofitable because
the greatest burden of the disease falls on the poorest parts of
the world.
5. The Parliamentary Assembly welcomes the fact that tuberculosis
will receive unprecedented attention at a United Nations General
Assembly high-level meeting to be held in September 2018. This is
a historic opportunity to tackle this preventable and (most often)
curable, yet still neglected, disease, to save millions of lives
and avoid the significant cost to the global economy. Therefore,
every effort should be made to maximise the impact of this upcoming
high-level meeting.
6. In the light of these considerations, the Assembly calls on
the Council of Europe member States to:
6.1. ensure that every tuberculosis patient is effectively
diagnosed (including for different strains of the disease) and has
access to appropriate, free, and when this is not possible, affordable,
treatment and care, as well as complementary support services, in
particular psycho-social support, with a view to reducing the disease’s
burden on the patient’s life and increasing treatment adherence;
6.2. provide integrated and patient-centred health services,
in particular by:
6.2.1. ensuring effective collaboration
between all stakeholders involved in the response to tuberculosis,
including government agencies, local authorities and civil society
organisations;
6.2.2. providing tuberculosis care mainly in outpatient and community
settings, together with appropriate infection-control measures;
6.2.3. involving civil society organisations in patient follow-up
and treatment support, also in view of decreasing the financial
burdens on already socially vulnerable and disadvantaged groups
of patients in need;
6.3. improve early detection mechanisms for tuberculosis by
investing in active case finding for tuberculosis among socially
vulnerable groups, who face a higher risk of exposure and infection, including
prisoners, people with HIV, refugees and migrants, and orient preventive
treatment towards these groups to prevent latent tuberculosis from
activating;
6.4. invest in research and development for new drugs, diagnostics
and vaccines for tuberculosis, including by offering incentives
and rewards for innovation;
6.5. develop, fund and implement a tailored national tuberculosis
strategy;
6.6. fight the stigma associated with tuberculosis by debunking
the myths and raising awareness of the realities of the disease;
6.7. continue to highlight the impact of antimicrobial resistance
on tuberculosis and support international efforts to prevent the
progression of such antimicrobial resistance.
7. The Assembly strongly encourages all heads of State of the
Council of Europe member States to attend the United Nations high-level
meeting on the fight against tuberculosis to be held in 2018.
8. Finally, stressing that tuberculosis and poverty are inextricably
linked, the Assembly calls on Council of Europe member States to
step up efforts to reduce global and regional inequalities. In this
context, it refers to its Resolution 1975
(2014) “Stepping up action against global inequalities:
Europe’s contribution to the Millennium Development Goals (MDGs)
process”.