Stockholm / Copenhagen, 24 March 2025
The 2025 ‘Tuberculosis surveillance and monitoring report’, released today by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe shows that children under 15 years of age accounted for 4.3% of those with new and relapsed tuberculosis (TB) in the WHO European Region*, representing a worrying 10% surge in paediatric TB for 2023, compared to the previous year.
Similarly, children under 15 years accounted for 4.3% of all TB cases in the European Union/European Economic Area (EU/EEA), signifying an increase for the third year in a row.
These findings of increased TB among children show that transmission of TB in the European Region is still ongoing, and immediate public health measures are needed to control and reduce the growing TB burden. The findings also highlight the escalating burden of the disease in younger populations, as overall TB notifications continue to rise, with over 650 additional TB cases among children reported between 2022 and 2023. A major concern is that for one in five children with TB in the EU/EEA, it is unknown whether their treatment has been completed. This uncertainty regarding completion of treatment may result in deteriorating health outcomes such as the emergence of drug-resistant TB (DR-TB) and its further transmission.
The most recent data in the 2025 report indicate that, although the Region is recovering from the impact of the COVID-19 crisis, the effects of the pandemic continue to be felt in TB testing, prevention, diagnosis and care.
‘The time to act to end TB is now. With just five years to meet our 2030 targets, it is critical that Europe renews its focus on prevention and timely, effective treatment. With the rise of drug-resistant TB, the cost of inaction today will be paid by us all tomorrow,’ said Dr Pamela Rendi-Wagner, ECDC Director.
Despite progress, TB burden remains high
In 2023, the number of people diagnosed and treated for TB began to increase again, following an unprecedented drop in 2020 due to COVID-19-related disruptions.
In the WHO European Region, covering Europe and Central Asia, over 172 000 people with new and relapsed TB were reported in 2023, similar to 2022 levels. Meanwhile in the EU/EEA, nearly 37 000 people were diagnosed, an increase on the 35 000 reported the previous year.
“Ending TB is not a dream. It’s a choice. Sadly, the current TB burden and the worrying rise in children with TB serves as a reminder that progress against this preventable and curable disease remains fragile,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “Even before the recent cuts to international development aid, the world was facing an $11 billion shortfall in the global TB response. Vital TB programmes across the European Region – particularly in non-EU countries – might be impacted. This means TB transmission may go unnoticed, further fuelling the rise in hard-to-treat strains. But we cannot give up. We must continue the fight against TB and find new partners to join us. We have the tools, thanks to new treatments, technological advancements and innovation. We are transforming TB care for the better – and I hope, forever.”
Treatment success rates still lagging behind
In the European Region, the treatment success rate among people with new and relapsed TB who started treatment with first-line drugs in 2022 was 75.5%. Similar to previous years, the treatment success rate in 2023 was lower in the EU/EEA countries than in the rest of the WHO European Region (67.9% versus 77.2%, respectively).
This represents a substantial gap between the current treatment success rates and the global targets set by the WHO, which aim for successful outcomes in at least 90% of patients.
Worryingly, multidrug-resistant tuberculosis (MDR-TB) remains a significant challenge in the WHO European Region, with treatment success rates for MDR-TB patients falling far below expectations. In 2023, the reported treatment success rate for MDR-TB in the Region using traditional treatments often involving injectables was only 59.7%, indicating the continued difficulties in managing these complex cases. The situation is even worse for the EU/EEA, with a 56.3% treatment success rate among MDR-TB patients.
These figures are of concern, as they highlight the continuing struggles to manage drug-resistant strains effectively, probably due to issues such as treatment adherence, delays in diagnosis, and insufficient access to appropriate therapies.
Despite improvements in TB diagnostics and care, the persistence of MDR-TB and other drug-resistant forms of TB underscores the urgent need for more effective treatment strategies and better patient management, such as new and shorter injection-free oral treatment regimes**.
TB and human immunodeficiency virus (HIV) co-infection remains a persistent threat
HIV co-infection remains a persistent issue for TB patients in Europe. In 2023, over 15%of patients with new and relapsed TB were reported to be co-infected with HIV. In the WHO European Region, this translates to over 19 000 people with TB and HIV co-infection while in the EU/EEA that figure was over 600. Available data indicate that one in five people with HIV/TB co-infection in the European Region may not be receiving antiretroviral therapy (ART) at all.
However, the picture is far from complete; only 21 countries provided information on the uptake of ART for HIV among TB patients and only four of these were in the EU/EEA. This emphasises the need for continued efforts to improve the reporting of HIV co-infection.
Both ECDC and WHO call on Member States to urgently address gaps in TB and HIV services, ensuring comprehensive care to reduce transmission and improve patient outcomes across the Region.
Progress toward TB elimination in the WHO European Region
To address these challenges and accelerate progress towards the global goal of ending TB, ECDC and WHO’s Regional Office for Europe emphasise the need to scale up efforts in order to detect and treat people with TB more effectively. This includes expanding access to shorter, fully oral treatment regimens, which have shown promise in improving outcomes for patients with drug-resistant TB. Further critical measures for reducing the burden of TB and drug-resistant TB include strengthening TB testing and ensuring that TB preventive treatments are available to all those at risk. Only by increasing efforts in these areas will it ultimately be possible to achieve the targets set for TB elimination in the Region.
To accelerate progress towards elimination, it is crucial to place a stronger focus on high-priority countries, enhance TB prevention strategies, and address the burden of TB and HIV co-infection.
There have never been so many tools and opportunities to control TB, from new diagnostic tests and treatments to new vaccines in the pipeline. If we commit to cross-country collaboration, sharing data transparently and addressing gaps and challenges together then eliminating TB is within our grasp.
Additional background
- ECDC Digital Publication – Ending Tuberculosis
- ECDC Presentation – Tuberculosis situation in the EU/EEA, 2023
- ECDC: On Air – Episode 59 – Beyond Numbers: Understanding TB
- Patient Stories: Frida’s battle with multidrug-resistant tuberculosis
Notes
* WHO European Region covers 53 countries from Europe and Central Asia, along with Israel.
** A recent study from 13 countries in the European Region showed they had a treatment success rate over 80%.
The ECDC/WHO Regional Office for Europe report ‘Tuberculosis surveillance and monitoring in Europe’ is published annually in conjunction with World TB Day, which this year falls on 24 March 2025. The report provides an overview of the trends, progress and challenges in efforts to end TB in the WHO European Region.
Source – ECDC: World Tuberculosis Day 2025