Tuberculosis (TB) continues to pose a serious public health challenge in Europe, even as some progress is being recorded.

A new report by the World Health Organization European Region and the European Centre for Disease Prevention and Control shows that 204,000 people fell ill with TB in 2024, which is equal to 22 cases per 100,000 population.

In the same year, 161,569 newly diagnosed TB cases were reported across 51 countries. This represents 79% of the estimated new and relapse cases, suggesting that a significant number of cases are still being missed.

Out of all reported cases, 151,933 patients, representing 82%, had pulmonary TB, the form that affects the lungs. Among these, 69% were confirmed through laboratory testing, while 92% of confirmed pulmonary TB cases were tested for rifampicin resistance.

The report highlights a worrying rise in drug-resistant TB. It shows that 28% of pulmonary TB patients tested for drug susceptibility had rifampicin-resistant or multidrug-resistant TB (RR/MDR-TB). The burden is even higher among previously treated patients, where 48% had RR/MDR-TB, compared to 21% among new cases.

Further analysis reveals that 28% of RR/MDR-TB cases had pre-extensively drug-resistant TB (pre-XDR-TB). Among those tested further, 15% had extensively drug-resistant TB (XDR-TB), which is the most difficult form to treat. Overall, an estimated 55,000 people developed RR/MDR-TB in 2024.

The link between TB and HIV remains a major concern. Data shows that 93% of TB patients were tested for HIV, with 16,307 cases found to be HIV-positive, representing 14% of those tested. Out of these, 13,243 patients, or 84%, received antiretroviral therapy (ART). Although this shows improvement over recent years, it is still below the global target of full treatment coverage.

Treatment success rates across the region remain low. The report indicates that 74% of new TB cases were successfully treated, while the success rate drops to 66% for RR/MDR-TB cases and further to 58% for pre-XDR and XDR-TB cases. Despite this, there has been some progress in improving outcomes for drug-resistant TB patients.

There is also some progress in reducing deaths, but targets have not been met. In 2024, there were 15,000 TB deaths among HIV-negative people, equal to 1.6 deaths per 100,000 population. Between 2015 and 2024, TB deaths dropped from 37,000 to 19,000, representing a 49% reduction. However, this falls short of the 75% reduction target set by the WHO for 2025. Similarly, TB incidence has reduced by 39% since 2015, missing the target of a 50% reduction.

The report also shows that TB-HIV co-infection is concentrated in a few countries. Out of an estimated 23,000 HIV-positive TB cases, about 80% are found in the Russian Federation and Ukraine, with 52% in Russia and 28% in Ukraine.

These findings were released ahead of World Tuberculosis Day marked on March 24. Health experts warn that although progress has been made, the region is still not on track to meet global targets.

The report recommends stronger efforts to improve detection, expand treatment, and control the spread of drug-resistant TB.