Healthcare Tips

Tackling Spread Of Drug-Resistant TB Across The WHO European Region

November 12, 2017

Measures aimed at stopping the threat of tuberculosis (TB) will be pioneered at a new research centre in Latvia. The Latvian Government and WHO have jointly established the centre, which will be officially opened on Monday, 22 November, in Riga. In particular, the centre will promote research and training to develop strategies to combat "super strains" of multidrug-resistant TB (MDR-TB) and prevent their further spread across eastern Europe and central Asia.

Patients in this region are 10 times more likely to be infected with MDR-TB than those in the rest of the world. A 2004 WHO report warns that eastern Europe and central Asia contain six of the top ten global hotspots: Estonia, Kazakhstan, Latvia, Lithuania, parts of the Russian Federation and Uzbekistan. Up to 14% of new patients have MDR-TB.

"The centre will help the countries of the WHO European Region address multidrug-resistant and HIV-related TB," said Dr Marc Danzon, WHO Regional Director for Europe. "Although there has been clear progress in TB control in the Region, the pace of effective anti-TB strategies must be increased rapidly if we want to achieve the global targets - to detect 70% of infectious patients and to effectively treat 85% of them by 2005."

The centre will draw on the expertise of health professionals and scientists from countries in the WHO European Region and be instrumental in encouraging innovative plans to contain and eradicate MDR-TB.

The Latvian Government has welcomed the opening of the centre as a significant contribution to disease control. "Multidrug-resistant TB continues to be a public health issue for Latvia and the neighbouring countries," stated Mr Rinalds Mucins, Latvian Minister of Health. "Having accumulated considerable experience in fighting TB and multidrug-resistant TB, Latvia is committed to take a lead in training experts from the Region on multidrug-resistant TB treatment and prevention."

Dr Jack Chow, WHO Assistant Director-General for HIV/AIDS, TB and Malaria, stressed: "We commend Latvia for its strong commitment to fighting TB and its drug-resistant strains. It has set a leading example for other countries in eastern Europe and central Asia. There is an urgent need for training opportunities to improve the capacity in the region to effectively treat and control the disease."

Latvia has made great strides in reducing the threat of MDR-TB following the rigorous implementation of the DOTS (directly observed treatment, short-course) strategy: the internationally recommended strategy for controlling TB. The Government backed this up with strong political and financial commitment, resulting in the TB cure rate's rising from 67% in 1996 to 76% in 2002. As a result of the successful introduction of the DOTS-Plus strategy, the number of MDR-TB cases in Latvia dropped by almost a third between 2001 and 2003.

Information on TB

TB is a contagious disease. Like the common cold, it spreads through the air. Only people who have TB germs, known as bacilli, in their lungs are infectious. When such people cough, sneeze, talk or spit, they propel bacilli into the air. Another person needs only to inhale a small number of these to be infected.

Left untreated, each person with active TB will infect an average of 10-15 others every year. People infected with TB, however, do not necessarily become ill. The immune system walls off the bacilli; protected by a thick waxy coat, they can lie dormant for years. When the immune system is weakened, the chances of becoming ill increase. Overall, a third of the world's population is currently infected with TB; 5-10% of infected people (except those also infected with HIV) become sick or infectious at some time in their lives.

MDR-TB comprises strains resistant to at least the two most effective treatment medicines, isoniazid and rifampicin. Super strains are resistant to three of the four most effective medicines. A six-month course of drugs, costing just US$ 10, cures normal TB cheaply and effectively. In contrast, treatment for MDR-TB can cost 100 times as much, and take more than two years. In addition, MDR-TB can be passed on as easily as normal TB.

Controlling TB through DOTS helps prevent drug resistance, which can develop through inconsistent or partial treatment: when patients do not take all their medicines regularly, when the wrong medicines are prescribed or when the supply of drugs is unreliable.

WHO offers further information on TB at the global level
( and in the European Region
( on the World Wide Web.

For more information contact:


Dr Risards Zaleskis
Regional Adviser for Tuberculosis Control
WHO Regional Office for Europe
Scherfigsvej 8, DK-2100 Copenhagen O, Denmark
Tel.: +45 39 17 13 35


Ms Liuba Negru
Press and Media Relations Officer
WHO Regional Office for Europe
Scherfigsvej 8, DK-2100 Copenhagen O, Denmark
Tel.: +45 39 17 13 44. Fax: +45 39 17 18 80

Ms Melanie Zipperer
Communication Adviser, HIV/AIDS, TB and Malaria, World Health Organization
in Riga, Latvia, on 22-23 November 2004
Tel: +41 22 791 1344. Mobile: +41 79 477 1722