WRITTEN QUESTION E-3642/97 by Clive Needle (PSE) to the Commission (13 November 1997)

Subject: The rise in the incidence of tuberculosis

The World Health Organization has just published a worrying and unprecedented report on the rise in the incidence of tuberculosis. This specifies a number of developing countries plus Latvia, Estonia and the Russian Federation as 'hot spots' where tuberculosis is resistant to antibiotics and treatment is described as 'therapeutic anarchy'.

Clearly this has implications for several aspects of EU policy and practice in the context of its public health competence as established in Article 129 of the Treaty on European Union.

Will the Commission therefore set out urgently its approach to tacking tuberculosis with particular reference to the potential applicants for EU membership, given concerns that public health is insufficiently addressed in the Agenda 2000 proposals?

Joint answer to Written Questions E-3642/97, E-3643/97 and E-3644/97 given by Mr Flynn on behalf of the Commission (20 January 1998)

The Honourable Member refers to a recent World Health Organisation (WHO) press release on the appearance of 'sensitive areas' where it has become practically impossible to protect the population from drug-resistant strains. The press release is based on a study entitled 'Anti-Tuberculosis Drug Resistance in the World', which cites cases of multi-resistant bacillary tuberculosis (MR-TB) in a large number of countries on all continents. The affected areas on the European continent are primarily the countries of eastern Europe (Russia, Latvia, Estonia).

In this field, the Commission has, since 1996, been providing funds for the establishment of a European tuberculosis surveillance network, known as EuroTB. This network extends beyond the Member States. The data collected cover 49 countries in the WHO European region, including the 15 Member States. The network operates in close cooperation with the WHO and the International Union against Tuberculosis and Pulmonary Diseases.

In addition, and in order to take better account of the problem of multiple resistance, EuroTB has since 1997 also been collecting and analysing data on resistance to tuberculosis treatment.

With regard to the particular problem of countries applying for membership of the Community, the Commission has carried out a preliminary assessment of the state of health and of the health system as part of the preparation for accession. Initial findings bear out the Commission's concern at the resurgence of communicable diseases in a number of applicant countries, and the problems which may arise from this situation not only for those countries but also for the Community.

The Commission intends to include in the accession partnerships which it is currently preparing measures which could be taken to improve the situation with regard to these communicable diseases in the applicant countries.

Although the Commission funds no specific programme to combat tuberculosis in the developing countries, it makes a significant contribution, through the many health programmes which it supports, to combating this major public health problem being faced by many of the developing countries.

It does this by supporting various types of projects, which include projects for developing primary health care and for supporting health districts, programmes aimed at improving the availability of and access to essential medicines, of which tuberculosis treatments form an integral part, and preventive measures targeting the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS). HIV/AIDS is in fact one of the causes of the resurgence of tuberculosis, particularly in sub-Saharan Africa. By acting to reduce the spread of the HIV/AIDS epidemic it is therefore possible to reduce the incidence of tuberculosis linked to that epidemic.

For the African, Caribbean and Pacific countries, funds committed under the seventh European Development Fund to these various types of projects total almost ECU 270 million. Substantial amounts have also been made available for such areas in the countries of the Mediterranean, Asia and Latin America.