WRITTEN QUESTION E-2457/00

by Elizabeth Lynne (ELDR) to the Commission

(24 July 2000)

Subject: Eradication of tuberculosis

I welcome the recent announcement at the 2000 Quelez EU-US Summit reiterating the EU's commitment to combat HIV/AIDS, malaria and tuberculosis.

With particular reference to tuberculosis, could the Commission confirm what practical measures will actually be taken to contribute to the eradication of this disease, particularly in Africa and Asia, and how much funding would be allocated to programmes?

The World Health Organisation states that, from a public health perspective, poorly supervised or incomplete treatment of TB is worse than no treatment at all. The WHO recommended treatment strategy for detection and cure of TB is DOTS (Directly Observed Treatment Short-course). Does the Commission agree that the DOTS strategy represents the most effective method for the detection and cure of tuberculosis?

Answer given by Mr Nielson on behalf of the Commission

(25 September 2000)

Tuberculosis (TB) is in most cases curable if the drugs are taken continually for the full duration of the course. Problems arise when there are interruptions to supply or when the patient stops treatment when he feels better. This is a recipe for development of resistance of the TB bacillus to drugs. DOTS (directly observed treatment, short-course) is the World Health Organisation (WHO) recommended standard treatment against tuberculosis

and has developed as a result of 20 years of programme experience. This strategy is adopted in most countries in Africa and Asia and receives Community support. TB control is an integral component part of health systems. Effective TB control and treatment should be a part of every national health programme and funded from the national budget. However, due to multiple demands and inadequate health funds, TB programmes, particularly in developing countries, have often relied on external donor assistance.

Many initiatives undertaken by the Community are important for tuberculosis control in Europe and in the rest of the world. The Community initiatives focused on Europe include the Community network for the epidemiological surveillance and control of communicable diseases(1), that brings into permanent communication the institutes and public health authorities dealing with infectious diseases, and the Community action programme on acquired immune deficiency syndrome (AIDS) and other communicable diseases(2), which provides financial assistance to projects such as Euro-TB (surveillance of TB in 51 countries of the WHO European region which comprises also many Asian countries).

The Community provides extensive support to strengthen health systems, including TB control, in developing countries. This preference for a system-oriented approach has been a deliberate Community policy. As a consequence, a detailed disease specific Community development budget breakdown for TB is not available. Community commitments to health, AIDS and population in 1998 amounted to well over 700 million for more than 100 developing countries.

Specific collaborative research activities with developing countries particularly geared to the development and testing of new drugs, diagnostics and vaccines are administered under the regular Community research budget. For the period 1994-1998, approximately 3,5 million were spent for research on TB.

In addition, the Commission is presently preparing a communication to be presented to the Council on a proposed accelerated action targeted at major communicable diseases (TB, malaria and human immundeficiency virus (HIV)/AIDS) within the context of poverty reduction. The new Community initiative offers the potential for innovative cohesive strategies for combating the disease. A high-level round table discussion on this new initiative is being organised by the Commission together with the WHO and the United Nations programme on AIDS to be held in Brussels on 28 September 2000.

(1) Decision No 2119/98/EC of the Parliament and of the Council of 24 September 1998 (OJ L 268, 3.10.1998).

(2) Decision No 647/96/EC of the Parliament and of the Council of 29 March 1996 (OJ L 95, 16.4.1996).