1. Tuberculosis (TB) is a contagious disease that spreads through the air. A person with active TB can expel TB bacilli into the air when coughing, sneezing, laughing or singing. People near the sick person can inhale the infectious TB bacilli. If left untreated, each person with active TB can infect, on average, 10 to 15 people per year.
2. More than two billion people, a third of the world’s total population, are infected with TB bacilli, the microbes that cause tuberculosis. Of them, one in 10 will become sick with active TB during their lifetime.
3. A total of 3 million people died from tuberculosis in 2012 (including 320,000 people with HIV), meaning about 3,500 deaths per day. In Romania, 1,200 people die from TB every year.
4. TB affects mostly adult men at their most productive age. In Romania over 15,000 persons are diagnosed every year.
5. Tuberculosis affects people living with HIV, who have a low immune system. Worldwide, about one in four deaths among people with HIV is caused by Tuberculosis.
6. In 2012 there were 8.6 million new cases of TB worldwide, of which 80% in just 22 countries.
7. Romania is one of the countries severely affected by TB worldwide and the EU country with the largest number of cases. 25% of the tuberculosis cases in the EU come from Romania.
8. MDR-TB (multi-drug resistant tuberculosis) is a form of TB that does not respond to standard treatments with so called “first-line drugs”.
9. XDR-TB (extensively resistant to treatment tuberculosis) occurs when resistance to second-line drugs is developed. XDR-TB is extremely difficult to treat, leading, in many cases, to the death of the patient. The cost of treatment for XDR-TB exceeds the GDP per capita.
10. The fight against tuberculosis, both worldwide and in Romania, is hampered by a significant lack of funds, with a deficit of over $ 2 billion per year (in the world) and over 15 million in Romania.
Romania registers the highest incidence of tuberculosis in the European Union (five times above the EU average), providing about 20% of the TB cases reported in the EU, given that it has only 4% of the EU population.
In Romania about 1,100 people die every year from TB and other 16,000 are diagnosed, mostly among the young and active population.
The major challenge in TB control in Romania is due to chronic underfunding of the National Tuberculosis Control Programme, leading to:
Problems in providing a rapid and complete diagnosis, especially for MDR/XDR-TB
The World Health Organization (WHO) estimates that, in Romania, between 800 and 1,000 new cases of MDR-TB should be diagnosed each year. In fact, due to the lack of the necessary equipment, Romania identifies every year only 600 cases of drug-resistant and extensively drug-resistant tuberculosis. Currently, there are rapid diagnostic methods worldwide that lower the diagnostic time from 6 months to 2 hours, but in Romania the access to this method is available only through projects with international funding, for a limited number of patients.
Deficiencies in providing a complete, continuous and properly administered treatment
According to WHO reports assessing the National TB Control Programme, only some of the drugs for drug resistant tuberculosis (MDR/XDR-TB) are available in Romania. If the treatment regimen is not administered correctly and completely, curing the patient is NOT possible. The patients are virtually condemned to death and for the general population they represent a source of infection. Romania recorded in recent years one of the lowest MDR-TB patient curing rates in the world, namely 20% (percentage that equals the rate of spontaneous curing, without treatment). In Romania, the reservoir of infectious patients is therefore growing.
Inability to ensure treatment adherence
Treatment default rate varies between 6% (of new cases) and 25% (of patients with resistant tuberculosis). One of the causes of default is the lack of medical and psycho-social care services to help the patient throughout treatment in order to cope with extremely severe drug side effects, lack of material resources for daily transport of the patient to the doctor, lack of proper nutrition absolutely necessary for curing (minimum 4,000 calories / day), lack of means to purchase additional drugs to treat side effects. According to the Report mapping the needs of TB patients in Romania (June 2014), throughout treatment, the patients require medical, psychological and social support in order to complete the treatment successfully.