The European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe today published the joint report ‘Tuberculosis Surveillance and Monitoring in Europe 2026’.
The report reveals that the European Region, covering 53 countries across Europe and Central Asia, including the 30 countries of the European Union and European Economic Area (EU/EEA), continues to fall short of regional and global End TB milestones on two fronts: a persistent detection challenge, with one in five TB cases going undiagnosed or unreported, and drug-resistance levels that remain far higher than in other regions.
These twin crises are inseparable. People who are diagnosed late have a higher chance of transmitting TB to others and are harder to treat. More TB transmission may result in high numbers of people with treatment failure, which is a primary driver of resistance. Closing the detection gap and tackling drug resistance are not parallel priorities, but part of the same fight.
While TB incidence across the WHO European Region has fallen by 39% since 2015, and the number of deaths by 49%, both figures fall well below the End TB Strategy’s 2025 milestones of 50% and 75%, respectively. Similar to the European Region, TB cases within the EU/EEA have decreased by 33% and the number of deaths by 17%, however most EU/EEA countries will not achieve their 2030 targets, resulting in thousands of new infections and deaths that could be prevented.
The detection and follow-up gap
In 2024, 161 569 newly diagnosed TB cases were reported in 51 of the 53 countries in the Region, yet only 79% of the estimated new and relapse TB cases in the WHO European Region were notified. This means that many people with TB went undiagnosed or unreported. This gap has direct consequences: undiagnosed individuals cannot access treatment and continue to transmit the disease in their communities.
In the EU/EEA, progress remains insufficient. While notification rates have stabilised, diagnostic gaps and a lack of follow-up persist due to limitations in healthcare systems. One in five people who start TB treatment in the EU/EEA are not evaluated after one year – a critical gap that also exists for children under 15 years of age.
These data underscore the need for strengthened efforts towards early detection, and robust follow-up once people are diagnosed.
Strong commitment
“During the past decade, the EU and EEA countries have seen the number of TB cases decrease by 33% and the number of deaths by 17%. This progress is the result of the strong commitment in the Member States and of our joint efforts”, said ECDC Director Dr. Pamela Rendi-Wagner. “To achieve the 2030 targets, continued efforts and collaboration are needed in early detection and sustained follow-up to support people already diagnosed with TB.”
“One in five people with TB in the European Region are still being missed by health services. That is not only a failure in detection – it is a missed chance to treat earlier, prevent suffering and stop further transmission,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.
“We have made progress, with TB incidence down by 39% and deaths down by 49% since 2015. But we are still not moving fast enough, and drug-resistant TB remains one of the most serious threats we face. In the words of this year’s World TB Day theme: yes, we can end TB — led by countries and powered by people. By investing in rapid diagnosis, shorter all-oral treatment regimens and stronger follow-up, countries can reach more people earlier, improve outcomes and put us back on track toward our targets.”
Drug resistance is a regional emergency
The WHO European Region accounts for a disproportionate share of the global burden of rifampicin/multidrug-resistant TB. Drug-resistant strains are considerably harder to treat, require longer and more complex regimens, and are responsible for substantially higher mortality.
In 2024, across the European Region there were 26 845 confirmed cases of rifampicin-resistant or multidrug-resistant TB; the number of cases in the EU/EEA was 817.
While globally 3.2% of new TB cases and 16% of previously treated cases are rifampicin-resistant or multidrug-resistant, in the European Region these figures are 23% and 53%, respectively. This amounts to roughly seven times the global average for rifampicin-resistant cases and three times the global average for those that are multidrug-resistant.
In the EU/EEA, 3.5% of TB cases are rifampicin-resistant or multidrug-resistant, however treatment success for these cases is just 56%. Poor treatment outcomes for multidrug-resistant-TB allow drug‑resistant strains to persist and spread, underscoring the urgent need for stronger diagnosis and care.
Call to action
ECDC and WHO’s Regional Office for Europe are calling on Member States and European institutions to urgently:
- intensify TB prevention and early case detection to close the one-in-five diagnostic gap, with a focus on high-risk and marginalised populations, including people in prison;
- scale up access to WHO-recommended rapid diagnostics and drug-susceptibility testing, particularly in high-burden settings;
- expand shorter, all-oral treatment regimens for drug-resistant TB to improve patient outcomes and reduce loss to follow-up;
- strengthen integration of TB and HIV services and improve antiretroviral therapy coverage for co-infected individuals;
- improve surveillance reporting on HIV co-infection, TB in prisons, and treatment outcomes to support evidence-based policy making and progress toward TB elimination.
Key figures at a glance
WHO European Region
- A total of 161 569 new and relapse TB cases were reported from 51 out of 53 countries in 2024, equivalent to 17.2 per 100 000 people.
- WHO estimates that 204 000 people fell ill with TB across the WHO European Region in 2024.
- One in five estimated cases in the European Region remain undiagnosed or unreported – a critical gap in detection.
- In total, 23% of new TB cases in Europe are multidrug-resistant, versus 3.2% globally.
- Overall, 51% of previously treated TB cases in Europe are resistant to rifampicin, versus 16% globally.
EU/EEA
- A total of 38 249 cases of tuberculosis were reported in 30 countries in 2024, resulting in a notification rate of 8.4 per 100 000 population.
- Overall, 4.2% of all new and relapse cases are in children under 15 years of age.
- The number of new TB cases that are multidrug-resistant is 3.5%.
- One in five (22%) people who start treatment are not evaluated after one year, a critical gap that also exists for children under 15 years of age.
- All three extensively drug-resistant TB cases, reported in the EU/EEA from the 2021 cohort, have died.
Additional findings
- TB/HIV co-infection: an estimated 23 000 HIV-positive TB cases were recorded in the European Region, with 80% concentrated in the Russian Federation (52%) and Ukraine (28%). Despite high HIV testing rates among TB patients (93%), antiretroviral therapy coverage remains below the WHO universal target.
- Treatment success remains well below targets: the treatment success rate in the European Region remains far below targets. The success rates for incident TB and rifampicin-resistant or multidrug-resistant TB were 74% and 66%, respectively, compared with targets of 90% and 80%. Overall treatment success in the EU/EEA stands at 64% against a WHO target of 90%. Outcomes are substantially worse for rifampicin/multidrug-resistant TB (56%) and pre-extensively drug-resistant TB (52%), with mortality rates of 13% and 11%, respectively.
- Prison populations at acute risk: in the EU/EEA, people in prison face a much greater risk of contracting TB. With a TB notification rate of 121.6 per 100 000 in the prison population, the relative risk is 13 times greater than among the general population. Data reporting on TB in prisons remains poor across the Region.
- Children and geographical inequality: several countries in the European Region report a child TB notification rate of over 10 per 100 000 for those aged 0–4 years, illustrating persistent disparities within the Region.
The report ‘TB Surveillance and Monitoring in Europe 2026’ is a joint publication of the WHO Regional Office for Europe and the European Centre for Disease Prevention and Control (ECDC). Data presented covers the 2024 surveillance year across the 53 countries of the WHO European Region and 30 EU/EEA countries. All TB burden estimates cited are drawn from the WHO Global Tuberculosis Report 2025.
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